Pharmacologically induced changes in arousal: effects on behavioral and electrophysiologic measures of alertness and attention

Oken, Barry; Kishiyama, Shirley S.; Salinsky, Martin

doi:10.1016/0013-4694(95)00124-h

Cited by 44 publications

(28 citation statements)

References 74 publications

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“…Past studies have indicated that diphenhydramine produces changes in EEG signals that are similar to those associated with increased drowsiness (Oken et al 1995). The data from the current experiment are consistent with this view.…”

Section: Changes In Neurophysiological Activity Following Treatment Wsupporting

confidence: 89%

“…In the current study we found that responses were significantly slower and less accurate following ingestion of diphenhydramine relative to the other test conditions. Similar effects have been observed in prior studies that have examined performance following diphenhydramine administration in subject populations and under dosing ranges and procedural conditions approximating those in the current study (Fine et al 1994b;Oken et al 1995;Rice and Snyder 1993;Tharion et al 1994). Of particular interest is the observation that the behavioral impairment produced by 50 mg of diphenhydramine was substantially greater than the behavioral change observed following a dose of alcohol adequate to raise blood alcohol to the Figure 7.…”

Section: Changes In Task Performance Following Treatment With Caffeinsupporting

confidence: 81%

“…Since these changes occurred independently of the task demands placed on the subject, they are unlikely to reflect specific changes in the way that attentional resources were allocated to the tasks. Rather, the general increase in rhythmic EEG activity following alcohol ingestion observed here and in other studies (Cohen et al 1993;Davis et al 1941;Gevins and Smith 1999;Lukas et al 1986) suggests that acute treatment with alcohol changes the intrinsic oscillatory properties of cortical neurons.Past studies have indicated that diphenhydramine produces changes in EEG signals that are similar to those associated with increased drowsiness (Oken et al 1995). The data from the current experiment are consistent with this view.…”

supporting

confidence: 89%

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Tracking the Cognitive Pharmacodynamics of Psychoactive Substances with Combinations of Behavioral and Neurophysiological Measures

Gevins

Smith

McEvoy

2002

Neuropsychopharmacology

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Many common pharmacological treatments have effects on cognitive ability. Psychometric task batteries used to characterize such effects do not provide direct information about treatment-related changes in brain function. Since overt task performance reflects motivation and effort as well as ability, behavioral measures alone may overestimate or underestimate the impact of a pharmacological intervention on brain function. Here we present a method that combines behavioral and neurophysiological measures in an attemptMany medications affect performance, attention, and alertness. The most common such side effect is sedation (Ramaekers 1998). Patients complain of somnolence, drowsiness, inability to concentrate, and diminished energy. On testing they tend to demonstrate diminished speed and accuracy of psychomotor and cognitive performance (Ramaekers 1998). Psychoactive medications may also impair memory, attention, and concentration in the absence of sedative effects. There is a growing literature on the cognitive side effects of treatments for many types of disorders. For example, recent articles have described acute cognitive impairments associated with interferon-␣ treatment (Valentine et al. 1998), chemotherapy (van Dam et al. 1998, antianxiety treatments (Sumner 1998), and treatment for allergies (Fireman 1997).A major problem in determining whether and to what extent drugs produce cognitive effects is that there are no standard effective means for objectively assessing cognitive impairments associated with pharmacological treatments. This lack of a clinical standard has 26 , NO . 1 been cited as a major confounding factor in the discrepancies between the results of different clinical trials (Vermeulen and Aldenkamp 1995). In most cases performance on an ad hoc battery of rating scales and behavioral tests of cognitive and psychomotor functions is employed. Such tests likely vary widely in their sensitivity. A subtler problem with this approach is the fact that behavior is the end product of many neural systems, some of which may be recruited or adapted in some way to compensate for deficits. That is, an individual might be able to temporarily mobilize the necessary mental resources to perform a cognitive test even when mildly debilitated but not be able to maintain such extra effort over the course of a workday. Conversely, a low level of test performance may reflect motivational rather than ability factors. Hence, in isolation, behavior may not provide an accurate picture of the effects of a medication on cognitive brain function.Electroencephalogram (EEG) data can provide assessments of cognitive changes that complement the information provided by self-report and behavioral measures. When other factors are held constant, EEG signals tend to have high test-retest reliability (McEvoy et al., 2000;Salinsky et al. 1991). Despite this stability under normal conditions, EEG signals can be very sensitive to variations in alertness (Broughton 1982;Gevins et al. 1977;Makeig and Jung 1995;Matousek and Petersen 1983...

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Section: Changes In Neurophysiological Activity Following Treatment Wsupporting

confidence: 89%

Section: Changes In Task Performance Following Treatment With Caffeinsupporting

confidence: 81%

supporting

confidence: 89%

See 1 more Smart Citation

Tracking the Cognitive Pharmacodynamics of Psychoactive Substances with Combinations of Behavioral and Neurophysiological Measures

Gevins

Smith

McEvoy

2002

Neuropsychopharmacology

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“…There was also a temporal dissociation between the profiles of subjective sleepiness and PVT accuracy, with lapses and false responses higher when the patient was objectively, but not subjectively, sleepy. Despite the fact that the repetitive and unchallenging nature of the tasks minimises factors modulating motivation [28], and that the duration and complexity of the present PVT measurement [29] facilitate dissociation between performance and sleepiness, it can be suggested that sleepiness and impaired performance are not physiologically equivalent phenomena in SRBD patients. First, it could be hypothesised that, at the beginning of the disease, a progressive dysfunction in systems underlying attention and alertness would be present, allowing patients to achieve a state of equilibrium in which alertness and performance are maintained at a stable, albeit reduced, level.…”

Section: Discussionmentioning

confidence: 87%

Performance vigilance task and sleepiness in patients with sleep-disordered breathing

Sforza¹,

Haba‐Rubio²,

Bilbao³

et al. 2004

Eur Respir J

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Altered vigilance performance has been documented in patients with sleep-related breathing disorders (SRBDs). Sleep fragmentation, sleepiness, respiratory disturbances and nocturnal hypoxaemia have been suggested as the pathogenesis of these deficits, yet it remains difficult to find a good correlation between performance deficits and the above factors. In the present study, which performance measure better characterised SRBD patients and the main factors implicated in these disturbances were examined.The study group consisted of 152 patients and 45 controls, all examined using a performance vigilance task and subjective sleepiness assessment. Speed and accuracy in the psychomotor vigilance task (PVT) were measured in patients and controls. Objective daytime sleepiness was assessed in the patient group using the maintenance of wakefulness test.In comparison with controls, PVT accuracy rather than speed seems to be affected in SRBD patients, with lapses and false responses significantly greater in patients with more severe objective sleepiness and higher apnoea/hypopnoea index. Although slowing and increased variability in reaction time were associated with shorter sleep latency in the maintenance of wakefulness test, subjective sleepiness, sleep fragmentation, nocturnal hypoxaemia and apnoea/hypopnoea index influenced mainly PVT accuracy.It is concluded that vigilance impairment, sleep fragmentation and severity of disease may partially and differentially contribute to the diurnal performance consequences found in sleep-related breathing disorders. Since the psychomotor vigilance task worsening is more marked in accuracy that in speed, measurement of lapses and false responses would better characterise the degree of diurnal impairment in these patients. It is well known that the main consequence of sleep-related breathing disorders (SRBDs) is excessive daytime sleepiness associated with several adverse effects, including impaired daytime performance [1], neuropsychological dysfunction [2,3] and increased risk of road traffic accidents [4][5][6]. Since the meaning of daytime dysfunction varies between patients and includes not only sleepiness but also reduced capacity to sustain attention and concentration [7], impaired short-term memory [8], and altered verbal learning and fluency [9], more objective measures of vigilance and attention have been developed in SRBD patients, such as the performance vigilance test [10,11] and the Oxford Sleep Resistance (OSLER) test [12]. Using these tests, several studies have shown that patients diagnosed with obstructive sleep apnoea (OSA) syndrome frequently exhibit some degree of performance impairment [7,13,14] that improves after treatment [15,16]. The problem in interpreting these results stems from whether the observed deficit is present in all patients with SRBD, mildto-moderately affected patients being frequently unaware of their alertness deficit and the decrement in their performance. Moreover, from a clinical perspective, unanswered questions remain as to t...

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“…Many other drugs used by people with MS may negatively affect cognitive function as assessed by controlled trials in healthy control subjects, patient groups, or animals. This list includes tricyclic antidepressants, anticholinergics, first generation antihistamines, baclofen, beta-blockers, amantadine, selective serotonin reuptake inhibitors (SSRIs), and benzodiazepines [6][7][11][12][13][14][15][16][17][18][19][20][21]. On the other hand, methylphenidate and related drugs (modafinil) improve some cognitive functions in healthy subjects [11,[22][23].…”

Section: Introductionmentioning

confidence: 99%

Cognition and fatigue in multiple sclerosis: Potential effects of medications with central nervous system activity

Oken

Flegal

Zajdel

et al. 2006

JRRD

Self Cite

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Abstract-To evaluate the potential effects of medications with central nervous system (CNS) activity on cognitive function and fatigue in multiple sclerosis (MS), we performed a retrospective analysis of medication use among 70 subjects with MS who were participating in a clinical trial for evaluation of the effects of yoga and exercise programs on cognition and fatigue. Among these MS subjects, 74% were taking at least one potentially CNS-active medication. These 70 subjects were divided into two groups: those taking at least one CNS-active medication (n = 52) and those not on any medications with potential CNS activity (n = 18). We compared assessments of cognitive function and fatigue using an analysis of covariance. MS subjects on CNS-active medication had greater impairment on measures of processing speed, sustained attention, and fatigue than those not on these medications. While these findings do not establish a causal relationship between medication use and cognitive impairment and fatigue, the data indicate that researchers need to control for use of CNS-active medications when conducting studies of cognitive impairment and fatigue in MS subjects.

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Pharmacologically induced changes in arousal: effects on behavioral and electrophysiologic measures of alertness and attention

Cited by 44 publications

References 74 publications

Tracking the Cognitive Pharmacodynamics of Psychoactive Substances with Combinations of Behavioral and Neurophysiological Measures

Tracking the Cognitive Pharmacodynamics of Psychoactive Substances with Combinations of Behavioral and Neurophysiological Measures

Performance vigilance task and sleepiness in patients with sleep-disordered breathing

Cognition and fatigue in multiple sclerosis: Potential effects of medications with central nervous system activity

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