Tart Montmorency cherries (MC) are a particularly rich source of anthocyanins and other polyphenols that have been shown to elicit antioxidant, anti-inflammatory and vasomodulatory actions. The current study aimed to determine the influence of chronic MC supplementation on cognitive function and mood. In a 3-month double-blinded, placebo-controlled parallel study, middle-aged adults (mean ± sd: 48 ± 6 years) were randomly assigned to either 30 ml twice daily of MC (n 25) or the same amount of an isoenergetic placebo (n 25). Cognitive function and mood were assessed before and after supplementation using a computerised cognitive task battery and visual analogue scales. Cerebral blood flow was also monitored by near-infrared spectroscopy during the task battery, and questionnaires were administered to determine subjective sleep and health status and plasma metabolomics were analysed before and after supplementation. After 3 months, the MC resulted in higher accuracy in digit vigilance (mean difference: 3·3, 95 % CI: 0·2, 6·4 %) with lower number of false alarms (mean difference: −1·2, 95 % CI: −2·0, −0·4) compared with the placebo. There was also a treatment effect for higher alertness (mean difference: 5·9, 95 % CI: 1·3, 10·5 %) and lower mental fatigue ratings (mean difference −9·5, 95 % CI: −16·5, −2·5 %) with MC. Plasma metabolomics revealed an increase in a number of amino acids in response to MC intake, but not placebo. These data suggest an anti-fatiguing effect of MC supplementation as well as the ability to improve sustained attention during times of high cognitive demand, this could be related to changes in amino acid metabolism.

The use of benzodiazepines seems to be associated with a deficit in the levels of arousal and attention during vigil. A number of studies have found residual effects a few hours after the intake of these drugs. This paper assesses the effects of a single dose of 10 mg diazepam on self-informed arousal (as evaluated with the Stanford Sleepiness Scale) and sustained attention (as evaluated with the Toulouse Piéron test) the morning after oral intake (11 hours later). Potential differences in the residual effects of benzodiazepines on men and women were also examined. A sample of 42 healthy young university students (21 female, 21 male) was exposed to three counterbalanced experimental conditions (control, placebo, diazepam). Diazepam only caused a reduction in arousal in women, and this deficit was similar to that caused by the intake of a placebo.

Attention is a complex cognitive function that is necessary for learning, for following social norms of behaviour and for effective performance of responsibilities and duties. It is especially important in sensitive occupations requiring sustained attention. Improvement of dietary diversity (DD) is recognised as an important factor in health promotion, but its association with sustained attention is unknown. The aim of this study was to determine the association between auditory and visual sustained attention and DD. A cross-sectional study was carried out on 400 women aged 20–50 years who attended sports clubs at Tehran Municipality. Sustained attention was evaluated on the basis of the Integrated Visual and Auditory Continuous Performance Test using Integrated Visual and Auditory software. A single 24-h dietary recall questionnaire was used for DD assessment. Dietary diversity scores (DDS) were determined using the FAO guidelines. The mean visual and auditory sustained attention scores were 40·2 (sd 35·2) and 42·5 (sd 38), respectively. The mean DDS was 4·7 (sd 1·5). After adjusting for age, education years, physical activity, energy intake and BMI, mean visual and auditory sustained attention showed a significant increase as the quartiles of DDS increased (P=0·001). In addition, the mean subscales of attention, including auditory consistency and vigilance, visual persistence, visual and auditory focus, speed, comprehension and full attention, increased significantly with increasing DDS (P<0·05). In conclusion, higher DDS is associated with better visual and auditory sustained attention.

Lazzaretti M, Morandotti N, Sala M, Isola M, Frangou S, De Vidovich G, Marraffini E, Gambini F, Barale F, Zappoli F, Caverzasi E, Brambilla P. Impaired working memory and normal sustained attention in borderline personality disorder.

Objective: Although reports in the literature describe deficits in working memory in borderline personality disorder (BPD), the evidence is limited and inconsistent. The aim of this study was to evaluate further this cognitive dimension and its clinical correlates in BPD.

Method: We compared the performance of 15 BPD patients to 1:1 matched healthy controls on verbal working memory as determined by the sequential letter N-back test and sustained attention as measured using the continuous performance test (CPT).

Results: BPD patients performed significantly worse on the N-back test compared to healthy controls (p < 0.05), but not on the CPT. The N-back deficit was more pronounced and significant in the 3-back condition and inversely correlated with impulsivity.

Conclusions: These results suggest the presence of working memory deficits in BPD that may be linked to greater impulsivity and sustained by impairment in the dorsolateral prefrontal cortex.

Although it is widely known that high intra-individual variability (IIV) is a key characteristic of attention deficit/hyperactivity disorder (ADHD), a detailed exploration of the IIV pattern during the time course of a cognitive task has never been carried out. In this study, 30 children with ADHD and 30 controls, were administered the Conners’ Continuous Performance Task (CPT-II). The across-block individual performance of the groups was analyzed using an ex-Gaussian approach, which enabled a clearer understanding of how individual response times (RTs) fluctuate during a task in comparison with conventional measures of central tendency. While the conventional measures showed a significant group effect on mean RTs but similar RT trends across blocks between the two groups, the ex-Gaussian results revealed no actual differences between the two groups in the normally distributed component of mean RTs (mu). In contrast to the control group, the children with ADHD showed a steep increase in the exponentially distributed component of RTs (tau) across blocks, thereby indicating that extremely long RTs progressively increased soon after the beginning of the task. Taken together, the results demonstrated that sustained attention deficit in ADHD can be detected by analyzing the IIV in the first few task blocks. (JINS, 2013, 19, 1–9)

Poor insight is associated with impaired cognitive function in psychosis. Whether poor clinical insight overlaps with other aspects of self-awareness in schizophrenia, such as cognitive self-awareness, is unclear. We investigated whether awareness of clinical state (“clinical insight”) and awareness of cognitive deficits (“cognitive insight”) overlap in schizophrenia in a sample of 51 stabilized patients with chronic schizophrenia. Cognitive insight was assessed in terms of the agreement between subjective self-report and neuropsychological assessment. Patients who show good cognitive insight did not necessarily show good clinical insight. By contrast, self-report and objective neuropsychological assessment only correlated for patients in the intact clinical insight group and not for those in the impairment clinical insight group. We conclude that while good cognitive insight may not be necessary for good clinical insight, good cognitive awareness is at least partly reliant on the processes involved in clinical insight. (JINS, 2009, 15, 471–475.)

Poor cardiac pumping efficiency has shown to lead to cognitive impairments in patients with cardiovascular disease (CVD). The current study examined the relationship between left ventricular ejection fraction and sustained attention and inhibitory processes measured by the Adaptive Rate Continuous Performance Task and the Go/No-go test. Participants were 67 older outpatients (age 68.5 ± 7.4) with a range of CVD. Associations between cognition and ejection fraction were examined via linear regression analysis. Results were consistent with the hypothesis that lower ejection fraction is significantly associated with decrements in sustained attention and vigilance. Overall, the results provide support for the hypothesis that a change in cardiac pumping leads to decrements in some aspects of attention; however, inhibitory processes are relatively spared. (JINS, 2009, 15, 137–141.)

The pharmacological, stimulus expectancy, and response expectancy effects of light cigarettes (0.60 mg yield of nicotine) compared with virtually nicotine-free cigarettes (less than 0.05 mg yield of nicotine) were examined using a between-subjects design. A total of 103 college student smokers completed tests of cognition before and after smoking one type of cigarette, which was evaluated on a number of dimensions. Cigarettes with nicotine were preferred on most dimensions, and stimulus expectancy partially mediated the relationship between nicotine and subjective effects of the cigarettes. Stimulus expectancy also mediated the effect of nicotine on tension reduction immediately after smoking, but not near the end of the experiment. Response expectancy effects of nicotine were related to predicted and actual recall performance, such that participants who performed well tended to attribute the effect to the cigarette they smoked. Implications for smoking cessation and research studies using non-nicotine cigarettes are discussed.

Attentional impairments in children occur in the context of both developmental and acquired disorders involving the central nervous system (CNS) and may have implications for ongoing development, potentially impeding cognitive, educational, and behavioral functions. Using a continuous performance paradigm (CPT), this study compared attentional profiles of children with developmental and acquired conditions impacting on the CNS: (i) attention deficit–hyperactivity disorder (ADHD: n = 27); (ii) moderate traumatic brain injury (TBI: n = 41); (iii) acute lymphoblastic leukemia (n = 31); and (iv) insulin-dependent diabetes mellitus (n = 39). A healthy control group (n = 46) was also examined. Groups were compared on measures of sustained attention, selective attention, and response inhibition. In addition, measures of performance variability and deterioration and processing speed were examined. Results showed that children with ADHD exhibited global and severe attentional impairments in contrast to all other groups. Children with moderate TBI displayed mild attentional difficulties, restricted to selective and sustained attention domains. In conclusion, although CPT parameters differentiated the ADHD group from all others, a disorder-specific profile was not observed. (JINS, 2006, 12, 519–531.)

We hypothesized that patterns of sustained attention performance in bipolar disorder were consistent with processing efficiency theory—a theory of the relationship between central processing capacity and performance. We predicted (1) sustained attention deficits during mania because symptoms interfere with limited-capacity executive control processes resulting in decreased performance effectiveness; and (2) decreased processing efficiency during euthymia, as indicated by speed/accuracy tradeoffs, consistent with a stable phenotypic abnormality. Twenty-five manic bipolar, 23 euthymic bipolar, and 28 healthy comparison participants were compared on a continuous performance task and administered symptom-rating scales. The manic group was significantly impaired on overall perceptual sensitivity and demonstrated a significant linear decrease in performance over time, consistent with impaired sustained attention. The euthymic group evidenced significantly slower overall hit reaction time (RT), but when RT was controlled they performed similarly to the healthy group over time. Two discriminant functions combined to separate the groups on manic symptom severity and on-task effort/strategy use. These findings are consistent with processing efficiency theory. They suggest that euthymic patients sustain attention through effortful control at the expense of processing efficiency, while acute mania reduces the capacity for control and impairs sustained attention. Problems with processing efficiency are viewed as trait characteristics of bipolar disorder that may be overlooked by traditional error-based assessments. (JINS, 2005, 11, 49–57.)