Vigilance Reaction Research Articles

293 Predictive utility of a brief scale to identify U.S. Army Soldiers who are genetically vulnerable and resilient to sleep loss

Abstract Introduction Sleep loss that is inherent to military operations can lead to cognitive errors and potential mission failure. Single Nucleotide Polymorphisms (SNPs) allele variations of several genes (COMT, ADORA2A, TNFa, CLOCK, DAT1) have been linked with inter-individual cognitive resilience to sleep loss through various mechanisms. U.S. Army Soldiers with resilience-related alleles may be better-suited to perform cognitively-arduous duties under conditions of sleep loss than those without these alleles. However, military-wide genetic screening is costly, arduous, and infeasible. This study tested whether a brief survey of subjective resilience to sleep loss (1) can demarcate soldiers with and without resilience-related alleles, and, if so, (2) can predict cognitive performance under conditions of sleep loss. Methods Six SNPs from the aforementioned genes were sequenced from 75 male U.S. Army special operations Soldiers (age 25.7±4.1). Psychomotor vigilance, response inhibition, and decision-making were tested after a night of mission-driven total sleep deprivation. The Iowa Resilience to Sleeplessness Test (iREST) Cognitive Subscale, which measures subjective cognitive resilience to sleep loss, was administered after a week of recovery sleep. A receiver operating characteristic (ROC) curve was used to determine whether the iREST Cognitive Subscale can discriminate between gene carriers, and a cutoff score was determined. Cognitive performance after sleep deprivation was compared between those below/above the cutoff score using t-tests or Mann-Whitney U tests. Results The iREST discriminated between allele variations for COMT (ROC=.65,SE=.07,p=.03), with an optimal cutoff score of 3.03 out of 5, with 90% sensitivity and 51.4% specificity. Soldiers below the cutoff score had significantly poorer for psychomotor vigilance reaction time (t=-2.39,p=.02), response inhibition errors of commission (U=155.00,W=246.00,p=.04), and decision-making reaction time (t=2.13,p=.04) than Soldiers above the cutoff score. Conclusion The iREST Cognitive Subscale can discriminate between those with and without specific vulnerability/resilience-related genotypes. If these findings are replicated, the iREST Cognitive Subscale could be used to help military leaders make decisions about proper personnel placement when sleep loss is unavoidable. This would likely result in increased safety and improved performance during military missions. Support (if any) Support for this study came from the Military Operational Medicine Research Program of the United States Army Medical Research and Development Command.

Phase II double-blind randomised controlled trial of exogenous administration of melatonin in chronic pain (DREAM—CP): a study protocol

IntroductionChronic pain is prevalent, and approximately half of patients with chronic pain experience sleep disturbance. Exogenous melatonin is licensed to treat primary insomnia and there is some evidence for analgesic...

Does work-induced fatigue accumulate across three compressed 12 hour shifts in hospital nurses and aides?

Fatigue-related impairments in the nursing workforce contribute to a multitude of health, safety, and economic consequences at the individual, organizational and societal levels. Long and compressed work schedules are commonly worked in the healthcare industry, but more research is needed to understand the cumulative effects of multiple work shifts on physiology-based performance outcomes in nurses. The purpose of this study was to compare the effects of a single nursing work shift versus three compressed (one every 24 hours) 12 hour shifts on performance-based fatigue in nurses and aides. Twenty-six fulltime hospital working nurses and aides (age = 36.1 ± 13.3 years) reported to the lab for testing before, immediately after working a single 12 hour shift, and after working three 12 hour shifts in a 72 hour period. Outcome measures included vigilance-based reaction time, lapses of attention, and muscle function assessments (lower and upper body muscle strength, explosive strength and vertical jump performance). All variables except hand grip strength showed a significant decline following the three work shifts. The psychomotor vigilance reaction time and lapses of attention variables also generally showed a significant decline from the end of shift one to the end of shift three, indicting an accumulation of fatigue in these metrics with increasing number of shifts worked. Muscle function variables responded early in the duty cycle, showing a significant decline after a single work shift, but did no further decline by the end of the third shift. These findings use objective measures to substantiate that fatigue impairments occur from working a single 12 hour shift, and in several instances, increase further with more successive work shifts. Caution should be employed by personnel and administrators with work schedules involving multiple compressed 12 hour shifts. Fatigue management strategies may be used to improve risks and consequences from fatigue-related mishaps, and this study reports several variables that appear sensitive to identifying and tracking fatigue in this population.

Acute Post-Prandial Cognitive Effects of Brown Seaweed Extract in Humans.

(Poly)phenols and, specifically, phlorotannins present in brown seaweeds have previously been shown to inhibit α-amylase and α-glucosidase, key enzymes involved in the breakdown and intestinal absorption of carbohydrates. Related to this are observations of modulation of post-prandial glycemic response in mice and increased insulin sensitivity in humans when supplemented with seaweed extract. However, no studies to date have explored the effect of seaweed extract on cognition. The current randomized, placebo-controlled, double-blind, parallel groups study examined the impact of a brown seaweed extract on cognitive function post-prandially in 60 healthy adults (N = 30 per group). Computerized measures of episodic memory, attention and subjective state were completed at baseline and 5 times at 40 min intervals over a 3 h period following lunch, with either seaweed or placebo consumed 30 min prior to lunch. Analysis was conducted with linear mixed models controlling for baseline. Seaweed led to significant improvements to accuracy on digit vigilance (p = 0.035) and choice reaction time (p = 0.043) tasks. These findings provide the first evidence for modulation of cognition with seaweed extract. In order to explore the mechanism underlying these effects, future research should examine effects on cognition in parallel with blood glucose and insulin responses.

Erratum to: Cognitive and mood improvements following acute supplementation with purple grape juice in healthy young adults.

In the original publication of the article, on page 7, paragraph "Discussion", line 12, 'blackcurrant has been observed to increase digit vigilance reaction time' should read as 'blackcurrant has been observed to decrease digit vigilance reaction time'.

Associations between heat exposure, vigilance, and balance performance in summer tree fruit harvesters

BackgroundWe sought to evaluate potential mediators of the relationship between heat exposure and traumatic injuries in outdoor agricultural workers. MethodsLinear mixed models were used to estimate associations between maximum work-shift Wet Bulb Globe Temperature (WBGTmax) and post-shift vigilance (reaction time) and postural sway (total path length) in a cross-sectional sample of 46 Washington State tree fruit harvesters in August–September 2015. ResultsThe mean (SD) WBGTmax was 27.4 (3.2)°C in August and 21.2 (2.0)°C in September. The mean pre-work-shift participant urine specific gravity indicated minimal dehydration. Twenty-four percent of participants exhibited possible excessive sleepiness. There was no association between WBGTmax and post-shift reaction time or total path length. ConclusionsHeat exposure was not associated with impaired vigilance or balance in this study, in which the overall mean (SD) WBGTmax was 25.9 (4.2)°C. However, the study identified opportunities to ensure adequate pre-work-shift hydration and to optimize sleep and work-shift timing in order to reduce occupational injury and heat-related illness risk.

Drivers' Attitude Towards Caffeine Chewing Gum As Countermeasure To Driver Task-Related Fatigue

Abstract: Driver fatigue is one of the major contributors to road accidents. In this study, we refer to task-related fatigue, in contrast to sleep-related fatigue. Sleep-related fatigue decrements in driving performance are related to the circadian rhythm, sleep disorders, and sleep deprivation or restriction. Task-related fatigue depends on driving conditions: active and passive task-related fatigue may arise according to the combination of driving task and driving environment. Active task-related fatigue is related to overload driving conditions, and passive task-related fatigue with underload ones. Several countermeasures have been proposed to face the problem of driver fatigue, such as taking a nap or caffeine beverages. The intake of caffeine has shown the enhancement of vigilance and choice reaction time. Those enhancements have an effect within 5-10 min in a caffeine chewing gum compared with 30 to 45 min in coffee. The enhancement in alertness within 5 min is crucial and potentially can reduce sleep related car accidents. Recent study showed that the caffeine effect is directly related to driving performance in monotonous conditions. In this study, two groups of drivers were asked to provide their preferences on several products that might positively affect their driving performance on long and monotonous conditions. The first group composed of participants that drove a driving simulator and actually consumed the products. The second group was composed of questionnaire responders that were presented with animations replicating the first group's actual driving. Both groups’ participants preferred to consume coffee or regular chewing-gum over caffeine chewing gum when asked at the beginning of the experiment (or survey). Drivers that actually consumed the products changed their attitude in favour of caffeine chewing-gum. On the other hand, the drivers that participated in the survey did not change their attitude, but rather changed their attitude with regards to the safety in using caffeine chewing-gum.

Effects of Sport-Specific Training Intensity on Sleep Patterns and Psychomotor Performance in Adolescent Athletes.

Adolescent student-athletes face time constraints due to athletic and scholastic commitments, resulting in habitually shortened nocturnal sleep durations. However, there is a dearth of research on the effects of sleep debt on student-athlete performance. The study aimed to (i) examine the habitual sleep patterns (actigraphy) of high-level student-athletes during a week of training and academic activities, (ii) ascertain the effects of habitual sleep durations experienced by high-level student-athletes on psychomotor performance, and (iii) examine the impact of sport training intensities on the sleep patterns of high-level student-athletes that participate in low and high intensity sports. Sleep patterns of 29 high-level student-athletes (14.7 ± 1.3 yrs) were monitored over 7 days. A psychomotor vigilance task was administered on weekdays to ascertain the effects of habitual sleep durations. Weekend total sleep time was longer than weekdays along with a delay in bedtime, and waketimes. Psychomotor vigilance reaction times on Monday were faster than on Thursday and Friday, with reaction times on Tuesday also faster than on Friday. False starts and lapses were greater on Friday compared with Monday. There was a negative impact of sleep debt on student-athletes' psychomotor performance.

Effects of short-term quetiapine treatment on emotional processing, sleep and circadian rhythms

Quetiapine is an atypical antipsychotic that can stabilise mood from any index episode of bipolar disorder. This study investigated the effects of seven-day quetiapine administration on sleep, circadian rhythms and emotional processing in healthy volunteers. Twenty healthy volunteers received 150 mg quetiapine XL for seven nights and 20 matched controls received placebo. Sleep-wake actigraphy was completed for one week both pre-dose and during drug treatment. On Day 8, participants completed emotional processing tasks. Actigraphy revealed that quetiapine treatment increased sleep duration and efficiency, delayed final wake time and had a tendency to reduce within-day variability. There were no effects of quetiapine on subjective ratings of mood or energy. Quetiapine-treated participants showed diminished bias towards positive words and away from negative words during recognition memory. Quetiapine did not significantly affect facial expression recognition, emotional word categorisation, emotion-potentiated startle or emotional word/faces dot-probe vigilance reaction times. These changes in sleep timing and circadian rhythmicity in healthy volunteers may be relevant to quetiapine's therapeutic actions. Effects on emotional processing did not emulate the effects of antidepressants. The effects of quetiapine on sleep and circadian rhythms in patients with bipolar disorder merit further investigation to elucidate its mechanisms of action.

The Standardized Field Sobriety Tests (SFST) and measures of cognitive functioning

ObjectiveThe Standardized Field Sobriety Tests (SFST) are utilised widely to assess fitness to drive when law enforcement suspects a driver's ability to drive is impaired, whether by drugs or alcohol. The SFST ostensibly achieve this through assessment of the level of drivers’ cognitive and psychomotor impairment, although no studies have explicitly assessed the relatedness of cognitive ability and performance on the SFST. The current study aimed to assess the relationship between the three components of the SFST with a well validated computerised cognitive battery. MethodA sub-set of 61 placebo condition participants comprised the sample, with 33 females and 28 males (mean age 25.45 years). Correlations between the individual SFST subscales ‘Horizontal Gaze Nystagmus’ (HGN), the ‘One Leg Stand’ (OLS) and the ‘Walk and Turn’ test (WAT) and Cognitive Drug Research (CDR) sub-scales of ‘Quality of Working Memory’, ‘Power of Attention’ and ‘Continuity of Attention’ were analysed using point-biserial correlation. ResultsSixty participants were included for analyses. A weak–moderate positive (five subscales) and a moderate–strong negative (two subscales) association was noted between seven of the nine individual CDR subscales and the SFST subscale of the WAT test (all p<0.05). Individually, a moderate positive association was noted between the sub-scale ‘Nystagmus lack of smooth pursuit’ and ‘digit vigilance reaction time’ and ‘choice reaction time; reaction time’ (both p<0.05) and ‘Nystagmus head move and/or jerk’ and ‘simple reaction time’ (p<0.001). When assessed as a partially composite factor, a comparable association was also noted between the composite score of the SFST subscale ‘Nystagmus head move and/or jerk’ and both (a) simple and (b) digit vigilance reaction time (both p<0.05). No association was noted between any of the individual cognitive variables and the SFST subscale ‘OLS’, or between composite cognitive scores ‘Quality of Working Memory’, ‘Power of Attention’ and ‘Continuity of Attention’ and total SFST scores. DiscussionVariation in some aspects of cognitive performance was found to be moderately and positively correlated with some individual aspects of the SFST; particularly among tasks which assess reaction time. Impairment of these cognitive processes can also contribute to the completion of complex tasks such as driving or the SFST. Complex behavioural tasks such as driving are often severely impaired due to intoxication, and thus in a practical sense, the SFST can still be considered a useful screening tool to identify drug or alcohol impaired drivers.

Summary of the Performance Effects of Sustained Operations

Sustained operations missions are performed in diverse environments. These environments include military command and control, process control, medical practice, and security surveillance. Research on the related fatigue effects of sustained operations is reviewed for each of these diverse environments. For military surge operations, both ground and airborne command and control operators show similar decrements in visual performance as a function of sleep loss. Other decrements include increased number of errors in vigilance tasks and reaction time tasks. In process control experiments, longer shifts resulted in more variance in reaction time to grammatical reasoning tasks. Night shift was associated with slower reaction times. For medicine, many studies compare performance on laboratory tasks across duty days as well as between participants who are rested and those who are not. Decrements occurred in reaction times. In security, both loss of sleep and work at night degrades operator performance.

Seated inversion adversely affects vigilance tasks and suppresses heart rate and blood pressure

Background: Inverted positions may arise with emergencies, work or recreational activities. Vigilance which can involve cognition, attention, and decision making is required for activities of daily living, in addition to the avoidance and escape from life threatening situations. Objective: The purpose of this study was to evaluate the effects of an inverted posture on vigilance, heart rate and blood pressure. Methods: Heart rate (HR) and blood pressure (BP), vigilance tasks (Tower of London (ToL), Selective Attention and Response Competition (SARC), Attention Networks Test (ANT)), anxiety and reaction time were assessed with 8 male subjects in an initial seated upright position, followed an inverted posture and returning to an upright position. Results: TOL was 63.4% and 40.7% slower and SARC was 10.4% and 11.7% slower during the inverted condition compared to the pre- and post-inversion upright assessments (p&lt;0.01). There were no significant changes in ANT. Systolic BP (p&lt;0.0001), diastolic BP (p=0.03), and HR (p&lt;0.01) decreased during inversion, whereas anxiety scores increased 25% and 51% compared to pre- and post-inversion upright conditions. Conclusions: Under inverted conditions, vigilance task capabilities and reaction time were significantly hampered. These decrements could substantially impact responses to emergency situations.

Effects of chewing gum and time-on-task on alertness and attention

RationaleChewing gum has been shown to reliably increase subjective alertness whereas the effects on attention are more variable. It has been suggested that chewing gum only enhances attention when the person has been performing a task for some time.ObjectivesThe current research aimed to investigate if time-on-task trends enhancing effects of chewing gum could be observed in alertness and attention during and following chewing.MethodsStudy 1 used tests of reported mood, including reported mood, and tests of attention (categoric search, focussed attention, simple reaction time, and vigilance). These tasks were performed shortly after the start of chewing. Study 2 examined effects of previous and current chewing on reported alertness and the attention tests.ResultsStudy 1 showed that chewing gum increased reported alertness and hedonic tone and improved performance on the categoric search task. Chewing gum maintained reported alertness across sessions in study 2. In the first experimental session of study 2 gum improved categoric search performance, and during the second session gum broadened focus of attention and quickened vigilance reaction time. This effect on vigilance reaction time was moderated by time-on-task, with an initial negative effect being replaced by a positive effect.DiscussionThe results confirm the robust effect of chewing gum on reported alertness and show that changes in the effects of chewing gum on attention require further investigation. Future research may also determine underlying mechanisms for an alerting effect.

Optimised Anaesthesia to Reduce Post Operative Cognitive Decline (POCD) in Older Patients Undergoing Elective Surgery, a Randomised Controlled Trial

BackgroundThe study determined the one year incidence of post operative cognitive decline (POCD) and evaluated the effectiveness of an intra-operative anaesthetic intervention in reducing post-operative cognitive impairment in older adults (over 60 years of age) undergoing elective orthopaedic or abdominal surgery.Methods and Trial DesignThe design was a prospective cohort study with a nested randomised, controlled intervention trial, using intra-operative BiSpectral index and cerebral oxygen saturation monitoring to enable optimisation of anaesthesia depth and cerebral oxygen saturation in older adults undergoing surgery.ResultsIn the 52 week prospective cohort study (192 surgical patients and 138 controls), mild (χ2 = 17.9 p<0.0001), moderate (χ2 = 7.8 p = 0.005) and severe (χ2 = 5.1 p = 0.02) POCD were all significantly higher after 52 weeks in the surgical patients than among the age matched controls. In the nested RCT, 81 patients were randomized, 73 contributing to the data analysis (34 intervention, 39 control). In the intervention group mild POCD was significantly reduced at 1, 12 and 52 weeks (Fisher’s Exact Test p = 0.018, χ2 = 5.1 p = 0.02 and χ2 = 5.9 p = 0.015), and moderate POCD was reduced at 1 and 52 weeks (χ2 = 4.4 p = 0·037 and χ2 = 5.4 p = 0.02). In addition there was significant improvement in reaction time at all time-points (Vigilance Reaction Time MWU Z = −2.1 p = 0.03, MWU Z = −2.7 p = 0.004, MWU Z = −3.0 p = 0.005), in MMSE at one and 52 weeks (MWU Z = −2.9 p = 0.003, MWU Z = −3.3 p = 0.001), and in executive function at 12 and 52 weeks (Trail Making MWU Z = −2.4 p = .0.018, MWU Z = −2.4 p = 0.019).ConclusionPOCD is common and persistent in older adults following surgery. The results of the nested RCT indicate the potential benefits of intra-operative monitoring of anaesthetic depth and cerebral oxygenation as a pragmatic intervention to reduce post-operative cognitive impairment.Trial RegistrationControlled-Trials.com ISRCTN39503939

The impact of low-frequency stimulation of the pedunculopontine nucleus region on reaction time in parkinsonism

ObjectivesAttentional augmentation and enhanced motor function are potential mechanisms by which stimulation of the region of the pedunculopontine nucleus (PPN) may improve gait in parkinsonism. Here, the authors assess the...

The effects of lunch time napping on habitual nappers’ mental work efficiency in the afternoon and early

30 college students who have the habit of lunch time napping (LTN) participated in experiments under two different conditions: Having lunch time napping and not having lunch time napping. They were asked to complete three tasks in-cluding vigilance reaction, short-term memory, addition arithmetic; their performance was re-corded automatically by computer during 3 dif-ferent periods in the afternoon and early eve-ning. The analysis about the experimental data showed that: as for habitual nappers, midafter-noon nap zone existed, LTN played a very im-portant role in overcoming it, and did great help in enhancing their vigilance in the afternoon and early evening, however, LTN didn’t bring sig-nificant positive effect to executing complex tasks (such as short-term memory and addition task) at the periods of time 16:30-17:30, 20:00- 21:00. Finally, this article discussed the conclu-sions and its significance.

Sympathetic and cardiovascular activity during cataplexy in narcolepsy

Autonomic nervous system activity changes have been described during cataplexy as playing a role in triggering it. To confirm these previous findings, we investigated the time course of sympathetic and cardiovascular activities during cataplexy. We made for the first time microneurographic recordings of 10 cataplectic episodes in three patients with hypocretin-deficient narcolepsy. During microneurography, muscle sympathetic nerve activity (MSNA) was recorded simultaneously with heart rate (HR), respiratory movements, arterial finger blood pressure (BP), electroencephalography, electro-oculogram and superficial electromyogram. Results showed no significant autonomic changes before the onset of the cataplectic episodes. Cataplexy was associated with a significant increase in MSNA and BP compared with baseline, whereas HR was markedly decreased. An irregular breathing pattern mainly characterized by apnea typically occurred during the attacks. In conclusion, our findings did not show significant changes in autonomic activity prior to cataplexy onset, ruling out a triggering role of the autonomic system. However, cataplexy was associated with co-activation of sympathetic and parasympathetic autonomic systems, a pattern reminiscent of that reported during the vigilance reaction in animals.

Poor attentional function predicts cognitive decline in patients with non-demented Parkinson’s disease independent of motor phenotype

Background: Postural instability gait difficulty (PIGD) motor phenotype in Parkinson’s disease (PD) is associated with a faster rate of cognitive decline than in tremor dominant cases and may be a...

The effects of l-theanine, caffeine and their combination on cognition and mood

l-Theanine is an amino acid found naturally in tea. Despite the common consumption of l-theanine, predominantly in combination with caffeine in the form of tea, only one study to date has examined the cognitive effects of this substance alone, and none have examined its effects when combined with caffeine. The present randomised, placebo-controlled, double-blind, balanced crossover study investigated the acute cognitive and mood effects of l-theanine (250 mg), and caffeine (150 mg), in isolation and in combination. Salivary caffeine levels were co-monitored. l-Theanine increased ‘headache’ ratings and decreased correct serial seven subtractions. Caffeine led to faster digit vigilance reaction time, improved Rapid Visual Information Processing (RVIP) accuracy and attenuated increases in self-reported ‘mental fatigue’. In addition to improving RVIP accuracy and ‘mental fatigue’ ratings, the combination also led to faster simple reaction time, faster numeric working memory reaction time and improved sentence verification accuracy. ‘Headache’ and ‘tired’ ratings were reduced and ‘alert’ ratings increased. There was also a significant positive caffeine × l-theanine interaction on delayed word recognition reaction time. These results suggest that beverages containing l-theanine and caffeine may have a different pharmacological profile to those containing caffeine alone.

Carnivore Repatriation and Holarctic Prey: Narrowing the Deficit in Ecological Effectiveness

The continuing global decline of large carnivores has catalyzed great interest in reintroduction to restore populations and to reestablish ecologically functional relationships. I used variation in the distribution of four Holarctic prey species and their behavior as proxies to investigate the pace and intensity by which responses are lost or reinvigorated by carnivore repatriation. By simulating the presence of wolves (Canis lupus), tigers (Panthera tigris), and brown bears (Ursus arctos) at 19 transcontinental sites, I assayed three metrics of prey performance in areas with no large terrestrial carnivores (the polar islands of Greenland and Svalbard), extant native carnivores (Eastern Siberian Shield, boreal Canada, and Alaska); and repatriated carnivores (the Yellowstone region and Rocky Mountains). The loss and reestablishment of large carnivores changed the ecological effectiveness of systems by (1) dampening immediate group benefits, diminishing awareness, and diminishing flight reaction in caribou (Rangifer tarandus) where predation was eliminated and (2) reinstituting sensitivity to carnivores by elk (Cervus elaphus) and moose (Alces alces) in the Yellowstone region to levels observed in Asian elk when sympatric with Siberian tigers and wolves or in Alaskan moose sympatric with wolves. Behavioral compensation to reintroduced carnivores occurred within a single generation, but only the vigilance reaction of bison (Bison bison) in Yellowstone exceeded that of their wolf-exposed conspecifics from boreal Canada. Beyond these overt responses by prey, snow depth and distance to suitably vegetated habitat was related to heightened vigilance in moose and elk, respectively, but only at sites with carnivores. These findings are insufficient to determine whether similar patterns might apply to other species or in areas with alien predators, and they suggest that the presumed excessive vulnerability of naïve prey to repatriated carnivores may be ill-founded. Although behavior offers a proxy to evaluate ecological effectiveness, a continuing challenge will be to understand how naïve prey respond to novel or introduced predators.