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Effects of working permanent night shifts and two shifts on cognitive and psychomotor performance.

OBJECTIVES: The study aimed to clarify whether cognitive and psychomotor performance, which are important for occupational and traffic safety, are impaired by working permanent night shifts (NSs) compared with early-late two shifts (TSs) and whether age and chronobiological type influences the relationship between shift and performance. METHODS: The study included 44 male automobile workers, 20 working TSs and 24 working NSs. Chronobiological type was determined by questionnaire (D-MEQ). Each subject was tested at the beginning and end of the shift for alertness [by a visual analogue scale (VAS)]; feeling of well-being (Basler); concentration and accuracy (d2); reaction speed, orientation and reaction to stress (Vienna System). RESULTS: TS workers were more frequently morning types whereas the NS workers were more frequently evening types. In the performance tests, the TS and NS workers did not differ at shift start or shift end. Over the course of the shift, concentration and accuracy improved in both groups, as did reaction to stress. Chronobiological type alone or in combination with shift type had no effect on performance. CONCLUSIONS: The results of this study indicate that-if chosen voluntarily-working NSs has no immediate negative effects on cognitive and psychomotor performance when compared with working TSs. There was no indication of an increased risk of accidents after working NSs. The unequal distribution of the circadian types in the shift groups may indicate selection.

Adult↗

Cognition and vigilance: differential effects of diazepam and buspirone on memory and psychomotor performance.

Effects of a single dose of the anxiolytic buspirone (15 mg) on memory and psychomotor performance were studied in healthy volunteers and compared to those of the classic benzodiazepine anxiolytic diazepam (15 mg). The study was performed in a double-blind, placebo-controlled way. Three groups of 12 subjects were exposed to an extended test battery before and after intake of drug or placebo. Next to this, an evaluation session took place 1 week later. Immediately after intake, diazepam exerted major effects on memory, impaired psychomotor performance and decreased alertness. In particular, long-term memory had deteriorated, which was interpreted as anterograde amnesia. One week later, more items were recalled from the predrug session compared to the number of items from the postdrug session; this was interpreted as retrograde facilitation. After intake of buspirone, there were no effects of alertness and vigilance, on psychomotor performance and on memory. One week later, a small memory decrement was noticed for verbal material, which was considered as a sign of anterograde amnesia. These results indicate that effects of anxiolytics on memory can be more easily demonstrated 1 week later than immediately after drug intake and, furthermore, that the disruptive effects of diazepam outweight the small effects of buspirone. Finally, it was established that the effects of diazepam on cognition might be mediated by its effects on alertness and vigilance and that cognitive effects are not related to the anxiolytic properties of the drug.

Adult↗

Effects of acute exposure to mild or moderate hypoxia on human psychomotor performance and visual-reaction time.

Objective. The aim of this study was to determine whether psychomotor performance and visual reaction time were affected by acute exposure to mild or moderate hypoxia. Method. Eighteen healthy male volunteers performed finger tapping, simple reaction time (SRT) and 4-choice reaction time (CRT) tests at simulated altitude of 300 m (control), 2800 m, 3600 m and 4400 m for 1 h in a hypobaric chamber. Result. SaO2 decreased from 98% (control) to 90%, 82% and 74% respectively at the various altitudes. All the performance parameters showed no significant change after exposure to 2800 m for 1 h relative to ground level (P>0.05). However the mean reaction time of 4-CRT under 3600 m prolonged and performance decreased as compared with baseline value (P<0.05), and the performance decreased further under 4400 m (P<0.01). No significant difference was found in finger tapping and SRT even under exposure to 4400 m for 1 h. Furthermore, no decrease in correct rate were observed at any altitude (P>0.05). Conclusion. The results from this study demonstrated that there were no measurable impairment of visual reaction time and psychomotor performance under exposure to an altitude of 2800 m for 1 h. However, adverse effects on psychomotor performance were observed under 3600 m and over.

Adolescent↗

Comparison of the effects of zolpidem and triazolam on memory functions, psychomotor performances, and postural sway in healthy subjects.

Zolpidem is a rapid-onset, short-duration imidazopyridine hypnotic drug and is specific agonist of the omega-1 (BZD1) receptors. Its hypnotic characteristics resemble those of triazolam. The aims of this study were to assess the effects of zolpidem on memory (the main objective), psychomotor performances, and postural sway (secondary objectives) in 18 healthy subjects and to compare them with those of triazolam and placebo. Short- and long-term memory (paired words associate and pictures test), psychomotor performances (critical flicker fusion frequency, choice reaction time, digit symbol substitution test), and postural sway were evaluated before and 1.5, 4, 6, and 8 h after the administration of a single dose of zolpidem (10 mg), triazolam (0.25 mg), and placebo. For each assessment, the maximal effect for both hypnotic drugs occurred 1.5 hour after intake. Both drugs decreased psychomotor performance, impaired memory, and increased postural sway. The effects of both hypnotic agents were short lasting, and no alterations were found 6 and 8 hours, respectively, after drug intake. No clinically relevant differences were found between zolpidem and triazolam for memory, psychomotor performance, postural sway, or adverse effects. It may be concluded that zolpidem, like triazolam, impairs short- and long-term memory, psychomotor performances, and postural sway and that these effects are of short duration.

Adult↗

Effects of brief caffeinated-beverage deprivation on mood, symptoms, and psychomotor performance.

The effects of short-term deprivation of caffeinated beverages on mood, withdrawal symptoms, and psychomotor performance were studied in habitual coffee drinkers. Twenty-four male and female coffee drinkers were tested at midday (1130-1330 h) under two conditions. On one day they consumed caffeinated beverages ad lib prior to testing, and on the other they remained caffeine abstinent. The order of treatments was counterbalanced. Mood and withdrawal symptom reports were collected by questionnaires. Psychomotor performance was tested with a computerized test battery. Caffeinated-beverage deprivation was associated with decreased vigor and increased fatigue and with symptoms including headache. No changes in psychomotor performance were observed. Even short periods of caffeinated-beverage deprivation, equivalent in length to missing regular morning coffee, can produce noticeable unpleasant caffeine-withdrawal symptoms by the middle of the day. These symptoms may be a common side effect of habitual caffeinated beverage consumption.

Adult↗

Effects of minor tranquilizers and antidepressants on psychomotor performance.

Results of laboratory and epidemiologic studies have raised concern that psychotropic drugs may contribute to accidents. This article reviews studies of the effects of minor tranquilizer and antidepressant drugs on psychomotor performance. Data clearly demonstrate that the most commonly prescribed tranquilizer, diazepam, impairs many aspects of psychomotor performance for several hours after dosing, and there is no evidence that behavioral tolerance develops with continued drug use or that patients are differently affected than nonpatients. Lorazepam similarly impairs psychomotor performance. Other frequently prescribed benzodiazepine drugs have not been sufficiently examined to warrant conclusions about their psychomotor effects. A newly marketed nonbenzodiazepine anxiolytic, buspirone, has been shown to have few effects on performance skills. Only one antidepressant, amitriptyline, has been studied thoroughly enough to conclude that it impairs psychomotor performance. The few studies of other, newer antidepressants suggest they may cause less impairment; however, more research is needed to confirm this.

Anti-Anxiety Agents↗

[The effect of a new analgesic, flupirtine, on psychomotor performance in humans].

Psychomotor efficiency was tested on 12 male patients after peroral administration of the analgesically acting monosubstance 2-amino-3-ethoxycarbonyl-amino-6-p-fluorobenzyl aminopyridine (flupirtine, Katadolon) (3 X 100 mg on the previous day and 100 mg before the test) and compared with the peroral administration of diazepam, chlorphenoxamine and a placebo using a combined multiple problem, which tests the fine motor coordination in the peripheral and central field of vision at high vigilance. Compared with the placebo, flupirtine lengthened the reaction time with only slight significance by 2.7 +/- 2.2%, but with significance the mental processing time by 3.0 +/- 1.9%. This sedative effect reached only 41% and 43% respectively of the sedative effect of the antihistamine chlorphenoxamine (80 mg daily dose on the preceding day and 20 mg 1 h before start of the test). Under the hangover effect of diazepam (evenings 10 mg perorally 2 days before and 5 mg perorally on the preceding day) slightly significant shorter times were determined than under flupirtine. Flupirtine does not change the number of standard errors and the uniformity of performance, but it does increase the number of signals overlooked in the experiment, to a considerably lesser degree, however, than chlorphenoxamine. In the hangover of diazepam, the number of standard errors is lower and the number of overlooked signals greater than under flupirtine. The errors and the number of overlooked signals are greatest under chlorphenoxamine.

Aminopyridines↗

Effects of CO2 and N2 partial pressures on cognitive and psychomotor performance.

This study examined N2 and CO2 components of narcosis by comparing the effects of three levels of PETCO2 [low = 29 mmHg (SD = 4 mmHg), medium = 47 mmHg (SD = 1 mmHg), high = 57 mmHg (SD = 2 mmHg)] at 1 and 6 atm abs in 12 male volunteers. Cognitive and psychomotor performances were examined using a variety of tasks, including a modified Stroop test, an arithmetic test, number comparison, a figure copying test, and the Purdue pegboard test. Performance on all tasks demonstrated significant (P less than 0.05) decrements at 6 atm abs. High CO2 tensions significantly impaired cognitive and psychomotor performance at 1 atm abs and caused further decrements at 6 atm abs (P less than 0.05). However, no significant N2-CO2 interaction (P greater than 0.05) or global threshold for the onset of CO2 narcosis was indicated by the test scores. The pattern of intratest results were different for N2 and CO2. At high PETCO2, performance deficits were due to a slowing of performance rather than a disruption of the accuracy of processing. Nitrogen narcosis, conversely, produced significant impairment through both decreases in the speed and accuracy of processing on the majority of performance tests. It was concluded that within the PETCO2 ranges studied: a) PETCO2 and PIN2 are additive in their effects on impaired cognitive and psychomotor performance at depth; b) high PETCO2 and PIN2 induce distinctly different strategic responses on the speed accuracy trade-off function of the performance tests; c) decrements in cognitive and psychomotor performance under high PETCO2 do not conform to the predicted narcotic potency of CO2 according to the lipid solubility theory of narcosis.

Adult↗

The impact of Malarone and primaquine on psychomotor performance.

INTRODUCTION: Recent evidence has established the effectiveness of Malarone and primaquine for chemoprophylaxis against Plasmodium falciparum malaria. Both have the advantage of providing causal prophylaxis and therefore require continued dosing for only 1 wk after departure from a malaria endemic area. Canadian Forces aircrews are often placed in situations that put them at risk for malaria infection but the safety of these drugs for use in aircrew has not been ascertained. This study was undertaken to determine whether or not Malarone or primaquine impact psychomotor performance. METHOD: Twenty-eight subjects (20 men and 8 women) ranging from 21 to 52 yr of age were assessed for psychomotor performance on 2 psychomotor test batteries at the end of a 7-d dosing protocol for each of placebo, Malarone, and primaquine treatment, in a double-blind crossover design with counterbalanced treatment order. All subjects were also assessed for psychomotor performance once per week during the 3-wk washout intervals. The daily Malarone dose was atovaquone 250 mg/proguanil 100 mg and the daily primaquine dose was 30 mg of base. In order to verify subject compliance with the medication dosing protocol, blood samples were drawn from all subjects at the end of each of the three 7-d loading protocols. All three medications were packaged in identical gelatin capsules for blinding purposes. At each psychomotor test session, all subjects completed a drug side-effect questionnaire, a mood questionnaire, and a sleepiness/fatigue questionnaire. RESULTS: There was no significant impact of Malarone or primaquine on serial reaction time, logical reasoning, serial subtraction, or multitask performance. With respect to drug adverse effects there were no significant main effects or interactions for the documented adverse effects of these medications (abdominal cramps, epigastric distress, nausea, vomiting, anorexia, headache, coughing and dizziness). CONCLUSIONS: There was no impact of either Malarone or primaquine on psychomotor performance, mood, sleepiness, or fatigue. The usual adverse effects of these medications were not significantly manifested in our subjects. These findings support the possible use of either Malarone or primaquine in aircrew for malaria chemoprophylaxis.

Adult↗

The effects of clobazam and lorazepam on aspects of psychomotor performance and car handling ability.

1 Laboratory tests of psychomotor performance and 'on road' assessments of car handling ability were made following repeated doses of clobazam 10 mg three times daily, lorazepam 1 mg three times daily and matching placebo 1 capsule three times daily. 2 Both active compounds produced on impairment, compared to placebo, in some mental arithmetic and letter cancellation tasks, but these effects were neither widespread nor consistent. 3 Lorazepam produced a significant impairment of car driving tasks and analogue rating scales of subjective alertness. The pronounced sedative activity of the drug was also shown in the verbal reports of side effects and in indices of early morning sedation derived from the Leeds Sleep Evaluation Questionnaire. 4 Clobazam did not produce either the objective, or the subjective impairment of performance and alertness found with lorazepam. 5 The results taken as a whole show important differences between the 1,4 benzodiazepine, lorazepam, and the 1,5 benzodiazepine, clobazam, in their effects on the integrity of psychomotor performance related to car driving ability.

Adult↗

Effects of highly active antiretroviral therapy (HAART) on psychomotor performance in children with HIV disease.

OBJECTIVE: This study assesses the effects of HAART on psychomotor performance of symptomatic HIV-infected children. It is one of the first studies to look at neurobehavioral functioning in children infected with HIV in resource-limited countries. DESIGN: A longitudinal pilot study of vertically HIV-infected children at the HIV Netherlands Australia Thailand Research Collaboration Center in Bangkok, Thailand. METHODS: A total of 34 children participated in the study of whom 16 had never received antiretroviral (ARV) therapy and were about to start HAART (Newly treated children), 7 did not receive antiretroviral therapy (Untreated children) and 11 had been treated with HAART for more than one year (HAART experienced children). All children were administered 4 psychomotor tasks at baseline and after 4 months. The Newly treated and the Untreated children were also evaluated after 12 months. RESULTS: In general, the children performed similarly on all psychomotor tasks at baseline. After 12 months of HAART, there was a significant increase in CD4% in the Newly treated group. Overall, psychomotor performance did not change at the 4-month evaluation in all groups. At the 12-month evaluation psychomotor performance had deteriorated substantially on all tasks in both the Newly treated and the Untreated children. CONCLUSIONS: There was no significant difference in psychomotor functioning between children newly treated, previously treated and untreated with HAART over the course of one year. Psychomotor performance deteriorated after 12 months of HAART, which provides important indications concerning the lack of benefits of HAART on psychomotor functions in children despite immunologic reconstitution. Further research with larger sample sizes is needed to confirm these findings.

Analysis of Variance↗

Acute and subacute effects on psychomotor performance of femoxetine alone and with alcohol.

The effects on human psychomotor performance of femoxetine (FEMO), a 5-hydroxytryptamine-selective antidepressant, alone and in combination with alcohol (EtOH) were compared with those of amitriptyline (AMI) and placebo in a controlled double-blind crossover trial in 11 student volunteers. Objective measurements (body sway, choice reaction, flicker fusion, tracking, nystagmus, digit symbol substitution, backwards recall) and subjective self-assessment (visual analogue scales, reporting of side-effects) were done after single doses of FEMO, AMI and placebo, and subacute administration of FEMO and placebo. Single doses of 200 mg FEMO did not impair psychomotor performance, but 50 mg AMI did so in several respects. AMI but not FEMO increased the objective and subjective effects of EtOH. After FEMO 600 mg/d for 10 days almost no objective difference from placebo was noted, although mild sedation at home was reported as a side-effect. FEMO either did not increase or slightly decreased the effect of EtOH on reactive and co-ordination skills. The plasma concentrations of FEMO varied widely from 0 to 156 ng/ml, as in previous clinical trials but reduced a blood 5-hydroxytryptamine concentration in each subject indicating an effect of FEMO on serotoninergic mechanisms.

Adult↗

A review of the effects of diazepam on cognitive and psychomotor performance.

Studies evaluating the effects of diazepam (Valium) on psychomotor and cognitive functions are reviewed an integrated. The importance of the full and clear documentation of such drug effects lies in the wide usage of diazepam today for a variety of medical, psychiatric, and dental purposes. The various tasks used to assess drug effects were classified into six major groups based on apparent similarity of functions tapped. These groupings are: reflex speed; critical flicker fusion threshold; attention and vigilance; decision making; learning and memory; psychomotor performance. In all functions except simple reflexive responding; some indications of impaired performances were reported, the results being most definitive for the critical flicker fusion where even small doses lowered the threshold and for a slower performance on letter cancellation tasks. There appeared to be some interaction between diazepam and alcohol although the nature of this interaction is still unclear. Because of the extensive use of both of these drugs and the possibility of a synergistic or a potentiation effect, it is important that this area receive further study. It was suggested that future studies either control for or analyze the data to assess the possible interactive effects of diazepam with subject variables such as sex, personality type, and for population characteristics. These variables have been shown to affect responses in other studies and hence could also interact with cognitive and psychomotor performance. It was noted that most of the studies reviewed used normal, healthy, male volunteer subjects and may not be comparable to the clinical populations for whom the drug is typically prescribed.

Attention↗

Pharmacokinetics and psychomotor performance of alprazolam: concentration-effect relationship.

The relationship between the pharmacokinetics of alprazolam and dose and the relationship between the concentration of alprazolam and psychomotor performance in healthy male volunteers were investigated in this double-blind, placebo-controlled, modified crossover study. Twenty-four volunteers received placebo in Phase I and then received single 2-mg, 4-mg, 8-mg, and 10-mg doses of a sustained-release formulation in Phases II through V, according to, a crossover design. Blood samples were collected at several times throughout each phase to 48 hours after the dose; the harvested plasma was assayed for concentrations of alprazolam, 4-hydroxyalprazolam, and alpha-hydroxyalprazolam by high-performance liquid chromatography. Sedation was rated at each blood-sampling time and psychomotor performance tests, consisting of digit-symbol substitution and card-sorting tasks, were conducted at several times after each dose. Area under the concentration-time curve and peak concentration for alprazolam increased proportionally with each higher dose; clearance did not differ significantly between treatments. The concentrations of 4-hydroxyalprazolam and alpha-hydroxyalprazolam increased proportionally with dose and the combined plasma concentration of the metabolites were less than 15% of unchanged concentrations of alprazolam for all doses. Maximum sedation increased with each increase in dose up to 8 mg, and psychomotor performance decreased with each increase in dose. Performance versus concentration curves for alprazolam exhibited a clockwise hysteresis loop in contrast to the counterclockwise hystereses previously reported for both intravenous and oral doses of immediate-release tablets. Data through 6 hours after dose were well described by a sigmoid Emax model. Alprazolam exhibits linear pharmacokinetics after single oral doses of sustained-release tablets between 2 mg and 10 mg. Reversal of the concentration-effect curve to a clockwise loop suggests the counterclockwise hystereses of rapidly absorbed doses was caused by the differing distribution rates into the systemic circulation and effect site and not by metabolite activity.

Adult↗

Effects of transient neonatal hyperthyrotropinemia on intellectual quotient and psychomotor performance.

Transient neonatal hyperthyrotropinemia (TNH) occurs frequently in areas of iodine deficiency. To evaluate the effect of TNH in intellectual function and psychomotor performance, a historical cohohrt study was performed in 9 years old children with documented TNH at birth. 18 children with TNH who had been born in Mahdieh Hospital were studied at age 9 and compared to 19 matcheal children born at the same time, but having normal thyroid function at birth. Global intelligence (IQ) and psychomotor performance were evaluated with Raven and Bender-Gestalt tests, respectively. Total serum T4 and T3 by commercial RIA and TSH by IRMA. Urine was tested for iodine content by digestion method. Height and weight were similar in two groups at birth and at 9 years of age. Thyroid function tests were similar in the two groups except for TSH at birth which was higher in TNH than in control group (23.4 +/- 8.3 vs 3.6 +/- 1.0 mU/L, P < 0.001). Results of T4, T3, resine uptake, and urinary iodine at 9 years of age were not different between two groups. Mean IQ was 98 +/- 11 and 106 +/- 8 in TNH and normal children, respectively (P < 0.01). There was no significant difference between psychomotor performance in the two groups. There was no correlation between TSH at birth and IQ at 9 years of age. The present finding suggests that TNH can adversely affect longterm intellectual development.

Case-Control Studies↗

Head acceleration and psychomotor performance.

Concussion resulting from head acceleration could explain the poor survival rates in some types of accidents. Experiments have been conducted on a decelerator using a tracking task to determine whether high head acceleration could affect psychomotor performance. Human subjects were exposed to impact acceleration of O (sham), 5, 10 and 12 -Gx facing forwards. Measurements were made of the linear and angular accelerations experienced at the head and a step tracking task was used to examine psychomotor performance. Electroencephalographs were also recorded. Both the linear and angular accelerations at the head were increased at the higher levels of impact acceleration. At -5Gx there were no significant differences in psychomotor performance when compared with controls, but at -10Gx, and especially -12Gx, significant differences were found. The EEG activity did not vary significantly and no concussive effects were observed in any subject. These results suggest that impairment of psychomotor performance severe enough to jeopardise survival could be produced by high accelerations of the head, though neither linear nor angular acceleration appear to have special significance.

Acceleration↗

A double-blind, placebo-controlled clinical study on the effect of a standardized ginseng extract on psychomotor performance in healthy volunteers.

Various tests of psychomotor performance were carried out in a group of 16 healthy male volunteers given a standardized preparation of Korean ginseng (G 115; 100 mg twice a day for 12 weeks) and in a similar group given identical placebo capsules under double-blind conditions. A favourable effect of G 115 relative to baseline performance was observed in attention (cancellation test), processing (mental arithmetic, logical deduction), integrated sensory-motor function (choice reaction time) and auditory reaction time. However, end performance of the G 115 group was superior statistically to the placebo group only in mental arithmetic. No difference between G 115 and placebo was found in tests of pure motor function (tapping test), recognition (digit symbol substitution) and visual reaction time. No adverse effects were reported. It is concluded that G 115 may be superior to placebo in improving certain psychomotor functions in healthy subjects.

Adult↗

Assessment of efficacy and psychomotor performances of thiocolchicoside and tizanidine in patients with acute low back pain.

Objectives of this study were to assess efficacy and effects on psychomotor performances of thiocolchicoside (TCC) and tizanidine (TZ) compared to placebo. Patients complaining of acute low back pain (LBP) associated with muscle spasm were enrolled in this randomised, double-blind clinical trial, comparing the effects of oral TCC, TZ and placebo on psychomotor performances assessed by a visual analogue scale of tiredness, drowsiness, dizziness and alertness and by psychometric tests after 2 and 5-7 days of treatment. The efficacy assessments, both TCC and TZ, were more effective than placebo in improving pain at rest, hand-to-floor distance, Schober test and decreased paracetamol consumption. There were significant differences among the treatment groups in favour of TCC compared to TZ in visual analog scale-parameters. TZ-induced reduction of psychomotor performances of the patients was confirmed by psychometric tests, which showed significant differences among groups. This study showed that TCC is at least as effective as TZ in the treatment of acute LBP, while it appears devoid of any sedative effect in contrast to TZ.

Acute Disease↗