Abstract
Acute anxiety impacts cognitive performance. Inhalation of air enriched with carbon dioxide (CO2) in healthy humans provides a novel experimental model of generalised anxiety, but has not previously been used to assess cognition. We used inhalation of 7.5% CO2 to induce acute anxiety and autonomic arousal in healthy volunteers during neuropsychological tasks of cognitive flexibility, emotional processing and spatial working memory in a single-blind, placebo-controlled, randomized, crossover, within-subjects study. In Experiment 1 (n = 44), participants made significantly more extra-dimensional shift errors on the Cambridge Neuropsychological Test Automated Battery (CANTAB) Intra-Extra Dimensional Set Shift task under CO2 inhalation compared with ‘normal’ air. Participants also had slower latencies when responding to positive words and made significantly more omission errors for negative words on the CANTAB Affective Go/No-go task. In Experiment 2 (n = 28), participants made significantly more total errors and had poorer heuristic search strategy on the CANTAB Spatial Working Memory task. In both experiments, CO2 inhalation significantly increased negative affect; state anxiety and fear; symptoms of panic; and systolic blood pressure/heart rate. Overall, CO2 inhalation produced robust anxiogenic effects and impaired fronto-executive functions of cognitive flexibility and working memory. Effects on emotional processing suggested a mood-congruent slowing in processing speed in the absence of a negative attentional bias. State-dependent effects of anxiety on cognitive-emotional interactions in the prefrontal cortex warrant further investigation.
Highlights
Emotion and cognition are closely integrated phenomena, such that emotions influence, and are influenced by, cognitive processes[1,2,3]
We report two experiments investigating the effects of 7.5% CO2 inhalation on cognitive flexibility, emotional processing and spatial working memory in healthy human volunteers
We investigated the effects of experimentally induced acute anxiety and autonomic arousal on core frontoexecutive functions in healthy humans as a model of those underlying generalised anxiety
Summary
Emotion and cognition are closely integrated phenomena, such that emotions influence, and are influenced by, cognitive processes[1,2,3]. Executive functions heavily rely on the frontal lobes and are necessary for optimal selection, organisation and monitoring of actions for attaining goals[4,5,6]. Negative emotional states, such as anxiety, increase arousal and corresponding autonomic responses and can bias cognitive processes in favour. Deficits in executive functions have been found in anxiety disorders[12,13,14]. Acute anxiety impairs cognitive flexibility, the ability to adapt one’s behaviour in response to rapid changes in the environment[15]. Individuals with high-trait anxiety favour recently acquired responses, even when they are no longer relevant[16]. Reduced cognitive flexibility has been proposed to be undermined by interference from irrelevant stimuli, in which anxiety
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