Attention Network Test Research Articles

Associations between ADHD symptoms, executive function and frontal EEG in college students

Introduction This study aims to assess whether electroencephalogram (EEG) spectral power change scores (e.g. task spectral power subtracted from resting state spectral power) across three different frequency bands, alpha (8–12 Hz), theta (4–7 Hz), and beta (13–30 Hz), predicts self-reported attention-deficit hyperactivity disorder (ADHD) symptoms using the Adult ADHD Self-Report Scale (ASRS) over and above self-reported executive function (EF) abilities using the Behavior Rating Inventory of Executive Function (BRIEF-A) Global Executive Composite (GEC) T-scores for adults. Methods Data were collected at a rural, mid-sized southeastern university (N = 52) and participants received course credit for participation. Participants self-reported ADHD symptoms and EF abilities before completing eyes open resting state and the attention network test (ANT), a common flanker task that measures ability to orient attention, stay alert, and resolve conflict (i.e. distractor arrows) while recording EEG spectral power at electrodes F3 and F4. Bivariate correlations determine associations between EEG measures and self-reported ADHD symptoms and EF abilities. Linear regressions were used to assess whether EEG change scores were predictive of ADHD symptoms over and above EF abilities. Results High correlation coefficients were found only when comparing the ASRS and BRIEF-A GEC T-scores (r = .822, p <.001). Regression analyses produced significant results indicating EEG spectral change scores were predictive of ADHD symptoms, over and above GEC T-Scores, for the alpha band but not the theta and beta bands. Additionally, we found an inverse relationship when comparing change scores in the alpha band across the right (F4) and left (F3) hemispheres supporting the theory of frontal asymmetry for individuals with increased ADHD symptoms. Conclusion This study is the first to assess the predictive ability of EEG spectral power change scores in predicting ADHD symptoms, which are not solely explained by deficits in executive control. Past research has indicated significant differences when comparing task and resting state spectral power indicating change scores might have some utility in measuring cognitive load, specifically in the alpha band, which has been associated with inhibition, working memory, and anticipation of stimuli. Further research should be conducted to assess the utility change scores might have in providing an objective measure related to a clinical population with ADHD.

Attentional network deficits in patients with migraine: behavioral and electrophysiological evidence.

Patients with migraine often experience not only headache pain but also cognitive dysfunction, particularly in attention, which is frequently overlooked in both diagnosis and treatment. The influence of these attentional deficits on the pain-related clinical characteristics of migraine remains poorly understood, and clarifying this relationship could improve care strategies. This study included 52 patients with migraine and 34 healthy controls. We employed the Attentional Network Test for Interactions and Vigilance-Executive and Arousal Components paradigm, combined with electroencephalography, to assess attentional deficits in patients with migraine, with an emphasis on phasic alerting, orienting, executive control, executive vigilance, and arousal vigilance. An extreme gradient boosting binary classifier was trained on features showing group differences to distinguish patients with migraine from healthy controls. Moreover, an extreme gradient boosting regression model was developed to predict clinical characteristics of patients with migraine using their attentional deficit features. For general performance, patients with migraine presented a larger inverse efficiency score, a higher prestimulus beta-band power spectral density and a lower gamma-band event-related synchronization at Cz electrode, and stronger high alpha-band activity at the primary visual cortex, compared to healthy controls. Although no behavior differences in three basic attentional networks were found, patients showed magnified N1 amplitude and prolonged latency of P2 for phasic alerting-trials as well as an increased orienting evoked-P1amplitude. For vigilance function, improvements in the hit rate of executive vigilance-trials were exhibited in controls but not in patients. Besides, patients with migraine exhibited longer reaction time as well as larger variability in arousal vigilance-trials than controls. The binary classifier developed by such attentional deficit features achieved an F1 score of 0.762 and an accuracy of 0.779 in distinguishing patients with migraine from healthy controls. Crucially,the predicted value available from the regression model involving attentional deficit features significantly correlated with the real value for the frequency of headache. Patients with migraine demonstrated significant attentional deficits, which can be used to differentiate migraine patients from healthy populations and to predict clinical characteristics. These findings highlight the need to address cognitive dysfunction, particularly attentional deficits, in the clinical management of migraine.

Convergent Validity of Experimental Cognitive Tests in a Large Community Sample.

Experimental cognitive tests are designed to measure particular cognitive domains, although evidence supporting test validity is often limited. The Consortium for Neuropsychiatric Phenomics test battery administered 23 experimental and traditional neuropsychological tests to a large sample of community volunteers (n = 1,059) and patients with psychiatric diagnoses (n = 137), providing a unique opportunity to examine convergent validity with factor analysis. Traditional tests included subtests from the Wechsler and Delis-Kaplan batteries, while experimental tests included the Attention Networks Test, Balloon Analogue Risk Task, Delay Discounting Task, Remember-Know, Reversal Learning Task, Scene Recognition, Spatial and Verbal Capacity and Manipulation Tasks, Stop-Signal Task, and Task Switching. Several experimental cognitive measures were insufficiently related to other tests and were excluded from factor analyses. In the remaining 18 tests, exploratory factor analysis and subsequent multigroup confirmatory factor analysis supported a three-factor structure broadly corresponding to domains of verbal/working memory, inhibitory control, and memory. In sum, several experimental measures of inhibitory control had weak relationships with all other tests, while the convergent validity of most tests of working memory and memory was supported.

Non-classical event-related potentials reveal attention network alteration in patients with temporal lobe epilepsy

ObjectiveTo explore the characteristic changes of multiple ERP components associated with attention impairments in patients with temporal lobe epilepsy (TLE). MethodsA total of 92 patients diagnosed with TLE at Xiangya Hospital during May 2022 and January 2023 and 85 healthy controls were included in this study. Participants were asked to complete attention network test with recording of electroencephalogram. ResultsCompared with healthy controls, significant lower amplitudes (cue-related N1, N2 and CNV) and longer latencies (target-related N2) were found in TLE patients. Besides classical components, other components could also reveal the impairments of attention function. Cue-related N1 (p ≤ 0.007) and N2 (p ≤ 0.01) components indicated impaired alerting and orienting network in TLE. And cue-related CNV-E component (p = 0.003) promoted the alerting network was damaged and target-related N2 component (p = 0.008) indicated the executive control network was impaired. ConclusionThese findings consummate the non-classical ERP features of attention impairments in TLE patients. SignificanceThe above findings have strong clinical guiding significance for early identification and intervention.

The recovery of decreased executive attention in Tibetan migrants at high-altitude.

Attention is one of the basic cognitive functions sensitive to high altitude, and most studies have focussed on exposure times of approximately 3 years; however, it is unclear how attention changes in migrants who have lived and worked at high altitude for nearly 20 years. We explored the dynamics of attentional networks and neurophysiological mechanisms in migrants over 3-20 years using the Attentional Network Test combined with Electrocardiograph and Electroencephalography and found a consistent quadratic correlation between exposure and executive control efficiency, P3 amplitude and heart rate variability (HRV), with a decrease followed by an increase/relative stability, with approximately 10 years being the breakpoint. However, neither linear nor quadratic trajectories were observed for the alerting and orienting network. Mediation analysis revealed that the P3 amplitude mediated the decrease and increase in executive control efficiency with exposure time depends on the breakpoint. Correlations between HRV and executive control efficiency and P3 amplitude suggest that U-shaped changes in executive control in migrants may be related to body homeostasis maintained by the autonomic nervous system, and that P3 amplitude may serve as a neurophysiological marker of migrants' adaptation/recovery from high-altitude exposure.

The Selective Impairments of Total Sleep Deprivation on Alerting, Orienting, and Executive Control: Evidence from Event-Related Potentials.

Many studies have shown that total sleep deprivation (TSD) impairs the attention network, which includes three subcomponents as follows: alerting, orienting, and executive control. However, the specific attention network(s) damaged by TSD remains unclear. Twenty two participants were enrolled to complete the attention network test (ANT) before and after 36 h of TSD with simultaneous electroencephalography recordings. The repeated-measures analysis of variance of the response time (RT) suggested that the interaction effect between sleep conditions (before versus after TSD) and target congruence (incongruent versus congruent target) was significant; that is, the RT of the incongruent target was longer than that of the congruent target, whereas this difference disappeared after TSD. Furthermore, the interaction effect of sustained potential (SP) amplitude between the sleep conditions and target congruence was significant; that is, the incongruent target invoked a less positive sustained potential amplitude after than before TSD; whereas that invoked by the congruent target was not. TSD selectively impairs attention networks. TSD affects the executive control network the most, which is followed by the alerting network rather than the orienting network. This provides a new perspective for understanding how shortened sleep affects attention. No: ChiCTR2400088448. Registered 19 August 2024, https://www.chictr.org.cn.

Dietary patterns related to attention and physiological function in high-altitude migrants.

High altitude exposure negatively affects human attentional function. However, no studies have explored the regulation of attentional and physiological functions from a dietary perspective. A total of 116 Han Chinese students from Tibet University who were born and raised in a plain area and had been living in Tibet for > 2 years were recruited. All participants were male migrants. A food frequency questionnaire, complete blood count, and attention network test were performed on the participants. Pearson's correlation was applied to assess the reliability and validity of the food frequency questionnaire. Principal component analysis was utilized to extract dietary patterns. A linear mixed model was employed to account for individual differences. The results showed that the five main dietary patterns were coarse grain, alcohol, meat, protein, and snacking dietary patterns. Furthermore, individuals who adhered to the coarse grain dietary pattern and had high mean corpuscular hemoglobin showed better attentional performance. Individuals with high alcohol consumption and systemic immune-inflammation index levels exhibited worse attentional performance. These findings imply that high-altitude migrants should include more coarse grains in their daily diet and avoid excessive alcohol consumption to improve attention.

Is dialect proficiency associated with improved executive function?

Abstract A broad and extensive literature has investigated the cognitive consequences of bilingualism on cognitive control. Results from these studies, while controversial, support the conclusion that speaking a second language confers non-linguistic benefits. Whether other related linguistic experiences, such as dialect use, confer similar benefits remains an underexplored and open question. The common use of a diverse range of local dialects across China provides ideal conditions under which to explore this question. Using a dialectally heterogeneous sample of Mandarin-English bilingual young adults (n = 74), the present study investigated whether differences in dialect proficiency impacted on inhibition and attentional control while accounting for variation in language experience. Dialect proficiency was not associated with improved performance on the Simon task, Attention Network Test, or Flanker task, suggesting no benefits in inhibition or attentional control. Considerations for future studies investigating the influence of Chinese dialect experience on cognitive control are discussed.

Neuropsychological impact of Sanda training on athlete attention performance.

Sanda, a martial art that primarily involves punching, kicking, and throwing techniques, requires athletes to maintain high levels of concentration during combat. Sanda principally involves striking the opponent to secure victory, with trauma frequently occurring to the head; however, it remains unclear whether prolonged training enhances or impairs the athletes' attentional capacities. This study aimed to investigate the impact of Sanda training on athletes' attention by employing attention network tests. A retrospective analysis was conducted on 37 professional Sanda athletes from a certain sports academy; 38 college students from the same institution majoring in physical education were recruited as the control group. Control participants had no prior experience in Sanda training, and the Sanda and control groups were matched in terms of sex, age, and education level. The Attention Network Test (ANT) was administered to both groups to compare differences in efficiency across the alerting, orienting, and executive control networks. Compared to the control group, the Sanda athletes exhibited significantly higher executive control network efficiency values and executive control network efficiency ratios (P < 0.05). There were no significant differences between the Sanda group and the control group regarding the efficiency values of the alerting and orienting networks (P > 0.05). Additionally, total accuracy and total reaction time between the Sanda athletes and control participants showed no statistically significant differences (P > 0.05). Sanda practice has detrimental effects on attention, including a decrease in the efficiency of the executive control network and a prolongation of the total reaction time. Therefore, athletes should improve attention training and use head protection to prevent frequent head impacts during training.

Original article: adolescent dietary patterns derived using principal component analysis and neuropsychological functions: a cross-sectional analysis of Walnuts Smart Snack cohort.

A balanced diet is relevant for neuropsychological functioning. We aimed to analyze the association between dietary patterns and neuropsychological outcomes in a sample of healthy adolescents of the Walnuts Smart Snack (WSS) cohort from Barcelona city.We performed principal components analysis (PCA) to determine dietary patterns in the adolescent sample using a food frequency questionnaire (60 items). Multiple linear regression models were performed to analyze the association between PCA dietary patterns with neuropsychological outcomes: Strengths and Difficulties (SDQ) externalizing and internalizing scores, Attention Network Test (ANT) Impulsivity Index and Emotional Recognition Task (ERT) scores. We additionally adjusted the models for child sex, age, body mass index (BMI), physical activity and maternal education.Six dietary patterns were identified in PCA analyses. "low consumption of calorie-dense foods" dietary pattern had a negative association (protective) with the both SDQ outcomes (p value < 0.001) and "Nuts" dietary pattern showed a negative (protective) association with impulsivity index = -24.60, 95% CI = -36.80, -12.41, p value < 0.001).Overall, our main results suggest that healthy dietary patterns, including higher intakes of "nuts" and a preference of "low consumption of calorie-dense foods" dietary patterns, could provide a beneficial association with neuropsychological functions during the adolescence period. The associations may include improvements of externalizing and internalizing problem symptoms, and impulsivity.

Nurturing attention through nature

BackgroundPrevious research suggests an association between exposure to nature and improved attention. However, no observational studies explored the underlying mechanisms or considered bluespace, and none used Polish data. We investigated the association between exposure to nature and attention, and whether it was mediated by nature perception, physical activity and sleep duration. MethodsData derived from the case-control NeuroSmog study comprised 195 participants with attention deficit hyperactivity disorder (ADHD) and 457 participants without ADHD, all aged 10 to 13. Attention was evaluated using the computerized attention network test and the continuous performance test. Lifelong and current exposure to nature, determined by percentage of grass and tree cover and water presence within 500m buffer around residences, as well as domestic garden, were examined through linear, log-linear and negative binomial regressions. Potential pathways were explored using structural equation modelling. ResultsParticipants with ADHD with higher exposure to tree cover tended to have improved orienting ability, shorter reaction time and fewer correct rejections, while participants without ADHD tended to show decreased alertness and improved orienting ability. Participants with ADHD with higher exposure to grass cover tended to have longer reaction time, decreased alertness, improved orienting ability, reduced target discrimination ability, fewer correct rejections and less risky response style, while participants without ADHD tended to show decreased orienting ability, more mistakes, longer reaction time, better hit rate and more risky response style. Participants without ADHD with water in their neighbourhood tended to have improved orienting ability, fewer mistakes and better hit rate. Participants without ADHD with a garden tended to show improved target discrimination ability, better hit rate and more risky response style. No mediating pathways were revealed. ConclusionTree cover and presence of garden and water tended to be associated with improved attention in Polish adolescents while grass tended to have negative impact.

Identifying attention-deficit/hyperactivity disorder through the electroencephalogram complexity

There are reasons to suggest that a number of mental disorders may be related to alteration in the neural complexity (NC). Thus, quantitative analysis of NC could be helpful in classifying mental and understanding conditions. Here, focusing on a methodological procedure, we have worked with young individuals, typical and with attention-deficit/hyperactivity disorder (ADHD) whose NC was assessed using q-statistics applied to the electroencephalogram (EEG). The EEG was recorded while subjects performed the visual Attention Network Test (ANT) and during a short pretask period of resting state. Time intervals of the EEG amplitudes that passed a threshold were collected from task and pretask signals from each subject. The data were satisfactorily fitted with a stretched q-exponential including a power-law prefactor(characterized by the exponent c), thus determining the best (c,q) for each subject, indicative of their individual complexity. We found larger values of q and c in ADHD subjects as compared with the typical subjects both at task and pretask periods, the task values for both groups being larger than at rest. The c parameter was highly specific in relation to DSM diagnosis for inattention, where well-defined clusters were observed. The parameter values were organized in four well-defined clusters in (c,q)-space. As expected, the tasks apparently induced greater complexity in neural functional states with likely greater amount of internal information processing. The results suggest that complexity is higher in ADHD subjects than in typical pairs. The distribution of values in the (c,q)-space derived from q-statistics seems to be a promising biomarker for ADHD diagnosis.

Effects of Breast Cancer Treatment on Neural Noise: a Longitudinal Design.

Cognitive dysfunction has been observed consistently in a subset of breast cancer survivors. Yet the precise neurophysiological origins of cancer-related cognitive decline remain unknown. The current study assessed neural noise (1/f activity in electroencephalogram [EEG]) in breast cancer survivors as a potential contributor to observed cognitive dysfunction from pre- to post-treatment. We measured EEG in a longitudinal design during performance of the paired-click task and the revised Attention Network Test (ANT-R) to investigate pre- versus post-treatment effects of neural noise in breast cancer patients (n = 20 in paired click; n = 19 in ANT-R) compared with healthy controls (n = 32 in paired click; n = 29 in ANT-R). In both paradigms, one sensory (paired click) and one cognitive (ANT-R), we found that neural noise was significantly elevated after treatment in patients, remaining constant from pretest to posttest in controls. In the ANT-R, patients responded more slowly than controls on invalid cuing trials. Increased neural noise was associated with poorer alerting and poorer inhibitory control of attention (as measured by behavioral network scores), particularly for patients after treatment. The current study is the first to show a deleterious effect of breast cancer and/or cancer treatment on neural noise, pointing to alterations in the relative balance of excitatory and inhibitory synaptic inputs, while also suggesting promising approaches for cognitive rehabilitation.

Mindful Awareness Related to Working Memory Capacity and Response Inhibition

Objectives: This study investigated the associations among trait mindfulness, working memory capacity (WMC), and response inhibition. Mindfulness and WMC are thought to involve goal maintenance while resolving competing responses (inhibition), and studies have indeed found associations among mindfulness, WMC, and response inhibition. However, previous studies focused primarily on behavioral inhibition and many failed to differentiate components of mindfulness (awareness and acceptance). This study examined how self-reported mindfulness (awareness and acceptance) related to performance on tasks of WMC and multiple types of response inhibition (i.e., behavioral inhibition, interference control, and cognitive inhibition). Methods: Sixty-seven undergraduate students (75% female) received extra credit for participation. Measures included the Philadelphia Mindfulness Scale (measuring awareness and acceptance), Hayling Task (cognitive inhibition), go/nogo task (behavioral inhibition), Attention Network Test (interference control), n-back task (WMC), and Automated Reading Span Task (WMC). Results: Higher self-reported awareness was related to stronger performance on two measures of WMC (r =.29; r =.32) and multiple measures of response inhibition, including behavioral inhibition (r = -.25), interference control (r = -.25), and cognitive inhibition (r = -.28); response inhibition and WMC accounted for 22% and 16% of the variance in awareness respectively. No relations were found between self-reported acceptance and cognitive performance. Conclusions: Overall, this study found that the Mindfulness component of higher awareness (but not the component of acceptance) was related to stronger WMC and response inhibition. Because Mindfulness, WMC, and response inhibition are related in unique ways to healthy functioning and wellbeing; learning about how they interact increases scientific understanding, and suggests a direction for potential interventions to target these areas.

Overt and Covert Effects of Mental Fatigue on Attention Networks: Evidence from Event-Related Potentials during the Attention Network Test.

Mental fatigue is a variation in the psychophysiological state that subjects encounter during or after prolonged cognitive activity periods, affecting top-down attention and cognitive control. The present study aimed to investigate the effects of mental fatigue on attention in the context of the three attention networks according to the Posnerian model (alerting, orienting, and executive networks) by combining the Attentional Network Test (ANT) and event-related potentials technique. Thirty healthy subjects were enrolled in the study. A continuous arithmetic task lasting one hour induced mental fatigue, and EEG recordings were conducted before and after the task while subjects were performing the ANT. The efficiencies of three networks were comparable between groups, while RTs shortened only in the control group and the accuracy related to the alerting and conflict networks declined only after mental effort. Mental fatigue reduced N1 amplitude during alerting network engagement and p3 amplitude during orienting. It also reduced N2 and P3 amplitude during the conflict, particularly the incongruent target-locked response. These findings underscore the covert effects of mental fatigue on attention, suggesting that even in healthy young subjects, compensatory mechanisms may maintain adequate overt performances, but fatigue still has a detrimental effect on top-down attentional mechanisms.

Selective attention function impairment in HIV-negative patients with early forms of neurosyphilis

BackgroundThe attentional network test (ANT) is widely used to evaluate the performance of three attentional networks: alerting, orienting and executive attention networks. This study aimed to investigate the characteristics of attention functions in HIV-negative patients with early forms of neurosyphilis (NS) and their correlation with abnormalities in brain magnetic resonance imaging (MRI).MethodsThirty patients with early forms of NS, 31 patients with syphilis but without NS (Non-NS) and 35 healthy controls were recruited from an HIV-negative cohort between September 2020 and November 2022. The participants were evaluated with the ANT and the Mini-Mental State Examination (MMSE). Brain MRI was performed in NS and Non-NS patients.ResultsNo significant differences were observed in the MMSE scores among the three groups. However, patients with early forms of NS showed poorer performance in orienting and alerting functions than Non-NS group (F = 6.952, P = 0.011 and F = 8.794, P = 0.004, respectively); No significant difference was observed in executive function between the two groups (F = 0.001, P = 0.980). Multivariate analysis of variance using the Bonferroni post hoc test indicated that patients with NS exhibited less efficient orienting function (P = 0.023), and alerting function (P = 0.003) but not executive function (P = 0.99), compared to Non-NS patients. Additionally, a significant difference was found in orienting function between patients with NS and healthy controls (P < 0.001) compared to healthy controls. MRI scans revealed that the NS group had a higher prevalence of abnormalities in the frontal lobes and/or the temporoparietal junction compared to the Non-NS group (24/25 vs. 13/19, P = 0.032).ConclusionsThe orienting and alerting functions but not executive function were significantly less efficient in early forms of NS group than in the Non-NS group (P < 0.01). This indicates deficits in selective attention in patients with early forms of NS. Brain MRI scans revealed abnormalities in the frontal and/or parietal lobes, as well as the temporoparietal junction, suggesting potential neuropathological correlates of these attentional deficits.

Acute cognitively challenging exercise as “cognitive booster” for children: Positive feedback matters!

Background and aimAcute exercise can enhance children's cognition. Heterogeneous effect sizes necessitate investigating exercise task characteristics, contextual factors, and related affective states. The study aimed to test whether different feedback forms during acute cognitively challenging exercise affect children's executive control, alerting, and orienting performances, also considering the potential mediational role of affective states. MethodsIn a within–subjects posttest only design, 100 children (Mage = 11.0, SDage = 0.8, 48% female) participated weekly in one of three exergames with different feedback: no feedback (NO-FB), standard acoustic environment (ST-FB), positive feedback (PO-FB). Acute bouts were designed to keep physical intensity (65% HRmax) and duration (15-min) constant and to have a high cognitive challenge. Valence, arousal, perceived physical exertion, cognitive engagement, and flow were assessed before, during and after exergaming. Each bout was followed by an Attention Network Test. ResultsANOVAs revealed a significant main effect of feedback on executive control (η2p = 0.09) with faster reaction times after PO-FB compared to the other conditions (η2ps > 0.06) and on valence at post–test (η2p = 0.11) with highest values in PO-FB (η2ps > 0.08). In PO-FB, valence was associated with executive control (r = −0.23) but did not mediate feedback effects on executive control (95% CI [–5.25, 4.68]). Alerting and orienting performances were unaffected by feedback (η2ps < 0.08). ConclusionResults suggest that positive feedback during acute cognitively challenging exergaming enhances children's executive control and positive affect, highlighting that exercise task characteristics and contextual factors are essential for cognitive benefits.

Cognitive tasks, anatomical MRI, and functional MRI data evaluating the construct of self-regulation

We describe the following shared data from N = 103 healthy adults who completed a broad set of cognitive tasks, surveys, and neuroimaging measurements to examine the construct of self-regulation. The neuroimaging acquisition involved task-based fMRI, resting state fMRI, and structural MRI. Each subject completed the following ten tasks in the scanner across two 90-minute scanning sessions: attention network test (ANT), cued task switching, Columbia card task, dot pattern expectancy (DPX), delay discounting, simple and motor selective stop signal, Stroop, a towers task, and a set of survey questions. The dataset is shared openly through the OpenNeuro project, and the dataset is formatted according to the Brain Imaging Data Structure (BIDS) standard.

Benefits of Early Hyperbaric Oxygen Therapy on Attention Networks in Patients with Subarachnoid Hemorrhage

In despite of an effective treatment for aneurysmal subarachnoid hemorrhage (aSAH), delayed cerebral ischemia (DCI) is also a common complication, and it will have significant impacts on the recovery of neurological functions. In this study, we aim to investigate the efficacy of hyperbaric oxygen therapy (HBOT) in the rehabilitation treatment of aSAH. In this study, a total of 98 patients with aSAH and 25 healthy individuals were recruited. Among the patients, 51 individuals received the application of HBOT after the effective treatment of aSAH, while other 47 individuals just received physical rehabilitation. Modified Rankin scale (mRS) and mini-mental state examination (MMSE) scales at 7 days after aSAH were applied for all patients to determine the baselines of neurological deficits and cognitive functions. Attention network test (ANT) was performed at the 6th month. The results indicated that the patients receiving HBOT had a lower incidence of DCI (p=0.026) and a better improvement of executive control function (p<0.001) of ANT, in comparison with those without HBOT. However, there were no differences of orienting, alerting, mean reaction time and accuracy between the two groups. In summary, early hyperbaric oxygen therapy reduced the DCI rate in aSAH patients and consequently promote the improvement of the executive control function of ANT.

Effects of Shugan Tiaoshen intradermal needling intervention on attentional networks in subthreshold depression: a randomized controlled trial

To analyze the effects of Shugan Tiaoshen (regulating liver and harmonizing spirit) intradermal needling protocol on the attentional networks of patients with subthreshold depression using the attention network test (ANT). Eighty patients with subthreshold depression were randomly divided into an intradermal needling group (40 cases) and a sham needling group (40 cases, 2 cases dropped out), with an additional 43 healthy subjects as a normal group. The intradermal needling group received intradermal needling treatment, while the sham needling group received sham intradermal needling, with the needle tip not penetrating the skin. The bilateral Xinshu (BL 15), Ganshu (BL 18), Shentang (BL 44) as well as auricular points Xin (CO15) and Gan (CO12) were selected alternately. Treatments were administered twice a week for a total of 6 weeks in the two groups. The patient health questionnaire-9 (PHQ-9) and generalized anxiety disorder (GAD-7) scores were observed before treatment, after 3 weeks of treatment, after treatment, and at 1 month after the end of treatment (follow-up), and the ANT of the two groups of patients with subthreshold depression before and after treatment as well as the normal group of healthy subjects was compared. The PHQ-9 and GAD-7 scores of the patients with subthreshold depression were decreased after 3 weeks of treatment, after treatment, and in follow-up in the two groups (P<0.05), the differences in PHQ-9 and GAD-7 scores before and after treatment were greater in the intradermal needling group than those in the sham needling group (P<0.01). Before treatment, the executive control network reaction time of the subthreshold depression group (the intradermal needling group and the sham needling group) was higher than that of the normal group (P<0.05). Compared before treatment, the executive control network reaction time of the patients in the intradermal needling group and the sham needling group was decreased after treatment (P<0.05), and the alerting network reaction time of the intradermal needling group was increased after treatment (P<0.05); the difference in alerting network reaction time before and after treatment was greater in the intradermal needling group than that of the sham needling group (P<0.01). Regulating liver and harmonizing spirit intradermal needling protocol could effectively improve depressive and anxious symptoms in patients with subthreshold depression, and enhance the efficiency of the alerting network.