Continuous Performance Test Research Articles

The Structure and Diagnostic Accuracy of the QbTest in Pediatric ADHD: A Retrospective Clinical Study

Objective: The QbTest that combines a continuous performance task (CPT) with a motion-tracking system may help identify attention deficit hyperactivity disorder (ADHD). This study examined the structure and diagnostic ability of the QbTest in children and adolescents. Method: Retrospective data from 1,274 children and adolescents were analyzed. The study assessed data on a principal component analysis (PCA), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Results: The QbActivity component included the variables micro-events, distance, area, and time active; the QbImpulsivity included normalized commissions and commissions (anticipatory errors were added in a version for 6–12-year-olds only); and the QbInattention included omissions, reaction time, and reaction time variation. Sensitivity ranged between 22% and 50%, specificity 79% and 96%, PPVs 40% and 95%, and NPVs 24% and 66%. Conclusion: The structure of the QbTest with three cardinal parameters and nine/ten CPT and motion analysis variables was supported. The diagnostic accuracy was found to be poor to moderate. Given that this is a retrospective study, the interpretation of diagnostic accuracy should be considered within this context.

Seeing in my way or your way: impact of intelligence, attention, and empathy on brain reactivity.

Previous studies showed that neurotypical adults are able to engage in unconscious analyses of others' mental states in the context of automatic perspective taking and experience systematic difficulties when judging the conflicts between their own (Self) and another's (Other) perspective. Several functional MRI (fMRI) studies reported widespread activation of mentalizing, salience, and executive networks when adopting the Other compared to Self perspective. This study aims to explore whether cognitive and emotional parameters impact on brain reactivity in dot perspective task (dPT). We provide here an fMRI analysis based on individual z-scores in eighty-two healthy adults who underwent the Samson's dPT after detailed assessment of fluid intelligence, attention, levels of alexithymia and social cognition abilities. Univariate regression models were used to explore the association between brain activation patterns and psychological variables. There was a strong positive association between Wechsler Adult Intelligence Scale (WAIS) and fMRI z-scores in Self perspective. When the Other perspective is taken, Continuous Performance Test (CPT)-II parameters were negatively associated with fMRI z-scores. Individuals with higher Toronto Alexithymia scale (TAS) score and lower scores in mini-Social cognition and Emotional Assessment (SEA) displayed significantly higher egocentric interference-related fMRI z-scores. Our data demonstrate that brain activation when focusing on our own perspective depends on the levels of fluid intelligence. Decreased attentional recruitment and decreased inhibitory control affects the brain efforts to adopt the Other perspective. Egocentric interference-associated brain fMRI activation was less marked in cases with better empathy abilities but the opposite was true for persons who experience increased difficulties in the recognition of emotions.

Influence of game features on attention in adults.

The incorporation of game features into cognitive tasks can inform us about the influence of reward and motivation on attention. Continuous performance tasks (CPTs), designed to assess attention abilities, are examples of cognitive tasks that have been targeted for the addition of game features. However, previous results have been mixed regarding how game elements affect attention abilities and task performance. Here, we studied if there were factors that predict which individuals exhibit changes in attention from game features added to a CPT. Participants (N = 94, aged 21-71) played a traditional CPT and a game CPT with identical mechanics, but featured engaging game elements (aesthetics, storyline, competition, feedback, and reward). We first found corroborating evidence that game features have mixed effects on attention performance: most attention metrics of interest exhibited no overall difference between the traditional and game CPT, while game elements reduced performance for a few metrics. Importantly, we also found that specific behavioral and demographic profiles predicted individual differences in performance on the game CPT compared to the traditional CPT. Those with more attention difficulties (ADHD symptoms), more reward responsiveness, and younger adults performed better on the game CPT while, conversely, those with fewer ADHD symptoms, less reward responsiveness, and older adults performed better on the traditional CPT. These findings provide insights into how game features can influence attention in different individuals and have important implications for the use of game elements in cognitive tasks and training interventions.

Effect of metabolic control on cognitive functions in children and adolescents with type 1 diabetes mellitus.

Neurocognitive functions of children with type 1 diabetes mellitus (T1D) are reported to be poorer than those of healthy peers. The aim was to investigate the effects of age of onset of diabetes, metabolic control, and type of insulin regimen on neurocognitive functions in children and adolescents with T1D. Forty-seven children aged 6-18 years, with T1D for at least five years, were included. Children with a known psychiatric disorder or chronic diseases other than T1D were excluded. Intelligence via the Wechsler children's intelligence scale (WISC-R), short-term memory via the audio-auditory digits form B (GISD-B) test, visual motor perception via the Bender Gestalt test, and attention via the Moxo continuous attention and performance test, timing, hyperactivity, and impulsivity (Moxo-dCPT) were assessed. Compared with the T1D group, healthy controls had higher scores in terms of verbal intelligence quotient (IQ), performance IQ, and total IQ mean scores on WISC-R (p=0.01, p=0.05 and p=0.01, respectively). On the MOXO-dCPT test, the T1D group had higher impulsivity compared to the control group (p=0.04). Verbal IQ was better in the moderate control group than in the poorer metabolic control (p=0.01). Patients with no history of diabetic ketoacidosis (DKA) had higher performance, verbal and total intelligence scores than the group with history of DKA. Poor metabolic control and a history of DKA in children with T1D adversely affected neurocognitive functions. It would be beneficial to consider the assessment of neurocognitive functions in T1D and to take the necessary precautions in follow-up.

Features of Cognitive Ability and Central Auditory Processing of Preschool Children With Minimal and Mild Hearing Loss.

This study aimed to investigate the current status of cognitive development and central auditory processing development of preschool children with minimal and mild hearing loss (MMHL) in Nanjing, China. We recruited 34 children with MMHL and 45 children with normal hearing (NH). They completed a series of tests, including cognitive tests (i.e., Wechsler Preschool and Primary Scale of Intelligence and Continuous Performance Test), behavioral auditory tests (speech-in-noise [SIN] test and frequency pattern test), and objective electrophysiological audiometry (speech-evoked auditory brainstem response and cortical auditory evoked potential). In addition, teacher evaluations and demographic information and questionnaires completed by parents were collected. Regarding cognitive ability, statistical differences in the verbal comprehensive index, full-scale intelligence quotient, and abnormal rate of attention test score were found between the MMHL group and the NH group. The children with MMHL performed poorer on the SIN test than the children with NH. As for the auditory electrophysiology of the two groups, the latency and amplitude of some waves of the speech-evoked auditory brainstem response and cortical auditory evoked potential were statistically different between the two groups. We attempted to explore the relationship between some key indicators of auditory processing and some key indicators of cognitive development. Children with MMHL are already at increased developmental risk as early as preschool. They are more likely to have problems with attention and verbal comprehension than children with NH. This condition is not compensated with increasing age during the preschool years. The results suggest a possible relationship between the risk of cognitive deficit and divergence of auditory processing. https://doi.org/10.23641/asha.22670473.

Mindfulness for voices: An experimental analogue study of the effect of manipulating response style to simulated voices in a non-clinical population.

We aimed to investigate the effects of directly manipulating response style to simulated voice hearing on emotional and cognitive outcomes in a non-clinical population. A between-subjects design with one independent variable, response style (with two levels: mindful acceptance vs attentional avoidance). The dependent variables were subjective distress and anxiety (primary outcomes) and performance on a sustained attention task (secondary outcomes). Participants were randomly assigned to one of two response styles (mindful acceptance vs. attentional avoidance). They completed a computerised attention task (continuous performance task) whilst listening to a simulation of voice hearing. Participants rated their experience of anxiety and distress before and after completing the sustained attention task which was used to measure their accuracy and response times. One hundred and one participants took part (mindful acceptance (n = 54); attentional avoidance (n = 47)). There were no statistically significant group differences on post-test distress and anxiety scores, correct response rate or response times on the computerised attention task. Participants reported a range of different response styles along the spectrum of avoidance to acceptance, but this had no association with their assigned experimental condition. Adherence to task instructions was therefore low. We are unable to conclude from this study whether experimentally inducing people to respond to voices under cognitively demanding conditions in an avoidant or accepting way has an impact on their emotional or cognitive outcomes. Further research should focus on the development of more robust and reliable procedures for inducing differences in response style under experimental conditions.

Experimental Improvement of Attention/Cognitive Speed Does Not Improve Memory in Multiple Sclerosis (P13-3.001)

<h3>Objective:</h3> To investigate whether atomoxetine (FDA-approved to improve attention) versus placebo improves memory in persons with MS. <h3>Background:</h3> Correlational studies link memory performance with attention and cognitive speed in persons with MS, which has led to the belief that inattention or slowed cognitive speed underlie MS memory deficits. This assumption has shaped memory rehabilitation approaches, which have been ineffective. Herein we used data from a pilot cross-over trial of atomoxetine in persons with MS to examine whether experimentally improving attention and cognitive speed improves memory. <h3>Design/Methods:</h3> Ten persons with MS with objective memory impairment (mean[sd] normative z: −1.86[0.55]) completed a double-blind randomized controlled crossover trial of atomoxetine (80mg daily) versus placebo for 14 weeks (two counterbalanced six-week phases separated by two-week washout). Primary memory outcome (MEMORY) was a composite of the Selective Reminding Test and Brief Visuospatial Memory Test, Revised. Patients also completed CANTAB Rapid Visual Information Processing (RVP) assessing sustained attention and cognitive speed during a six-minute continuous performance task requiring persons to monitor single-digit numbers rapidly presented onscreen to identify target three-digit sequences (e.g., 3-5-7). Paired two-tailed t-tests compared outcomes (norm-referenced z-scores) between placebo and drug after adjusting for counterbalanced order. <h3>Results:</h3> Improvement on RVP (attention/cognitive speed) from baseline was better on atomoxetine (mean[sd] z change: +0.57[0.48]) than placebo (+0.25[0.29]; t[9]=3.96, p=0.003, d=0.72). In contrast, change from baseline on MEMORY did not differ between atomoxetine (+0.32[0.76]) and placebo (+0.24[0.70]; t[9]=0.40, p=0.700, d=0.10). <h3>Conclusions:</h3> Experimental improvement of attention/cognitive speed with atomoxetine did not improve memory in persons with MS, which refutes correlational evidence linking these functions. We lack validated memory rehabilitation approaches, perhaps in part because attention/cognitive speed have been treatment targets. Renewed investigation of underlying mechanisms of MS memory impairment is necessary to develop strategies for memory rehabilitation. <b>Disclosure:</b> Ms. Dvorak has nothing to disclose. The institution of Dr. Katz Sand has received research support from National Multiple Sclerosis Society. The institution of Dr. Katz Sand has received research support from US Department of Defense. The institution of Dr. Katz Sand has received research support from Biogen. Dr. Katz Sand has received personal compensation in the range of $500-$4,999 for serving as a Grant reviewer with US Department of Defense. Mr. Sumowski has nothing to disclose.

Effects of Videogaming on Attention and Conduct in Adolescents with Tourette’s Syndrome (P12-11.010)

<h3>Objective:</h3> To assess the association between time spent playing videogames on attention and behavior in adolescents with Tourette’s Syndrome (TS). <h3>Background:</h3> As adolescents spend more time playing videogames, the effects of gaming on cognitive and behavioral function remain heavily debated. There is literature emphasizing the negative effects of gaming on conduct, but there is also literature showing improvement in attention skills. This may be dependent on the amount of time spent on gaming. The effects of videogaming on attention and conduct in adolescents with TS have not been investigated yet. <h3>Design/Methods:</h3> Patients with TS, age 12–19, seen at the Rush Movement Disorders Clinic were invited to participate in the study. They completed questionnaires including demographics and number of hours spent playing video games per day (0–1, 1–3, more than 3 hours). The primary outcome measures included the Continuous Performance Test, 3rd Edition (CPT-3) and the Behavioral Assessment System for Children, 3rd Edition (BASC). Other assessments included the Yale Global Total Tic Severity Scale (YGTTSS), Yale-Brown Obsessive Compulsive Scale (YBOCS), and Revised Children’s Manifest Anxiety Scale (RCMAS). Demographics were summarized with descriptive statistics. CPT-3 (detectability, omissions, commissions, hit reaction, variability) and BASC (externalizing, internalizing, behavioral problems) T-scores were compared between groups of time spent gaming using the ANOVA model. <h3>Results:</h3> 19 subjects were included in the study, 11 male, mean age 14.8 (SD 1.9), mean YGTTSS 53.4 (SD 14.2), median YBOCS 8 (range 0–42), and median RCMAS 14 (range 4–38). 47.4% of subjects carried the diagnosis of ADHD, 5.3% learning disorder, 36.8% obsessive compulsive disorder, 26.3% depression, and 68.4% anxiety. There was no significant association between time spent playing video games and CPT-3 or BASC. <h3>Conclusions:</h3> In this cohort, time spent videogaming did not affect attention or behavior in TS patients. We will continue to recruit patients to adequately characterize this in a larger cohort. <b>Disclosure:</b> Mr. Colgan has nothing to disclose. Bichum Ouyang has nothing to disclose. Dr. Gera has nothing to disclose. Dr. Kompoliti has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Kompoliti has received personal compensation in the range of $0-$499 for serving as a Consultant for Sunovion. Dr. Kompoliti has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Acadia. Dr. Kompoliti has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Scion. Dr. Kompoliti has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Abbvie. The institution of Dr. Kompoliti has received research support from Emalex. The institution of Dr. Kompoliti has received research support from Aeon. The institution of Dr. Kompoliti has received research support from Sun Pharma. The institution of Dr. Kompoliti has received research support from Revance. The institution of Dr. Kompoliti has received research support from Restore. The institution of Dr. Kompoliti has received research support from Theravance.

The association between Attention-Deficit-Hyperactivity-Disorder (ADHD) symptoms and disease severity in people with Cystic Fibrosis (pwCF)

BackgroundThe hallmarks of Cystic fibrosis (CF), chronic infection and inflammation, require intensive daily treatment to maintain and improve quality of life and outcome. The incidence of Attention Deficit/Hyperactivity Disorder (ADHD) is increased in chronic inflammatory diseases. Previous studies suggested that the prevalence of ADHD in people with CF (pwCF) is higher than in the general population. The objective of this study was to evaluate the association between ADHD symptoms and parameters of CF disease severity, measured by demographic and clinical data. MethodsBased on our previous study, the results of ADHD questionnaires and the MOXOCPT (continuous performance task) from 143 pwCF (7–68 years old) were analyzed and linked to patient data such as forced expiratory volume in 1 second (FEV1)%predicted, body mass index (BMI), number of pulmonary exacerbations, days of antibiotic (Abx) treatment and serum inflammatory markers. ResultsA positive correlation between FEV1 and ADHD questionnaire's score (p = 0.046) was observed in the children's group. Furthermore, BMI, white blood cells (WBC) count, and days of Abx treatment showed a positive correlation with some of the MOXOCPT parameters. ConclusionThere is an association between ADHD symptoms and some parameters of CF disease severity. These results highlight the need for an early diagnosis of ADHD in pwCF, which have the potential to improve their ability to deal with the burden of their disease and consequently their quality of life. Additional research is needed to understand the full spectrum of ADHD pathophysiology and the relationship with chronic inflammatory diseases such as CF.

Assessing Adult ADHD Through Objective Neuropsychological Measures: A Critical Overview

Objective: This review examines the role of neuropsychological tests in the diagnostic assessment of adult ADHD, focusing on their ability to discriminate individuals with ADHD from those with other psychiatric conditions. Method: PubMed, Embase, and PsycINFO were searched for eligible peer-reviewed studies from inception to September 2022. Results: Ten studies were included. Among the objective measures analyzed, Continuous Performance Tests were the only capable to reliably distinguish individuals with ADHD from other psychiatric patients, in a combined approach with clinical interview instruments. The other objective tests showed mixed and inconsistent results. Conclusion: This finding suggest that further studies are needed to develop objective measures more tailored to the core symptoms of ADHD, in order to improve the discriminatory ability of the tests and help the clinicians in the complex differential diagnosis between ADHD and other psychiatric disorders.

Outcomes of a Cognitive Management Program (CMP) for an Individual with Mild Neurocognitive Disorder at Risk of Developing Alzheimer

Individuals with mild neurocognitive disorder (mild-NCD) may suffer from one or a range of mild neurocognitive dysfunctions that disturb their daily life routines. This study tested the outcomes of an author-compiled cognitive management program (CMP) on a patient at the risk of developing Alzheimer. The CMP comprised a careful diagnostic procedure, a multi-dimensional cognitive assessment of the participant's cognitive functioning, and a series of cognitive rehabilitation procedures. A 59-year old woman (diagnosed based on DSM-5 and Addenbrooke’s Cognitive Examination-Revised (ACE-R)) was included in the study. The participant's cognitive rehabilitation program consisted of a face-to-face training for twelve sessions and a daily homework-based training (35 days). The participant was tested at the baseline, at the end of the rehabilitation procedure, and 6- and 12-month follow-ups. To measure memory, attention, executive function, language, and reasoning abilities the following tests were administered: (a) Forward and Backward Digit Span Test; (b) Rey Complex Figure Test; (c) Continuous Performance Test; (d) Color-Word Interference; (e) Verbal Fluency; (f) Trial Making Test; (g) Symbol Digit Modality Test; and (h) The Twenty Questions Test and the Word Context Test. The Mean Percentage Improvement (MPI) index suggested improvements in the participant's scores for ACE-R subscales, memory, attention, language, executive functions, and reasoning and persistent improvements in the Word Context Test (55% at post-test and 63% at follow-up) and Rey Complex Figure Test (33% at the post-test and 47% at the follow-up). The results suggest that the CMP could improve the overall cognitive functioning of the participant.

Psychometric properties of a combined go/no-go and continuous performance task across childhood.

Despite the critical importance of attention for children's self-regulation and mental health, there are few task-based measures of this construct appropriate for use across a wide childhood age range including very young children. Three versions of a combined go/no-go and continuous performance task (GNG/CPT) were created with varying length and timing parameters to maximize their appropriateness for age groups spanning early to middle childhood. As part of the baseline assessment of a clinical trial, 452 children aged 3-12 years (50% male, 50% female; 52% White, non-Hispanic, 27% Black, 16% Hispanic/Latinx; 6% other ethnicity/race) completed the task. Confirmatory factor analysis indicated that all task versions assessed two latent factors, labeled response inhibition and sustained attention. Versions for older children elicited lower overall accuracy while equating levels of inhibitory demand. All versions showed limited floor and ceiling effects, as well as developmental sensitivity. Boys showed higher commission error rates and children from lower income households showed lower performance across multiple task metrics. Task metrics, especially d prime and accuracy summary scores, correlated with parent-reported executive function and externalizing behavior. Task scores show promise as valid and sensitive indicators of inhibition and sustained attention across heterogeneous pediatric age groups. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Sex differences in medication-naïve adults with attention-deficit/hyperactivity disorder: A counting Stroop functional MRI study

Emerging evidence supports deficits in executive functions in the fronto-striato-parietal network in individuals with attention-deficit/hyperactivity disorder (ADHD). However, most functional studies recruited men with ADHD only, leaving it unclear whether executive deficits are also demonstrated in women with ADHD. Thus, we used functional magnetic resonance imaging to examine the sex differences in a counting Stroop task that explored interference control. The sample consisted of 55 medication-naïve adults with ADHD (28 men, 27 women) and 52 healthy controls (HC, 26 men, 26 women). The Conners' Continuous Performance Test further evaluated the performance of focused attention (standard deviation of the reaction time, RTSD) and vigilance (the reaction time change across different inter-stimulus intervals, RTISI). First, for the main effect of diagnosis, compared to the HC group, the ADHD group showed less activation in the caudate nucleus and inferior frontal gyrus (IFG). Second, for the main effect of sex, no significant effects were found. Third, a diagnosis-by-sex interaction indicated that the magnitude of ADHD-HC difference was greater for women than men in the right IFG and precuneus, reflecting greater difficulties for ADHD women to resolve interference. Conversely, no significant brain activation showed greater ADHD-HC difference in men than women. Also, reduced right IFG and precuneus activation was negatively associated with the scores assessing focused attention and vigilance in ADHD women, indicating that the attentional abilities are disrupted in ADHD women. Abnormalities in the frontoparietal areas may represent the main difference between ADHD women and ADHD men.

Systematic Review and Meta-Analysis: Clinical Utility of Continuous Performance Tests for the Identification of Attention-Deficit/Hyperactivity Disorder

We aimed to quantify the clinical utility of continuous performance tests (CPTs) for the diagnosis of attention-deficit/hyperactivity disorder (ADHD) compared to a clinical diagnosis in children and adolescents. Four databases (MEDLINE, PsycINFO, EMBASE, and PubMed) were screened until January 2023. Risk of bias of included results was judged with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). We statistically pooled the area under the curve, the sensitivity, and the specificity of 3 commonly used CPTs subscales: omission/inattention, commission/impulsivity, and total number of errors/ADHD subscales (PROSPERO registration: CRD42020168091). A total of 19 studies using commercially available CPTs were identified. Results from up to 835 control individuals and 819 cases were combined in the summary receiver operating characteristic (ROC) curve analyses (sensitivity and specificity pooling), and up to 996 cases and 1,083 control individuals in the area under the curve (AUC) analyses. Clinical utility as measured by AUCs could be considered as barely acceptable (between 0.7 and 0.8) for the most part, with the best results for the total/ADHD score, followed by omissions/inattention, and poorest for commission/impulsivity scores. A similar pattern was found when pooling sensitivity and specificity: 0.75 (95% CI= 0.66-0.82) and 0.71 (0.62-0.78) for the total/ADHD score; 0.63 (0.49-0.75) and 0.74 (0.65-0.81) for omissions; and 0.59 (0.38-0.77) and 0.66 (CI= 0.50-0.78) for commissions. At the clinical level, CPTs as a stand-alone tool have only a modest to moderate ability to differentiate ADHD from non-ADHD samples. Hence, they should be used only within a more comprehensive diagnostic process. A systematic review of screening tools for ADHD in children and adolescents; https://www.crd.york.ac.uk/prospero/; CRD42020168091.

Residential green space improves cognitive performances in primary schoolchildren independent of traffic-related air pollution exposure

BackgroundCognitive performances of schoolchildren have been adversely associated with both recent and chronic exposure to ambient air pollution at the residence. In addition, growing evidence indicates that exposure to green space is associated with a wide range of health benefits. Therefore, we aimed to investigate if surrounding green space at the residence improves cognitive performance of primary schoolchildren while taking into account air pollution exposure.MethodsCognitive performance tests were administered repeatedly to a total of 307 primary schoolchildren aged 9-12y, living in Flanders, Belgium (2012–2014). These tests covered three cognitive domains: attention (Stroop and Continuous Performance Tests), short-term memory (Digit Span Forward and Backward Tests), and visual information processing speed (Digit-Symbol and Pattern Comparison Tests). Green space exposure was estimated within several radii around their current residence (50 m to 2000 m), using a aerial photo-derived high-resolution (1 m2) land cover map. Furthermore, air pollution exposure to PM2.5 and NO2 during the year before examination was modelled for the child’s residence using a spatial–temporal interpolation method.ResultsAn improvement of the children’s attention was found with more residential green space exposure independent of traffic-related air pollution. For an interquartile range increment (21%) of green space within 100 m of the residence, a significantly lower mean reaction time was observed independent of NO2 for both the sustained-selective (-9.74 ms, 95% CI: -16.6 to -2.9 ms, p = 0.006) and the selective attention outcomes (-65.90 ms, 95% CI: -117.0 to -14.8 ms, p = 0.01). Moreover, green space exposure within a large radius (2000 m) around the residence was significantly associated with a better performance in short-term memory (Digit-Span Forward Test) and a higher visual information processing speed (Pattern Comparison Test), taking into account traffic-related exposure. However, all associations were attenuated after taking into account long-term residential PM2.5 exposure.ConclusionsOur panel study showed that exposure to residential surrounding green space was associated with better cognitive performances at 9–12 years of age, taking into account traffic-related air pollution exposure. These findings support the necessity to build attractive green spaces in the residential environment to promote healthy cognitive development in children.

Smoking and attention in schizophrenia spectrum disorders: What are we neglecting?

Individuals with schizophrenia spectrum disorders (SSDs) record elevated rates of smoking, which is often attributed to their effort to self-medicate cognitive and attentional symptoms of their illness. Empirical evidence for this hypothesis is conflicting, however. In this study, we aimed to test predictions derived from the cognitive self-medication hypothesis. We predicted that cigarette smoking status and extent would predict the attentional performance of participants with SSDs. Simultaneously, we wished to address methodological gaps in previous research. We measured distinct attentional components and made adjustments for the effects of other, attention-modulation variables. Sixty-one smokers (82.0% males, 26.73 ± 6.05 years) and 61 non-smokers (50.8% males, 27.10 ± 7.90 years) with recent-onset SSDs completed an X-type Continuous Performance Test, which was used to derive impulsivity and inattention component scores. Relationships between the two component scores and cigarette smoking status and extent were assessed using hierarchical regression. Effects of estimated premorbid intellectual functioning and antipsychotic medication dosage were held constant. Smokers had significantly higher inattention component scores than non-smokers when covariates were controlled (p = 0.026). Impulsivity remained unaffected by smoking status (p = 0.971). Cigarette smoking extent, i.e., the number of cigarettes smoked per day, was not associated with either inattention (p = 0.414) or impulsivity (p = 0.079). Models of smoking-related attentional changes can benefit from the inclusion of sample-specific component scores and attention-modulating covariates. Under these conditions, smokers with SSDs can show a partial attentional benefit. However, the limited scope of this benefit suggests that the cognitive self-medication hypothesis requires further testing or reconsidering.

Cognitive deficits in multiple sclerosis: Auditory and visual attention and inhibitory control

Background A growing body of evidence has been paid to the cognitive impairment in patients with multiple sclerosis (MS). However, studies concerning cognitive functions in MS have also yielded conflicting results. This study investigates the attention and inhibitory control functions in patients with MS and their relationship with other clinical features, such as depression and fatigue in these patients. Methods Participants included 80 patients with MS and 60 healthy controls. The attention and inhibitory control, fatigue, and psychiatric screening in all subjects were studied, respectively with the Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), Fatigue Severity Scale (FSS), and the Hospital Anxiety and Depression Scale (HADS). Results Patients with MS performed the IVA-CPT task more poorly than the healthy control group (p < 0.001). However, multiple regression analysis did not show any significant relationship between disease duration, FSS, and HADS on attention and inhibitory control. Conclusion Inhibitory control and attention are significantly impaired in patients with MS. Finding the basics of cognitive deficits in MS have potentially important clinical implications for developing better cognitive rehabilitation strategies.

Presence and simulator sickness predict the usability of a virtual reality attention task

Attention is the ability to actively process specific information within one’s environment over longer periods of time while disregarding other details. Attention is an important process that contributes to overall cognitive performance from performing every day basic tasks to complex work activities. The use of virtual reality (VR) allows study of the attention processes in realistic environments using ecological tasks. To date, research has focused on the efficacy of VR attention tasks in detecting attention impairment, while the impact of the combination of variables such as mental workload, presence and simulator sickness on both self-reported usability and objective attention task performance in immersive VR has not been examined. The current study tested 87 participants on an attention task in a virtual aquarium using a cross-sectional design. The VR task followed the continuous performance test paradigm where participants had to respond to correct targets and ignore non-targets over 18 min. Performance was measured using three outcomes: omission (failing to respond to correct targets), commission errors (incorrect responses to targets) and reaction time to correct targets. Measures of self-reported usability, mental workload, presence and simulator sickness were collected. The results showed that only presence and simulator sickness had a significant impact on usability. For performance outcomes, simulator sickness was significantly and weakly associated with omission errors, but not with reaction time and commission errors. Mental workload and presence did not significantly predict performance. Our results suggest that usability is more likely to be negatively impacted by simulator sickness and lack of presence than performance and that usability and attention performance are linked. They highlight the importance of considering factors such as presence and simulator sickness in attention tasks as these variables can impact usability.

Sustained attention performance deficits in the three-choice serial reaction time task in male and female rats after experimental brain trauma

Impaired attention is central to the cognitive deficits associated with long-term sequelae for many traumatic brain injury (TBI) survivors. Assessing complex sustained attention post-TBI is clinically-relevant and may provide reliable avenues towards developing therapeutic and rehabilitation targets in both males and females. We hypothesized that rats subjected to a moderate TBI will exhibit attentional deficits seen as reduced accuracy and increased distractibility in an operant 3-choice serial reaction time task (3-CSRT), designed as an analogue of the clinical continuous performance test. Upon reaching baseline of 70% accuracy at the 300 ms cue, adult male and female Sprague-Dawley rats were subjected to a controlled cortical impact (2.8 mm deformation at 4 m/s) or sham injury over the right parietal cortex. After two weeks of recovery, they were retested on the 3-CSRT for ten days. Dependent measures include percent accuracy (overall and for each of the three cue ports), percent omissions, as well as latency to instrumental poke and retrieve reward. Results demonstrate that both males and females displayed reduced percent accuracy and increased omissions when re-tested post-TBI on 3-CSRT compared to Sham rats and to their own pre-insult baseline (p’s < 0.05). Performance accuracy was impaired consistently throughout the ten days of post-surgery re-testing, suggesting pronounced and long-lasting dysfunction in sustained attention processes. Deficits were specifically more pronounced when the cue was pseudorandomly presented in the left-side cue port (p < 0.05), mirroring clinical hemispatial neglect. These data demonstrate significant and persistent complex attention impairments in both sexes after TBI, rendering identifying efficient therapies for cognitive recovery as pivotal.

A virtual reality program to assess cognitive function in multiple sclerosis: A pilot study.

Introduction: Cognitive impairment is a debilitating symptom in people with multiple sclerosis (MS). Most of the neuropsychological tasks have little resemblance to everyday life. There is a need for ecologically valid tools for assessing cognition in real-life functional contexts in MS. One potential solution would involve the use of virtual reality (VR) to exert finer control over the task presentation environment; however, VR studies in the MS population are scarce. Objectives: To explore the utility and feasibility of a VR program for cognitive assessment in MS. Methods: A VR classroom embedded with a continuous performance task (CPT) was assessed in 10 non-MS adults and 10 people with MS with low cognitive functioning. Participants performed the CPT with distractors (i.e., WD) and without distractors (i.e., ND). The Symbol Digit Modalities Test (SDMT), California Verbal Learning Test-II (CVLT-II), and a feedback survey on the VR program was administered. Results: People with MS exhibited greater reaction time variability (RTV) compared to non-MS participants, and greater RTV in both WD and ND conditions was associated with lower SDMT. Conclusions: VR tools warrant further research to determine their value as an ecologically valid platform for assessing cognition and everyday functioning in people with MS.