Deficits In Sustained Attention Research Articles

P.672 Physical, physiological and biochemical parameters of adults with schizophrenia: Data from cognitive rehabilitation and training with exercise for schizophrenia study

Exercise training has been shown to improve learning and memory, and to protect against the negative impact of sleep deprivation. The aim of this study was to investigate the effects of seven weeks of moderate- and high-intensity interval exercise training on vigilance/sustained attention, inhibition processes and working memory during 40-h total sleep deprivation (TSD) in 16 healthy young men.The subjects were evaluated before (Baseline, BAS) and during TSD, and the day after a night of recovery sleep (Recovery, REC).Exercise training significantly decreased errors and increased speed assessed by the psychomotor vigilance task (PVT) during TSD and REC while no difference was found in executive inhibition (Go–noGo task) and working memory (2-Back task) performances. The multiple sleep latency test results were higher during BAS and REC at Post-exercise training, and no difference occurred in subjective sleepiness and daytime microsleeps over the 40-h TSD. The PVT speed was positively correlated with maximal oxygen consumption and maximal aerobic power measured before entry in the in-laboratory TSD protocol, and stage 3 sleep duration measured during the first night in the in-laboratory TSD protocol (N-1). Exercise training effects on sleep were found during the night recovery with lower stage-3 sleep and higher rapid eye movement (REM) sleep durations. An exercise training effect was also found on free insulin-like growth factor I levels with lower levels during TSD at Post-exercise training.In healthy young men, exercise training reduced sleep pressure at baseline and protected against sustained attention deficits induced by TSD with persistent effect after one night of recovery sleep. Nevertheless, exercise training was not effective in reducing deficits in executive inhibition and working memory induced by TSD.

Neuropsychological Outcomes of Exposure to Hurricane Katrina and Relocation.

Survivors of natural disasters are at risk for mental health sequela, including deficits in neurocognitive functioning. This study explores links between hurricane exposure and resulting psychiatric symptoms and deficits in cognitive processing, attention, learning, and memory. Relocated Katrina survivors and demographically matched controls completed neurocognitive tests assessing processing speed (Trail Making Test, Part A), mental flexibility (Trail Making Test, Part B), sustained attention (Conner's Continuous Performance Test), and learning and memory (Rey Auditory-Verbal Learning Test). PTSD (Clinician-Administered PTSD Scale) and depressive symptoms (BDI- II) were also measured. Survivors had more PTSD and depression symptoms and weaker performance in cognitive processing, mental flexibility, and sustained attention, but not memory and learning compared to controls. When controlling for depression and PTSD symptoms (analysis of covariances), only CPT-II response time remained significantly different for survivors, so that sustained attention deficits were independent of emotional symptoms. Survivors had more psychiatric symptoms and neurocognitive dysfunctions than controls in most assessed measures. Our study had mixed results in identifying cognitive deficits related to psychopathology. Results suggest that disaster survivors, even those without psychopathology, should be assessed for cognitive issues that may affect their ability to process post-disaster instructions and access assistance in recovery efforts.

Lateralized cognitive functions in Parkinson’s patients: A behavioral approach for the early detection of sustained attention deficits

Parkinson’s disease (PD) has been described as a disconnection syndrome. The lateralized motor onset of symptoms indicates asymmetrical dysregulation of the dopamine production in the substantia nigra, in the striatum and, in turns, a dysfunction of the basal ganglia and of the connected cortical areas. However, lateralization of cognitive symptoms is less clear, and it would be important to determine whether lateralized motor deficits are associated with cognitive impairments typically documented following damage to one specific hemisphere.We tested twenty-two PD patients at various stages of the disease on a sustained attention task, namely a multiple object tracking (MOT). This task is particularly sensitive at revealing lateralized deficits, and is often used to diagnose visual field attentional deficits in stroke patients with unilateral parietal lesions. In the present study, PD patients were asked to track four moving discs (two in the left and two in the right hemifield) amidst moving distracters. Left and right visual field tracking accuracy was psychophysically measured and compared to that of age-matched controls.Results revealed distinct behaviors: left (motor deficit) PD patients showed impaired performance in the left, while right (motor deficit) PD patients were impaired in the right hemifield. Data indicate that PD affects motor as well as attentional functions. Interestingly, performance correlated with scores on the Montreal Cognitive Assessment (MoCA) a measure of cognitive functioning. Crucially, results suggest that cognitive skills might be affected as early as motor functions, and that early evaluation might be key to predicting disease progression and planning interventions.

Predicting Attentional Impairment in Women With Posttraumatic Stress Disorder Using Self-Reported and Objective Measures of Sleep.

There is growing evidence to support sleep impairment as a core feature of posttraumatic stress disorder (PTSD). Sleep impairment in PTSD is associated with severe distress and poorer treatment outcomes. Therefore, specific attention to this symptom of PTSD is warranted and accurate assessment of sleep impairment is critical. The current study investigated the association between self-reported and objective assessment of sleep and sustained attention in women with PTSD. Study participants include 50 treatment-seeking, female, interpersonal violence survivors who have PTSD. Nocturnal sleep duration was measured with self-report sleep diaries and objective actigraphy assessment over the course of 7 nights. Sustained attention during daytime was measured by the Psychomotor Vigilance Task (PVT). Results indicated that self-reported nocturnal sleep duration, but not objective or global sleep quality measures, best predicted attentional deficits as indicated by lapses and inverse reaction time on the PVT. Daily sleep diaries predicted 19% and 14% of the variance in attentional lapses and inverse reaction time, respectively. In a sample of women with PTSD, self-reported nocturnal sleep duration predicted deficits in sustained attention. Conversely, sleep duration as measured by actigraphy and global sleep quality, did not predict sustained attention. Findings suggest that assessing sleep impairment on a daily basis may provide clinically relevant information in evaluating daytime symptoms and provide guidance in targeting this particularly troublesome symptom in the treatment of PTSD. Werner KB, Arditte Hall KA, Griffin MG, Galovski TE. Predicting attentional impairment in women with posttraumatic stress disorder using self-reported and objective measures of sleep. J Clin Sleep Med. 2019;15(9):1329-1336.

Effects of orthostatic hypotension on cognition in type 2 diabetes mellitus.

To evaluate the effect of a decrease in blood pressure (BP) fulfilling the diagnostic criteria for orthostatic hypotension (OH) on performance in each domain of cognitive function in patients with type 2 diabetes mellitus using a cross-sectional and within-group design. Subjects were individuals without dementia and with type 2 diabetes mellitus, including 107 individuals without OH and 94 with OH (DMOH); 95 control participants were also included. BP was assessed in both the supine and standing positions. A detailed neuropsychological assessment was made in each posture for all subjects. There were statistically significant differences between the patients without OH and the DMOH group with regard to some cognitive measures while supine. Standing posture exacerbated and broadened cognitive deficits in the DMOH group for all measures in the different domains of cognition including executive functioning, memory, visuospatial skills, information processing speed, and attention. When group-specific supine scores were used as baseline anchors, both the patients without OH and the DMOH group showed cognitive changes when transitioning from a supine to a standing, upright position, with the DMOH group exhibiting a wider range of neuropsychological deficits in memory, visuospatial skills, executive function, and sustained attention, as well as significant changes in information processing speed. These data demonstrate that type 2 diabetes mellitus patients with OH had transient, posture-mediated cognitive deficits in excess of those found in diabetes mellitus without OH. Understanding the effects of OH on cognition due to autonomic failure is important, particularly as clinical assessments and neuroimaging collect data only in the seated or supine positions. ANN NEUROL 2019;86:754-761.

C-69 Neuropsychological Functioning in a Patient with an Unspecified Pediatric Movement Disorder Without Abnormal Brain MRI

Abstract Objective Neuropsychological profiles of patients with pediatric movement disorders are not fully understood, though research suggests greater impairments in cognitive processes reliant on white matter functional integrity. Interpretation of neuropsychological data in these patients is often informed by imaging data that suggests specific areas of brain abnormality. The purpose of this presentation is to discuss the neurocognitive profile of a patient with an unspecified, progressive movement disorder with onset in middle childhood with no observable brain abnormality. Method The patient is an 11-year-old, right-handed male with a history of spastic diplegia and ataxia, onset at seven years of age, in the context of a normal brain MRI and genetic anomaly of unclear clinical significance. Patient has since experienced progressive weakness and spasticity of his bilateral lower limbs, and increasing inflammation in the upper thoracic region. He also has a history of auditory hallucinations. Results His neuropsychological profile was indicative of white matter and right hemispheric dysfunction in the brain with well-preserved left hemisphere functions. He demonstrated stronger verbal reasoning and verbally-based executive functioning abilities compared to visual-spatial reasoning and visual perception. Deficits in sustained attention, vigilance, working memory, and processing speed were also noted. Psychomotor coordination and planning was impaired bilaterally, with more pronounced left-hand deficits. He also demonstrated significant speech dysarthria and dyspraxia. He denied experiencing auditory hallucinations in the past six months. Conclusions This patient’s neurocognitive profile is largely consistent with literature on neuropsychological functioning in pediatric movement disorders despite the absence of an identifiable region of brain abnormality.

Beneficial effects of exercise training on cognitive performances during total sleep deprivation in healthy subjects

ObjectiveExercise training has been shown to improve learning and memory, and to protect against the negative impact of sleep deprivation. The aim of this study was to investigate the effects of seven weeks of moderate- and high-intensity interval exercise training on vigilance/sustained attention, inhibition processes and working memory during 40-h total sleep deprivation (TSD) in 16 healthy young men. MethodsThe subjects were evaluated before (Baseline, BAS) and during TSD, and the day after a night of recovery sleep (Recovery, REC). ResultsExercise training significantly decreased errors and increased speed assessed by the psychomotor vigilance task (PVT) during TSD and REC while no difference was found in executive inhibition (Go–noGo task) and working memory (2-Back task) performances. The multiple sleep latency test results were higher during BAS and REC at Post-exercise training, and no difference occurred in subjective sleepiness and daytime microsleeps over the 40-h TSD. The PVT speed was positively correlated with maximal oxygen consumption and maximal aerobic power measured before entry in the in-laboratory TSD protocol, and stage 3 sleep duration measured during the first night in the in-laboratory TSD protocol (N-1). Exercise training effects on sleep were found during the night recovery with lower stage-3 sleep and higher rapid eye movement (REM) sleep durations. An exercise training effect was also found on free insulin-like growth factor I levels with lower levels during TSD at Post-exercise training. ConclusionsIn healthy young men, exercise training reduced sleep pressure at baseline and protected against sustained attention deficits induced by TSD with persistent effect after one night of recovery sleep. Nevertheless, exercise training was not effective in reducing deficits in executive inhibition and working memory induced by TSD.

Eye Movement Patterns and Approximate Number Sense Task Performance in Williams Syndrome and Down Syndrome: A Developmental Perspective

It has been reported that approximate number sense (ANS) task performance is impaired in individuals with Williams syndrome (WS) and Down syndrome (DS). Research with infants has suggested this impairment is caused by sticky fixation in WS and sustained attention deficits for those with DS. This study examined looking patterns of older children and adults with WS (n = 24) and DS (n = 23) during an ANS task compared to typically developing controls matched for chronological age and those matched for mental age. Results showed that, although there were no group differences, looking patterns changed with chronological age for both the WS and DS groups. Looking behaviour related to ANS performance only in the WS group. Implications for interventions are discussed.

Sustained Attention and Working Memory in Children with Autism Spectrum Disorder

ABSTRACT The aim of the present study was to investigate sustained attention and working memory in children with autism spectrum disorder (ASD), as this issue has not been widely investigated in this population. Children with ASD were age-matched with children diagnosed with dyslexia based on standardised reading assessments. All children were administered tests of working memory, IQ, and visual sustained attention. The results using a MANOVA indicated that children with ASD performed worse than children with dyslexia on verbal tests of working memory and IQ. However, their performance in the visual tests (working memory and IQ) was similar. Furthermore, correlational analyses demonstrated considerable variability in sustained attention (accuracy and errors of commission), in contrast to children with dyslexia. This pattern suggests that children with ASD may not have a deficit in sustained attention per se. Some explanations for this attentional pattern are discussed and could be linked to their motivational framework, which means that they are less responsive to the effects of reinforcement.

White Matter Abnormalities in Major Depression Biotypes Identified by Diffusion Tensor Imaging.

Identifying data-driven biotypes of major depressive disorder (MDD) has promise for the clarification of diagnostic heterogeneity. However, few studies have focused on white-matter abnormalities for MDD subtyping. This study included 116 patients with MDD and 118 demographically-matched healthy controls assessed by diffusion tensor imaging and neurocognitive evaluation. Hierarchical clustering was applied to the major fiber tracts, in conjunction with tract-based spatial statistics, to reveal white-matter alterations associated with MDD. Clinical and neurocognitive differences were compared between identified subgroups and healthy controls. With fractional anisotropy extracted from 20 fiber tracts, cluster analysis revealed 3 subgroups based on the patterns of abnormalities. Patients in each subgroup versus healthy controls showed a stepwise pattern of white-matter alterations as follows: subgroup 1 (25.9% of patient sample), widespread white-matter disruption; subgroup 2 (43.1% of patient sample), intermediate and more localized abnormalities in aspects of the corpus callosum and left cingulate; and subgroup 3 (31.0% of patient sample), possible mild alterations, but no statistically significant tract disruption after controlling for family-wise error. The neurocognitive impairment in each subgroup accompanied the white-matter alterations: subgroup 1, deficits in sustained attention and delayed memory; subgroup 2, dysfunction in delayed memory; and subgroup 3, no significant deficits. Three subtypes of white-matter abnormality exist in individuals with major depression, those having widespread abnormalities suffering more neurocognitive impairments, which may provide evidence for parsing the heterogeneity of the disorder and help optimize type-specific treatment approaches.

The complexity of the interaction between binge-eating and attention.

ObjectiveTo investigate whether binge-eating in patients with eating disorders (EDs) is associated with attentional deficits.MethodsWe studied ED patients with binge-eating (n = 51), no binge-eating (n = 59) and controls (n = 58). ED patients were assessed following the stabilization of weight and ED pathology. Attention assessment included evaluation of attention deficit hyperactivity disorder (ADHD) diagnosis, the Adult ADHD Self-Report (ASRS) and ADHD Rating Scale-IV-Home Version (ADHD-RS) questionnaires, and attention functioning assessed with neuropsychological tools. The severity of eating-related pathology, depression, anxiety and obsessionality was also monitored.ResultsPatients with binge-eating showed more ADHD symptomatology on the ADHD-RS compared with non-binge-eating patients. No differences were found between binge-eating and non-binge-eating patients in ADHD diagnosis and neuropsychological functioning. Among the specific ED subtypes, patients with anorexia nervosa binge/purge type (AN-B/P) showed the highest rates of ADHD symptomatology on the ADHD-RS, and were characterized with sustained attention deficits.ConclusionBinge-eating is not associated with attention deficits as measured by objective neuropsychological tools. Nonetheless, it is associated with attentional difficulties as measured with the self-reported ADHD-RS. AN-B/P patients are the only ED category showing objective sustained attention deficits.

Selective activation of Dopamine D3 receptors and norepinephrine transporter blockade enhances sustained attention

Catecholamine transmitters dopamine (DA) and norepinephrine (NE) regulate prefrontal cortical (PFC) circuit activity and PFC-mediated executive functions. Accordingly, pharmacological agents that influence catecholamine neurotransmission exert prominent effects on cognition. Many such agents are used clinically to treat attention disorders. For example, methylphenidate blocks DA and NE reuptake and is the leading choice for attention deficit hyperactivity disorder (ADHD) treatment. Recently, we have designed SK609 – a selective small molecule agonist of the DA D3 receptor (D3R). In this study, we further characterized SK609's ability to selectively inhibit the reuptake of NE by NE transporters (NET). Our results indicate SK609 selectively inhibits NET with a Ki value of ∼500 nM and behaves as a NET substrate. Systemic dosing of SK609 (4 mg/kg; i.p.) in naïve rats produced a 300% and 160% increase in NE and DA, respectively, in the PFC as measured by microdialysis. Based on these neurochemical results, SK609 was tested in a PFC-dependent, visually-guided sustained attention task in rats. SK609 improved performance in a dose-dependent manner with a classical inverted-U dose response function with a peak effect at 4 mg/kg. SK609's peak effect was blocked by a pre-treatment with either the D2/D3R antagonist raclopride (0.05 mg/kg; i.p) or the alpha-1 adrenergic receptor antagonist prazosin (0.25 mg/kg; i.p), confirming a role for both DA and NE in promoting sustained attention. Additionally, SK609 improved sustained attention more prominently among low-performing animals. Doses of SK609 (2, 4, and 8 mg/kg) associated with cognitive enhancement did not produce an increase in spontaneous locomotor activity, suggesting a lack of side effects mediated by DA transporter (DAT) activity. These results demonstrate that the novel catecholaminergic modulator SK609 has the potential to treat sustained attention deficits without affecting DAT activity, distinguishing it from amphetamines and methylphenidate.

How does methylphenidate affect default mode network? A systematic review.

Methylphenidate is a widely-used drug for the treatment of attention deficit/hyperactivity disorder (ADHD) and other neuropsychiatric disorders. Sustained-attention deficits and poorer task performance in these disorders have been associated with default mode network (DMN) dysfunction in fMRI studies. DMN is a set of brain areas more activated during the resting-state. Under the execution of external tasks, there is an attenuation of DMN activity. In healthy individuals, DMN and task-positive network are anticorrelated. It has been suggested that methylphenidate could normalize the attenuated task-related DMN deactivation in attention- and inhibitory control-related disorders and that such normalization could improve task performance. To explore the hypothesis of DMN deactivation after methylphenidate administration, we conducted a systematic review of the literature. After a systematic search, 12 studies were included in this review. For eligibility, studies were required to measure the effects of methylphenidate administration on the DMN activity. Eleven studies showed evidence of MPH-induced improvements in brain areas related to DMN. The results suggest a normalization of brain circuits in individuals with DMN dysfunction. Our preliminary findings strongly suggest methylphenidate improves DMN dysfunction presented in ADHD and other neuropsychiatric disorders. Further studies are needed to better understand this effect and expand comprehension of methylphenidate action mechanisms.

Resting-State Default Mode Network Related Functional Connectivity Is Associated With Sustained Attention Deficits in Schizophrenia and Obsessive-Compulsive Disorder.

Background: Previous studies have indicated the resting-state default mode network (DMN) related connectivity serving as predictor of sustained attention performance in healthy people. Interestingly, sustained attention deficits as well as DMN-involved functional connectivity (FC) alterations are common in both patients with schizophrenia (SCZ) and with obsessive-compulsive disorder (OCD). Thus, the present study was designed to investigate whether the DMN related resting-state connectivity alterations in these two psychiatric disorders were neural correlates of their sustained attention impairments.Methods: The study included 17 SCZ patients, 35 OCD patients and 36 healthy controls (HCs). Sustained attention to response task was adopted to assess the sustained attention. Resting-state scan was administrated and seed-based whole-brain FC analyses were performed with seeds located in classical DMN regions including bilateral medial prefrontal cortex (mPFC) and posterior cingulate cortex (PCC).Results: Both SCZ and OCD patients had poorer sustained attention than HCs. Sustained attention deficits in OCD was negatively correlated with their impaired FC of right mPFC-left superior frontal gyrus (SFG) within DMN, and that in SCZ was significantly correlated with their altered FC of left mPFC-bilateral anterior cingulate cortex (ACC) which indicated interaction between DMN and salience network. In addition, the FC between left mPFC and right parietal lobe indicating the interaction between DMN and frontal-parietal network was correlated with sustained attention in both SCZ and OCD.Conclusion: These findings suggest the importance of DMN-involved connectivity, both within and between networks in underlying sustained attention deficits in OCD and SCZ. Results further support the potential of resting-state FC in complementing information for cognitive deficits in psychiatric disorders.

Transcranial Doppler sonography reveals sustained attention deficits in young adults diagnosed with ADHD.

The National Institute of Mental Health has recently launched the Research Domain Criteria framework that seeks to inform clinical classification schemes by elevating the status of neuroscience research in the diagnosis of mental disorders. The current research seeks to contribute to that initiative by using a neurophysiological measure, transcranial Doppler sonography that has been shown to be sensitive to decrements in sustained attention and may provide an additional biomarker of executive dysfunction in ADHD. Twenty-seven participants performed a 12-min vigilance task while cerebral blood flow velocity (CBFV) was recorded. Thirteen participants were included in an ADHD condition if they had been formally diagnosed with ADHD. The remaining 14 participants who had never been formally diagnosed with ADHD were included in the control condition. Participants that had been diagnosed with ADHD demonstrated a steeper decrement in performance accuracy, a steeper decrement in perceptual sensitivity, and employed a more liberal response bias over time as compared to the control participants. Critically, the decrement in CBFV was steeper for participants previously diagnosed with ADHD than those who were not. Moreover, CBFV was found to better predict decreases in sensitivity and hit rate, as well as increases in liberal responding above and beyond self-reported ADHD symptoms. Results suggest that CBFV can be used to index failures of executive control in ADHD and can predict response strategy, and that the measure may provide an additional index of the sustained attention deficits associated with ADHD compared to traditional diagnostic methods.

Mouse Gambling Task reveals differential effects of acute sleep debt on decision-making and associated neurochemical changes

Sleep loss is associated with sleepiness, sustained attention, and memory deficits. However, vulnerability of higher cognitive processes (i.e. decision making) to sleep debt is less understood. Therefore, a major challenge is to understand why and how higher cognitive processes are affected by sleep debt. We had established in mice correlations between individual decision-making strategies, prefrontal activity, and regional monoaminergic levels. Now, we show that acute sleep debt (ASD) disturbs decision-making processes and provokes brain regional modifications of serotonin and dopamine that could explain why ASD promotes inflexible and more risk-prone behaviors. Finally, we highlight, for the first time, that in a large group of healthy inbred mice some of them are more sensitive to ASD by showing inflexible behavior and decision-making deficits. We were also able to predict mice that would be the most vulnerable to ASD depending of their behavior before ASD exposure.

4.26 Sustained Attention Deficit in Unaffected Offspring of Parents With Bipolar Disorder

4.26 Sustained Attention Deficit in Unaffected Offspring of Parents With Bipolar Disorder

Eotaxin, an Endogenous Cognitive Deteriorating Chemokine (ECDC), Is a Major Contributor to Cognitive Decline in Normal People and to Executive, Memory, and Sustained Attention Deficits, Formal Thought Disorders, and Psychopathology in Schizophrenia Patients.

Eotaxin is increased in neurodegenerative disorders and schizophrenia, and preclinical studies indicate that eotaxin may induce cognitive deficits. This study aims to examine whether peripheral levels of eotaxin impact cognitive functioning in healthy volunteers and formal thought disorder (FTD) and psychopathology in schizophrenia patients. Serum levels of eotaxin were assayed and cognitive tests were performed on a sample of 40 healthy participants and 80 schizophrenia patients. Among healthy participants, eotaxin levels were significantly associated with episodic/semantic memory, executive functions, Mini Mental State Examination, emotion recognition, and sustained attention. In addition, age-related effects on these cognitive measures were partly mediated by eotaxin. The super-variable "age-eotaxin" predicted a large part of the variance in cognitive functions among healthy participants, and hence, eotaxin may act as an "accelerated brain aging chemokine" (ABAC). In schizophrenia, eotaxin levels had a strong impact on formal thought disorders and psychopathology. In schizophrenia, increased eotaxin strongly impacts memory and sustained attention, which together to a large extent determine FTD. FTD together with memory deficits predicts around 92.5% of the variance in psychopathology. Moreover, the effects of eotaxin are partially mediated by executive functioning, while the effects of male sex on FTD and psychopathology are mediated by eotaxin. In healthy subjects, eotaxin strongly impacts executive functioning and multiple cognitive domains. In schizophrenia, peripheral levels of eotaxin strongly impact both negative symptoms and psychosis (hallucinations and delusions), and these eotaxin effects are mediated by impairments in frontal functioning, memory, sustained attention, and FTD. Eotaxin is an endogenous cognitive deteriorating chemokine (ECDC) and a novel therapeutic target for age-related cognitive decline and schizophrenia as well.

Neuropsychological assessment of a long-term (LT) outcome after severe traumatic brain injury (TBI)

Neuropsychological assessment of a LT outcome after severe TBI, in correlation with daily life disability. Severe TBI patients admitted in the Intensive Care Unit in Pitié-Salpêtrière hospital (France) from 2005 to 2012 were included. MRI, clinical PRM and neuropsychological assessments were performed. Neuropsychological performances were measured by 10 composite scores (CS) representing the main cognitive functions. The Glasgow Outcome Scale Extended (GOSE) assessed the global functional outcome. Use of self and relatives’ assessment questionnaires allowed evaluation of cognitive complaints in everyday life (Dysexecutive questionnaire–DEX; Working Memory Questionnaire - WMQ; Brain Injury Complaint Questionnaire - BICoQ). 101 patients (84.16% men; mean age 38.55 ± 16.03 [19–73]) were included. They presented with initial severity of TBI: GSC median ± 3.6 [3–15]; coma duration 19.01 days ± 18.22 [0–120]; PTA duration 97.8% > 1 day. Assessments were performed at a mean delay of 5 years and 2 months after BI. This cohort had a mean moderate disability according to GOSE (Median ± 1.32 [3–8]). Neuropsychological evaluation emphasized high prevalence of different cognitive deficits: attention (sustained attention deficit in 63.04% of subjects, tonic alertness 24.75%, divided attention 43.56%), executive functions (EF) (planning 55.56%, mental flexibility 24.75%, generation of new information 20.79%), working memory (WM) (46%) and update (46.88%), anterograde episodic memory (AEM) (46%). Surprisingly inhibition was not noticeable in this cohort (1%). GOSE was significantly related to EF, WM (0.0047*), AEM (< 0.0001*), Tonic alertness (< 0.0001*), divided attention (0.0012*) and to relatives’ complaints questionnaire (DEX & BICoQ < 0.0001*). Moreover, several CS (AEM, fluency…) were significantly associated with the relatives’ complaints in the BICoQ. Five years after TBI, patients and their relatives are still affected by cognitive disorders. Relatives complaints are clearly informative of participation restrictions. This study emphasizes the importance of LT assessment and follow up in TBI patients and their relatives.

Sex differences in stress reactivity in arousal and attention systems.

Women are more likely than men to suffer from psychiatric disorders with hyperarousal symptoms, including posttraumatic stress disorder (PTSD) and major depression. In contrast, women are less likely than men to be diagnosed with schizophrenia and attention deficit hyperactivity disorder (ADHD), which share attentional impairments as a feature. Stressful events exacerbate symptoms of the aforementioned disorders. Thus, researchers are examining whether sex differences in stress responses bias women and men towards different psychopathology. Here we review the preclinical literature suggesting that, compared to males, females are more vulnerable to stress-induced hyperarousal, while they are more resilient to stress-induced attention deficits. Specifically described are sex differences in receptors for the stress neuropeptide, corticotropin-releasing factor (CRF), that render the locus coeruleus arousal system of females more vulnerable to stress and less adaptable to CRF hypersecretion, a condition found in patients with PTSD and depression. Studies on the protective effects of ovarian hormones against CRF-induced deficits in sustained attention are also detailed. Importantly, we highlight how comparing males and females in preclinical studies can lead to the development of novel therapeutics to improve treatments for psychiatric disorders in both women and men.