Sustained Attention Task Research Articles

Incidental Physical Activity and Physical Fitness Associate with Sustained Attention and Impulse Control in Older Adults

Age-related changes have been observed in sustained attention and impulse control. Deficits in these functions are related to pathological aging. However, research suggests that an active lifestyle may exert a protective effect on cognition in aging. While the association between physical activity and cognitive functioning in older adults has been previously described, few studies have explored the relationship between incidental physical activity and fitness with sustained attention and impulse control in this population. Therefore, this study aimed to evaluate the association between incidental physical activity and various components of fitness and sustained attention and impulsivity in older adults. Fifty-four older adults were recruited (41 females and 13 males) with a mean age of 76.76 years (SD = 8.94). Physical activity levels were assessed using the Yale Physical Activity Survey (YPAS), physical function in healthy older adults was evaluated with the Senior Fitness Test, and sustained attention and impulsivity were measured using a computerized continuous performance task. Significant correlations were found between higher energy expenditure during housework and yardwork activities, and fewer commission errors and shorter reaction times during sustained attention task, and higher sensitivity during impulse control task (rho between 0.35 and 0.40, p < .01, β = 0.80). Additionally, higher scores between agility and balance were associated with better accuracy during the sustained attention task, and faster speed processing correlated to better performance impulse control task (rho between 0.33 and 0.36, p < .05, β = 0.80). Our study highlights the importance of incidental physical activity and various components of fitness on sustained attention and impulse control in aging.

Structural brain correlates of sustained attention in healthy ageing: Cross-sectional findings from the LEISURE study

Sustained attention is important for maintaining cognitive function and autonomy during ageing, yet older people often show reductions in this domain. The role of the underlying neurobiology is not yet well understood, with most neuroimaging studies primarily focused on fMRI. Here, we utilise sMRI to investigate the relationships between age, structural brain volumes and sustained attention performance. Eighty-nine healthy older adults (50–84 years, Mage 65.5 (SD=8.4) years, 74 f) underwent MRI brain scanning and completed two sustained attention tasks: a rapid visual information processing (RVP) task and sustained attention to response task (SART). Independent hierarchical linear regressions demonstrated that greater volumes of white matter hyperintensities (WMH) were associated with worse RVP_A’ performance, whereas greater grey matter volumes were associated with better RVP_A’ performance. Further, greater cerebral white matter volumes were associated with better SART_d’ performance. Importantly, mediation analyses revealed that both grey and white matter volumes completely mediated the relationship between ageing and sustained attention. These results explain disparate attentional findings in older adults, highlighting the intervening role of brain structure.

B - 98 Effect of Insomnia on Sustained Attention in Post-Acute Sequelae of COVID-19 (PASC)

Abstract Objective Insomnia symptoms are prevalent among individuals with post-acute sequelae of COVID-19 (PASC) and may, to some extent, reflect virally-mediated neurological changes. Mood disturbance and cognitive impairment, including weaknesses in attention and processing speed, are also observed. There is limited research examining the association between insomnia, mood, and cognition in PASC, which we aimed to elucidate. Methods Patients were 69 consecutive adults (M-age = 46.5 ± 11.6 years; M-education = 15.03 ± 2.66 years; M-TOPF-SS = 104.6 ± =12.58; 69.6% female; 95.7% White) seen for neuropsychological evaluation in a PASC clinic. They completed the Conners Continuous Performance (CPT-3), Symbol Digit Modalities Test, Insomnia Severity Index, Beck Anxiety Inventory, and Beck Depression Inventory as part of a larger battery of measures. Cognitive performance was compared between patients with elevated versus non-elevated insomnia symptoms. Models were also adjusted for mood symptoms via MANCOVA. Results Group demographics were unrelated to mood, sleep, and cognition. MANOVA yielded a significant main effect (Wilks’ Λ = 0.656, F(7,61) = 4.57, p &amp;lt; 0.001), with more CPT-3 commission errors (p &amp;lt; 0.001, ηp2 = 0.247), faster reaction times (p = 0.012, ηp2 = 0.090), and more variable response speed consistency (p = 0.027, ηp2 = 0.071) in those with insomnia. Commission errors and reaction times remained significant after covarying for mood. The insomnia group displayed slower responses across block changes (p = 0.038, ηp2 = 0.065) when mood was controlled. Conclusion Patients with PASC with elevated insomnia symptoms showed greater inaccuracy and more variable reaction times on a sustained attention task, in a pattern suggesting impulsivity, even after controlling for mood symptoms. Findings suggest that improving sleep may ameliorate attention deficits in persons with PASC.

Association between physical activity and inhibitory control in children

ABSTRACT Evidence supports a positive association between physical activity and executive function in children. How physical activity performed in different contexts associates with inhibitory control remains unclear. This cross-sectional study examined associations between inhibitory control and four measures of physical activity (activity during PE, breaktime, outside school and in sport) in 340 primary school children (8.6 ± 1.6 years old, n = 197 female). In models adjusted for sex, age, adiposity and SES, greater activity during breaktime was associated with fewer commission errors in the sustained attention (β =−0.10, 95%CI: −0.19, −2.95e-03, p = .04) and inhibition tasks (β = −0.06, 95%CI: −0.11, −9.33e-03, p = .02). These results suggest that unsupervised active play at school is associated with higher levels of inhibitory control.

Strategic stabilization of arousal boosts sustained attention

Arousal and motivation interact to profoundly influence behavior. For example, experience tells us that we have some capacity to control our arousal when appropriately motivated, such as staying awake while driving a motor vehicle. However, little is known about how arousal and motivation jointly influence decision computations, including if and how animals, such as rodents, adapt their arousal state to their needs. Here, we developed and show results from an auditory, feature-based, sustained-attention task with intermittently shifting task utility. We use pupil size to estimate arousal across a wide range of states and apply tailored signal-detection theoretic, hazard function, and accumulation-to-bound modeling approaches in a large cohort of mice. We find that pupil-linked arousal and task utility both have major impacts on multiple aspects of task performance. Although substantial arousal fluctuations persist across utility conditions, mice partially stabilize their arousal near an intermediate and optimal level when task utility is high. Behavioral analyses show that multiple elements of behavior improve during high task utility and that arousal influences some, but not all, of them. Specifically, arousal influences the likelihood and timescale of sensory evidence accumulation but not the quantity of evidence accumulated per time step while attending. In sum, the results establish specific decision-computational signatures of arousal, motivation, and their interaction in attention. So doing, we provide an experimental and analysis framework for studying arousal self-regulation in neurotypical brains and in diseases such as attention-deficit/hyperactivity disorder.

The influence of transcranial direct current stimulation to the trigeminal nerve on attention and arousal.

One mechanism by which transcranial direct current stimulation (tDCS) has been proposed to improve attention is by transcutaneous stimulation of cranial nerves, thereby activating the locus coeruleus (LC). Specifically, placement of the electrodes over the frontal bone and mastoid is thought to facilitate current flow across the face as a path of least resistance. The face is innervated by the trigeminal nerve, and the trigeminal nerve is interconnected with the LC. In this study, we tested whether stimulating the trigeminal nerve impacts indices of LC activity and performance on a sustained attention task. We replicated previous research that shows deterioration in task performance, increases in the rate of task-unrelated thoughts, and reduced pupil responses due to time on task irrespective of tDCS condition (sham, anodal, and cathodal stimulation). Importantly, tDCS did not influence pupil dynamics (pretrial or stimulus-evoked), self-reported attention state, nor task performance in active versus sham stimulation conditions. The findings reported here are consistent with theories about arousal centered on a hypothesized link between LC activity indexed by pupil size, task performance, and self-reported attention state but fail to support hypotheses that tDCS over the trigeminal nerve influences indices of LC function.

Cross-sectional and longitudinal changes in mind-wandering in older adulthood.

Age-related declines in the frequency of mind-wandering are well established. Theories of mind-wandering have attempted to explain why this decline occurs, but no one theory firmly predicts such changes. One problem with these theoretical views, and the studies that have grown out of them, is their reliance on cross-sectional methods, which do not account for within-person changes over time in mind-wandering, and it is well-documented that cross-sectional and longitudinal changes in some cognitive domains do not align. We present a novel analysis of longitudinal change in subjective and objective indicators of mind-wandering during a sustained attention task. Cognitively normal adults (N = 277, age range 42-94) completed a sustained attention task with thought probes to measure mind-wandering repeatedly over several years. Linear mixed effect models revealed baseline differences in subjective mind-wandering reports among middle-aged and older adults. However, longitudinally, middle-aged participants showed a significant increase in subjective mind-wandering, whereas older participants showed no change. Changes in mind-wandering could not be explained by attentional control ability or contemporaneous estimates of interest and perceived difficulty, but they were explained by baseline levels of conscientiousness. Objective measures of mind-wandering did not show these same patterns and were largely only associated with participants perceived difficulty. Our results build on previous cross-sectional research and suggest that incorporating longitudinal analyses into theories of ageing and mind-wandering and mind-wandering more broadly is important for refining these theories. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A new perspective on binaural beats: Investigating the effects of spatially moving sounds on human mental states.

When individuals are exposed to two pure tones with close frequencies presented separately in each ear, they perceive a third sound known as binaural beats (BB), characterized by a frequency equal to the difference between the two tones. Previous research has suggested that BB may influence brain activity, potentially benefiting attention and relaxation. In this study, we hypothesized that the impact of BB on cognition and EEG is linked to the spatial characteristics of the sound. Participants listened to various types of spatially moving sounds (BB, panning and alternate beeps) at 6Hz and 40Hz frequencies. EEG measurements were conducted throughout the auditory stimulation, and participants completed questionnaires on relaxation, affect, and a sustained attention task. The results indicated that binaural, panning sounds and alternate beeps had a more pronounced effect on electrical brain activity than the control condition. Additionally, an improvement in relaxation was observed with these sounds at both 6Hz and 40Hz. Overall, these findings support our hypothesis that the impact of auditory stimulation lies in the spatial attributes rather than the sensation of beating itself.

Patterns of neural activity in prelimbic cortex neurons correlate with attentional behavior in the rodent continuous performance test.

Sustained attention, the ability to focus on a stimulus or task over extended periods, is crucial for higher level cognition, and is impaired in individuals diagnosed with neuropsychiatric and neurodevelopmental disorders, including attention-deficit/hyperactivity disorder, schizophrenia, and depression. Translational tasks like the rodent continuous performance test (rCPT) can be used to study the cellular mechanisms underlying sustained attention. Accumulating evidence points to a role for the prelimbic cortex (PrL) in sustained attention, as electrophysiological single unit and local field (LFPs) recordings reflect changes in neural activity in the PrL in mice performing sustained attention tasks. While the evidence correlating PrL electrical activity with sustained attention is compelling, limitations inherent to electrophysiological recording techniques, including low sampling in single unit recordings and source ambivalence for LFPs, impede the ability to fully resolve the cellular mechanisms in the PrL that contribute to sustained attention. In vivo endoscopic calcium imaging using genetically encoded calcium sensors in behaving animals can address these questions by simultaneously recording up to hundreds of neurons at single cell resolution. Here, we used in vivo endoscopic calcium imaging to record patterns of neuronal activity in PrL neurons using the genetically encoded calcium sensor GCaMP6f in mice performing the rCPT at three timepoints requiring differing levels of cognitive demand and task proficiency. A higher proportion of PrL neurons were recruited during correct responses in sessions requiring high cognitive demand and task proficiency, and mice intercalated non-responsive-disengaged periods with responsive-engaged periods that resemble attention lapses. During disengaged periods, the correlation of calcium activity between PrL neurons was higher compared to engaged periods, suggesting a neuronal network state change during attention lapses in the PrL. Overall, these findings illustrate that cognitive demand, task proficiency, and task engagement differentially recruit activity in a subset of PrL neurons during sustained attention.

Adding a sustained attention task to a physically demanding cycling exercise exacerbates neuromuscular fatigue and impairs cognitive performance in both normoxia and hypoxia.

Both cognitive motor dual-tasks (CMDT) protocols and hypoxic environments have been associated with significant impairments in cognitive and physical performance. We aimed to determine the effects of hypoxia on cognitive performance and neuromuscular fatigue during a highly physically demanding CMDT. Fifteen young adults completed a first session involving a cognitive task (CTLCOG) followed by cycling exercise (CTLEX) in normoxia. After that, they randomly participated in CMDT sessions in normoxia (DTNOR) and hypoxia (DTHYP). The physical exercise consisted of 20min cycling at a "hard" perceived effort, and the cognitive task consisted of 15min sustained attention to response time task (SART). Concurrent psycho-physiological measurements included: quadriceps neuromuscular fatigue (peripheral/central components from femoral nerve electrostimulation), prefrontal cortex (PFC) oxygenation by near-infrared spectroscopy, and perception of effort. SART performance significantly decreased in DTNOR (-15.7 ± 15.6%, P < 0.01) and DTHYP (-26.2 ± 16.0%, P < 0.01) compared to CTLCOG (-1.0 ± 17.7%, P = 0.61). Peripheral fatigue similarly increased across conditions, whereas the ability of the central nervous system to activate the working muscles was impaired similarly in DTNOR (-6.1 ± 5.9%, P < 0.001) and DTHYP (-5.4 ± 7.3%, P < 0.001) compared to CTLEX (-1.1 ± 0.2%, P = 0.52). Exercise-induced perception of effort was higher in DTHYP vs. DTNOR and in DTNOR vs. CTLEX. This was correlated with cognitive impairments in both normoxia and hypoxia. PFC deoxygenation was more pronounced in DTHYP compared to DTNOR and CTLEX. In conclusion, performing a sustained attention task together with physically challenging cycling exercise promotes central neuromuscular fatigue and impairs cognitive accuracy; the latter is particularly noticeable when the CMDT is performed in hypoxia.

Intrasubject variability of sustained attention is associated with elevated self-reported attention deficits in women with a fragile X premutation allele.

Women with a fragile X premutation (PM) self-report higher rates of attention difficulties than women without a PM; however, results of studies using objective measures of attention are inconsistent. The present study assessed whether intrasubject variability during a sustained attention task better predicted functional outcomes in women with a PM than the previously published standard reaction time and accuracy variables. We analyzed continuous performance test, a computerized measure of sustained attention, and the Conners' Adult Attention-Deficit/Hyperactivity Disorder Rating Scale Report (CAARS) data from 273 women with a PM and 175 women without a PM aged 18-50 years. Separate analyses using Pearson correlations and independent t tests were performed on the full range of coefficient of variation (CV) of reaction time scores and the subset of scores that showed higher variability. Performance variability of sustained attention measured by the continuous performance test was associated with functional outcomes measured by the CAARS in women with a PM but not women without a PM. Specifically, the CV in those with higher variability was correlated with two CAARS subscale scores (p = .006). Independent t tests showed significant differences in CV between CAARS scores dichotomized for the presence of subclinical symptoms for two subscales (p ≤ .001-.007). Correlation between the full range of CV scores and the CAARS Inattention/Memory Problems subscale approached significance (p = .012). Findings highlight the importance of including intrasubject variability in analyzing attention in clinical populations as a more sensitive objective measure associated with reported symptoms and to assist in predicting functional outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Sensitivity to and Control of Distraction: Distractor-Entrained Oscillation and Frontoparietal EEG Gamma Synchronization.

While recent advancements have been made towards a better understanding of the involvement of the prefrontal cortex (PFC) in the context of cognitive control, the exact mechanism is still not fully understood. Successful behavior requires the correct detection of goal-relevant cues and resisting irrelevant distractions. Frontal parietal networks have been implicated as important for maintaining cognitive control in the face of distraction. The present study investigated the role of gamma-band power in distraction resistance and frontoparietal networks, as its increase is linked to cholinergic activity. We examined changes in gamma activity and their relationship to frontoparietal top-down modulation for distractor challenges and to bottom-up distractor processing. Healthy young adults were tested using a modified version of the distractor condition sustained attention task (dSAT) while wearing an EEG. The modified distractor was designed so that oscillatory activities could be entrained to it, and the strength of entrainment was used to assess the degree of distraction. Increased top-down control during the distractor challenge increased gamma power in the left parietal regions rather than the right prefrontal regions predicted from rodent studies. Specifically, left parietal gamma power increased in response to distraction where the amount of this increase was negatively correlated with the neural activity reflecting bottom-up distractor processing in the visual area. Variability in gamma power in right prefrontal regions was associated with increased response time variability during distraction. This may suggest that the right prefrontal region may contribute to the signaling needed for top-down control rather than its implementation.

Modulation of the p75NTR during Adolescent Alcohol Exposure Prevents Cholinergic Neuronal Atrophy and Associated Acetylcholine Activity and Behavioral Dysfunction.

Binge alcohol consumption during adolescence can produce lasting deficits in learning and memory while also increasing the susceptibility to substance use disorders. The adolescent intermittent ethanol (AIE) rodent model mimics human adolescent binge drinking and has identified the nucleus basalis magnocellularis (NbM) as a key site of pathology. The NbM is a critical regulator of prefrontal cortical (PFC) cholinergic function and attention. The cholinergic phenotype is controlled pro/mature neurotrophin receptor activation. We sought to determine if p75NTR activity contributes to the loss of cholinergic phenotype in AIE by using a p75NTR modulator (LM11A-31) to inhibit prodegenerative signaling during ethanol exposure. Male and female rats underwent 5 g/kg ethanol (AIE) or water (CON) exposure following 2-day-on 2-day-off cycles from postnatal day 25-57. A subset of these groups also received a protective dose of LM11A-31 (50 mg/kg) during adolescence. Rats were trained on a sustained attention task (SAT) and behaviorally relevant acetylcholine (ACh) activity was recorded in the PFC with a fluorescent indicator (AChGRAB 3.0). AIE produced learning deficits on the SAT, which were spared with LM11A-31. In addition, PFC ACh activity was blunted by AIE, which LM11A-31 corrected. Investigation of NbM ChAT+ and TrkA+ neuronal expression found that AIE led to a reduction of ChAT+TrkA+ neurons, which again LM11A-31 protected. Taken together, these findings demonstrate the p75NTR activity during AIE treatment is a key regulator of cholinergic degeneration.

Sustained attention operates via dissociable neural mechanisms across different eccentric locations.

In primates, foveal and peripheral vision have distinct neural architectures and functions. However, it has been debated if selective attention operates via the same or different neural mechanisms across eccentricities. We tested these alternative accounts by examining the effects of selective attention on the steady-state visually evoked potential (SSVEP) and the fronto-parietal signal measured via EEG from human subjects performing a sustained visuospatial attention task. With a negligible level of eye movements, both SSVEP and SND exhibited the heterogeneous patterns of attentional modulations across eccentricities. Specifically, the attentional modulations of these signals peaked at the parafoveal locations and such modulations wore off as visual stimuli appeared closer to the fovea or further away towards the periphery. However, with a relatively higher level of eye movements, the heterogeneous patterns of attentional modulations of these neural signals were less robust. These data demonstrate that the top-down influence of covert visuospatial attention on early sensory processing in human cortex depends on eccentricity and the level of saccadic responses. Taken together, the results suggest that sustained visuospatial attention operates differently across different eccentric locations, providing new understanding of how attention augments sensory representations regardless of where the attended stimulus appears.

Improved motor skills in autistic children after three weeks of neurologic music therapy via telehealth: a pilot study.

Many autistic children experience motor skill deficits which can impact other areas of functioning, and research on therapeutic interventions for motor skills in autism is in a preliminary stage. Music-based therapies have been used extensively to address motor skills in non-autistic populations. Though a handful of studies exist on the effects of music-based therapies for movement in autistic children, none have investigated the possibility of administering sessions via telehealth. This mixed-methods pilot study investigated whether nine Neurologic Music Therapy (NMT)® sessions via telehealth would improve motor and attention skills in autistic children. Five autistic children between five and 10 years of age participated in the study, with support from their caregivers. Motor skills were assessed using the Bruininks-Oseretsky Test of Motor Proficiency second edition, short form (BOT-2 SF), and a selective attention and sustained attention task were taken from the Test of Everyday Attention for Children, Second Edition (TEA-Ch2). Caregivers and the two neurologic music therapists involved in the study provided qualitative input about the perceived effectiveness of telehealth NMT for the children involved. Their responses were analyzed using qualitative content analysis. Caregivers also filled out a Sensory Profile 2 assessment prior to the onset of sessions so that each child's sensory profile could be compared to their motor and attention results. Statistically significant improvements in motor skills were observed between pre-test assessment and a two-week follow-up assessment. Results from attention test scores were not significant. Caregivers and neurologic music therapists generally perceived sessions positively and noted the importance of having caregivers actively involved. When compared with individual progress on the BOT-2 SF assessment, sensory profile results revealed that children with fewer sensory sensitivities tended to improve the most on motor skills. The improvements in motor skills and positive caregiver and therapist views of telehealth indicate that NMT motor interventions administered via telehealth are a promising avenue of therapeutic support for movement skill development in autistic children.

Extended wakefulness alters the relationship between EEG oscillations and performance in a sustained attention task.

During drowsiness, maintaining consistent attention becomes difficult, leading to behavioural lapses. Bursts of oscillations in the electroencephalogram (EEG) might predict such lapses, given that alpha bursts increase during inattention and theta bursts increase with time spent awake. Paradoxically, however, alpha bursts decrease with time awake and theta bursts increase during focussed attention and cognitive tasks. Therefore, we investigated to what extent theta and alpha bursts predicted performance in a sustained attention task, either when well rested (baseline, BL) or following 20 h of extended wakefulness (EW). High-density EEG was measured in 18 young adults, and the timing of bursts was related to trial outcomes (fast, slow, and lapse trials). To increase the likelihood of lapses, the task was performed under soporific conditions. Against expectations, alpha bursts were more likely before fast trials and less likely before lapses at baseline, although the effect was substantially reduced during extended wakefulness. Theta bursts showed no significant relationship to behavioural outcome either at baseline or extended wakefulness. However, following exploratory analyses, we found that large-amplitude theta and alpha bursts were more likely to be followed by lapse trials during extended wakefulness but not baseline. In summary, alpha bursts during baseline anticipated better trial outcomes, whereas large-amplitude theta and alpha bursts during extended wakefulness anticipated worse outcomes. Therefore, neither theta nor alpha bursts maintain a consistent relationship with behaviour under different levels of overall vigilance.

Translational validity of neuropsychological tasks of sustained attention between rodents and humans: A systematic review of three rodent tasks.

Atypical sustained attention is a symptom in a number of neurological and psychological conditions. Investigations into its neural underpinnings are required for improved management and treatment. Rodents are useful in investigating the neurobiology underlying atypical sustained attention and several rodent tasks have been developed for use in touchscreen testing platforms that mimic methodology used in human clinical attention assessment. This systematic review was conducted to assess how translatable these rodent tasks are to equivalent clinical human tasks. Studies using the rodent Continuous Performance Task (rCPT), Sustained Attention Task (SAT), and 5-choice CPT (5C-CPT) were sought and screened. Included in the review were 138 studies, using the rCPT (n = 21), SAT (n = 90), and 5C-CPT (n = 27). Translatability between rodent and human studies was assessed based on (1) methodological similarity, (2) performance similarity, and (3) replication of results. The 5C-CPT was found to be the most translatable cross-species paradigm with good utility, while the rCPT and SAT require adaptation and further development to meet these translatability benchmarks. With greater replication and more consistent results, greater confidence in the translation of sustained attention results between species will be engendered.

The role of mood and arousal in the effect of background music on attentional state and performance during a sustained attention task

Across two online experiments, this study explored the effect of preferred background music on attentional state and performance, as well as on mood and arousal, during a vigilance task. It extended recent laboratory findings—showing an increase in task-focus and decrease in mind-wandering states with music—to environments with more distractions around participants. Participants—people who normally listen to background music during attention-demanding tasks—completed the vigilance task in their homes both with and without their chosen music and reported their attentional state, subjective arousal, and mood valence throughout the task. Experiment 1 compared music to relative silence and Experiment 2 compared music against the backdrop of continuous noise to continuous noise alone. In both experiments, music decreased mind-wandering and increased task-focus. Unlike in previous laboratory studies, in both experiments music also led to faster reaction times while increasing low-arousal external-distraction states. Importantly, mood and arousal increased with music and were shown to mediate its effects on reaction time and for the first time attentional state, both separately and together. Serial mediation effects were mostly confined to models where mood was entered first and arousal second and were consistent with the mood-arousal account of the impact of background music listening.

The non-visual effects of correlated color temperature on the alertness, cognition, and mood of fatigued individuals during the afternoon

Railway dispatchers are prone to mental fatigue due to prolonged periods of intense concentration. As the main or even the only light source in the enclosed control centers, artificial lighting has non-visual effects on human alertness, cognition, and mood. To investigate whether external environmental cues could counteract performance decline induced by endogenous cardiac exhaustion, the current study modulated four correlated color temperature (CCT) levels and developed one visual task and six cognitive tasks representing basic and advanced cognitive functions, including sustained attention, response inhibition, working memory, risk decision-making, executive control, and emotion perception. A within-subjects design was employed to collect subjective and behavioral responses under both normal and fatigued mental antecedent states. Electroencephalogram (EEG) with alpha and theta bands as well as four fatigue-related algorithms including θ/β, α/β, (θ+α)/β, and (θ+α)/(α+β) were analyzed to explore the underlying neural mechanisms behind these responses. The results indicated a complex interactive pattern of CCT and mental antecedent state on alertness, cognition, and mood. Higher CCT had a supportive effect on subjective alertness and positive mood, independent of mental antecedent state. However, it exhibited a slight performance-impairing effect on sustained attention tasks. Conversely, higher CCT demonstrated a significant enhancement in advanced cognitive functions for fatigued individuals. EEG data revealed alpha oscillations increased, but theta activity and (θ + α)/β suppressed at 12,000 K, suggesting higher CCT partially alleviated the decline in alertness and cognition induced by mental fatigue. To develop an appropriate photobiological lighting scheme for fatigue intervention, larger and longer-term studies are needed in the future to measure a range of confounding factors and individual differences.

Neuropsychological functioning of pediatric patients with long COVID

Objective: To determine the neurocognitive profile for youth with long COVID presenting with cognitive concerns. Method: This study is a case series of 54 pediatric patients (65% female, M age = 13.48, SD age = 3.10, 5–19) with long COVID who were referred for neuropsychological testing from a post-COVID-19 multidisciplinary clinic. The outcomes of interest were neuropsychological test scores and parent ratings of mood, attention, and executive functioning. The percentage of patients with neuropsychological test scores below the 9th percentile (below average range) and those with at-risk or clinically significant scores (T-scores > 59) on parent-informant inventories were computed. Results: A portion of children with long COVID showed weaknesses in sustained attention (29%) and divided attention (35%). This portion of patients did not significantly differ when comparing patients with and without pre-existing attention and mood concerns. A high percentage of parents reported at-risk to clinically significant concerns for cognitive regulation (53%), depression (95%), anxiety (85%), and inattention (66%) on standardized questionnaires. Conclusions: The present case series showed that approximately a third of children with long COVID demonstrate objective weaknesses on sustained and divided attention tasks but were largely intact in other domains of neuropsychological functioning. Importantly, children with long COVID had similar difficulties in attention, regardless of pre-existing attention or mood concerns. Parents reported high rates of mood, anxiety, and executive functioning difficulties which likely impact daily functioning. Attention and emotional regulation should be closely monitored and treated as necessary in pediatric patients with long COVID to aid functional recovery.