ADHD: Current Research On the Contribution of Physical Exercise to Improvements in Cognitive Performance and Executive Functions (EF)

Introduction: The prophylactic and therapeutic effects of physical exercise in cardiovascular and metabolic diseases are recognized. In the last ten years, studies have shown the association of active lifestyle with prevention and treatment of mental illnesses as well as the improvement of executive functions throughout life. Nevertheless, methodological problems make it difficult to use the evidence on practical clinic.Objective: To analyze recent evidence on the effects of physical exercise for cognitive performance improvement, prevention and treatment of mental illness and affective responses generated by exercise, highlighting the gaps that should be fulfilled and challenges on this knowledge area.Conclusion: Physical exercise contributes to reduce risks for mental illness and to enhance clinical response in patients with mood and anxiety disorders, and neurodegenerative diseases. Cognitive function, mainly executive functions, has been observed in different age groups. Affective responses generated during the exercise are influenced by various extrinsic and intrinsic factors and can contribute to the development of new prescription strategies to increase physical exercise adherence. Studies with greater methodological rigor and variable exercise prescriptions, like frequency, duration, intensity and the type of the exercise should be conduced for better targeting practical application of the knowledge.Exercício físico, desempenho cognitivo e saúde mental: perspectivas e desafiosIntrodução: O efeito profilático e terapêutico do exercício físico em doenças cardiovasculares e metabólicas é reconhecido. Nos últimos dez anos, estudos mostraram associação entre o estilo de vida ativo e a prevenção e o tratamento de doenças mentais, assim como, a melhora das funções executivas em diferentes faixas etárias. Entretanto, questões metodológicas dificultam a utilização das evidências na prática clínica.Objetivo: Apresentar as evidências recentes sobre o efeito do exercício físico na melhora do desempenho cognitivo, prevenção e tratamento de doenças mentais e respostas afetivas geradas pelo exercício, destacando lacunas a serem investigadas e desafios nessa área de conhecimento.Conclusão: O exercício físico contribui para a redução do risco de desenvolvimento de doenças mentais e melhora da resposta clínica de pacientes com transtornos de humor e de ansiedade e doenças neurodegenerativas. A melhora da função cognitiva, em especial as funções executivas, é observada em diferentes faixas etárias. As respostas afetivas geradas durante o exercício são influenciadas por diversos fatores extrínsecos e intrínsecos e podem contribuir para o desenvolvimento de novas estratégias de prescrição para a melhora da aderência ao exercício físico. Estudos com maior rigor metodológico e maior controle de variáveis de prescrição de exercícios, como frequência, duração, intensidade e tipo de exercício devem ser feitos para o melhor direcionamento da aplicação prática do conhecimento.

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Physical Exercise Intensity During Submersion Selectively Affects Executive Functions

Human Factors The Journal of the Human Factors and Ergonomics Society ◽

10.1177/0018720819879313 ◽

2019 ◽

pp. 001872081987931

Author(s):

Fabian Möller ◽

Uwe Hoffmann ◽

Marc Dalecki ◽

Tobias Dräger ◽

Michael Doppelmayr ◽

...

Keyword(s):

Physical Exercise ◽

Executive Functions ◽

Cognitive Performance ◽

Cognitive Processing ◽

Exercise Intensity ◽

Environmental Conditions ◽

Extreme Environments ◽

Reaction Times ◽

Before And After ◽

Wet Condition

Objective: The intact cognitive processing capacity in highly demanding and dynamically changing situations (e.g., in extreme environmental conditions) is of central relevance for personal safety. This study therefore investigated whether underwater physical exercise (PE) affected cognitive performance by comparing these effects during underwater fin-swimming as opposed to inactivity under normal environmental conditions. Background: Although acute bouts of PE can modulate cognitive performance under highly controlled and standardized laboratory conditions, no previous study has determined whether PE acutely modulates cognitive performance in non-laboratory testing conditions involving extreme environments (e.g., underwater). Method: A total of 27 healthy volunteers (16 males and 11 females; 28.9 ± 7.4 years of age) participated in two experiments involving either moderate or high PE intensity. A PRE/POST crossover design was employed among participants while performing cognitive tests in a counterbalanced order (i.e., before and after 20 min of PE in submersion [WET] and once before and after inactivity [DRY] while in the laboratory). Cognitive performance was measured as a combination of executive functions through the Eriksen Flanker (inhibition) and Two-Back (working memory) Tasks using an underwater tablet computer. Results: ANOVAs revealed enhanced reaction times only in the Flanker test after moderate PE for the WET condition. No other effects were detected. Conclusion: These findings indicate that cognitive performance is exercise-intensity-dependent with enhanced effects during moderate PE, even in extreme environments (i.e., underwater). Application: These results should be relevant in recreational and occupational contexts involving underwater activity and may also apply to microgravity (e.g., during extra-vehicular activities). Description This study compared the acute effects of physical exercise (PE) on cognitive performance in an underwater environment while participants fin-swam with SCUBA (self-contained underwater breathing apparatus) gear. Findings revealed that 20 min of moderate PE positively affected cognitive performance (i.e., inhibitory control ability). However, no changes were observed after high-intensity exercise.

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Effects of Fatigue on Cognitive Performance in Long-Duration Simulated Flight Missions

Aviation Psychology and Applied Human Factors ◽

10.1027/2192-0923/a000191 ◽

2020 ◽

Vol 10 (2) ◽

pp. 82-93

Author(s):

Eduardo Rosa ◽

Ola Eiken ◽

Mikael Grönkvist ◽

Roger Kölegård ◽

Nicklas Dahlström ◽

...

Keyword(s):

Executive Functions ◽

Task Performance ◽

Cognitive Performance ◽

Cognitive Tasks ◽

Fatigue Index ◽

Fighter Aircraft ◽

Long Duration ◽

Metacognitive Accuracy

Abstract. Fighter pilots may be exposed to extended flight missions. Consequently, there is increasing concern about fatigue. We investigated the effects of fatigue and cognitive performance in a simulated 11-hr mission in the 39 Gripen fighter aircraft. Five cognitive tasks were used to assess cognitive performance. Fatigue was measured with the Samn–Perelli Fatigue Index. Results showed that performance in the non-executive task degraded after approximately 7 hr. Fatigue ratings showed a matching trend to the performance in this task. Performance in tasks taxing executive functions did not decline. We interpreted that fatigue can be overridden by increased attentional effort for executive tasks but not for non-executive components of cognition. Participants underestimated their performance and metacognitive accuracy was not influenced by fatigue.

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Eye contact effect: The role of vagal regulation and reactivity, and self-regulation of attention

Current Psychology ◽

10.1007/s12144-021-01682-y ◽

2021 ◽

Author(s):

Alicja Niedźwiecka

Keyword(s):

Executive Functions ◽

Cognitive Performance ◽

Self Regulation ◽

Eye Contact ◽

Autonomic Regulation ◽

Face To Face ◽

Effective Strategies ◽

Contact Effect ◽

The Individual

AbstractEye contact is a crucial aspect of social interactions that may enhance an individual’s cognitive performance (i.e. the eye contact effect) or hinder it (i.e. face-to-face interference effect). In this paper, I focus on the influence of eye contact on cognitive performance in tasks engaging executive functions. I present a hypothesis as to why some individuals benefit from eye contact while others do not. I propose that the relations between eye contact and executive functioning are modulated by an individual’s autonomic regulation and reactivity and self-regulation of attention. In particular, I propose that individuals with more optimal autonomic regulation and reactivity, and more effective self-regulation of attention benefit from eye contact. Individuals who are less well regulated and over- or under-reactive and who do not employ effective strategies of self-regulation of attention may not benefit from eye contact and may perform better when eye contact is absent. I present some studies that justify the proposed hypothesis and point to a method that could be employed to test them. This approach could help to better understand the complex mechanisms underlying the individual differences in participant’s cognitive performance during tasks engaging executive functions.

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COMPUTERIZED COGNITIVE TRAINING, WITH OR WITHOUT EXERCISE, TO PROMOTE COGNITIVE FUNCTION: A RANDOMIZED TRIAL

Innovation in Aging ◽

10.1093/geroni/igz038.215 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S55-S56

Author(s):

Lisanne F ten Brinke ◽

John R Best ◽

Joey L Chan ◽

Cheyenne Ghag ◽

Kirk I Erickson ◽

...

Keyword(s):

Older Adults ◽

Physical Exercise ◽

Executive Functions ◽

Cognitive Training ◽

Verbal Learning ◽

Stroop Test ◽

Community Dwelling ◽

Computerized Cognitive Training ◽

Improved Performance ◽

At Home

Abstract Given the world’s aging population, it is important to identify strategies that promote healthy cognitive aging. Computerized cognitive training (CCT) may be a promising method to combat cognitive decline in older adults. Moreover, physical exercise immediately prior to CCT might provide additional cognitive benefits. We conducted a randomized controlled trial to examine the effect of a CCT intervention, alone or preceded by physical exercise, on memory and executive functions in older adults. 124 community-dwelling older adults aged 65-85 years were randomly assigned to either 8-weeks of: 1) 3x/week group-based CCT plus 3x/week CCT sessions at home; 2) 3x/week group-based CCT combined with a 15-minute brisk walk (Ex-CCT) plus 3x/week Ex-CCT sessions at home; or 3)3x/week group-based sham exercise and education sessions (CON). At baseline and 8-weeks standard neuropsychological tests of verbal memory and learning and executive functions were administered, including the Rey Auditory Verbal Learning Test (RAVLT), Stroop test, Flanker test, Trail Making Tests (TMT B-A), and Dimensional Change Card Sort (DCCS) Test. At trial completion, there were no differences in RAVLT performance. Compared with CON, FBT and Ex-FBT participants significantly improved performance on the Stroop test (p = .001 and p = .023, respectively). Additionally, those randomized to Ex-CCT improved performance on the Flanker test (p = .002), TMT B-A (p = .047), and the DCCS Test (p = .023) compared with BAT. These findings suggest that an 8-week CCT program could benefit executive functions, and that implementing exercise immediately prior to CCT could provide broader benefits.

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Application of Eye Tracking in Puzzle Games for Adjunct Cognitive Markers: Pilot Observational Study in Older Adults (Preprint)

10.2196/preprints.24151 ◽

2020 ◽

Author(s):

Christine Krebs ◽

Michael Falkner ◽

Joel Niklaus ◽

Luca Persello ◽

Stefan Klöppel ◽

...

Keyword(s):

Visual Search ◽

Eye Tracking ◽

Executive Functions ◽

Eye Movement ◽

Cognitive Performance ◽

Gaze Behavior ◽

Laptop Computer ◽

Board Size ◽

Older Subjects ◽

Puzzle Games

BACKGROUND Recent studies suggest that computerized puzzle games are enjoyable, easy to play, and engage attentional, visuospatial, and executive functions. They may help mediate impairments seen in cognitive decline in addition to being an assessment tool. Eye tracking provides a quantitative and qualitative analysis of gaze, which is highly useful in understanding visual search behavior. OBJECTIVE The goal of the research was to test the feasibility of eye tracking during a puzzle game and develop adjunct markers for cognitive performance using eye-tracking metrics. METHODS A desktop version of the Match-3 puzzle game with 15 difficulty levels was developed using Unity 3D (Unity Technologies). The goal of the Match-3 puzzle was to find configurations (target patterns) that could be turned into a row of 3 identical game objects (tiles) by swapping 2 adjacent tiles. Difficulty levels were created by manipulating the puzzle board size (all combinations of width and height from 4 to 8) and the number of unique tiles on the puzzle board (from 4 to 8). Each level consisted of 4 boards (ie, target patterns to match) with one target pattern each. In this study, the desktop version was presented on a laptop computer setup with eye tracking. Healthy older subjects were recruited to play a full set of 15 puzzle levels. A paper-pencil–based assessment battery was administered prior to the Match-3 game. The gaze behavior of all participants was recorded during the game. Correlation analyses were performed on eye-tracking data correcting for age to examine if gaze behavior pertains to target patterns and distractor patterns and changes with puzzle board size (set size). Additionally, correlations between cognitive performance and eye movement metrics were calculated. RESULTS A total of 13 healthy older subjects (mean age 70.67 [SD 4.75] years; range 63 to 80 years) participated in this study. In total, 3 training and 12 test levels were played by the participants. Eye tracking recorded 672 fixations in total, 525 fixations on distractor patterns and 99 fixations on target patterns. Significant correlations were found between executive functions (Trail Making Test B) and number of fixations on distractor patterns (<i>P</i>=.01) and average fixations (<i>P</i>=.005). CONCLUSIONS Overall, this study shows that eye tracking in puzzle games can act as a supplemental source of data for cognitive performance. The relationship between a paper-pencil test for executive functions and fixations confirms that both are related to the same cognitive processes. Therefore, eye movement metrics might be used as an adjunct marker for cognitive abilities like executive functions. However, further research is needed to evaluate the potential of the various eye movement metrics in combination with puzzle games as visual search and attentional marker.

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Estimation of Cognitive Performance Based on Premorbid Intelligence in Parkinson’s Disease

Journal of Parkinson s Disease ◽

10.3233/jpd-202142 ◽

2020 ◽

Vol 10 (4) ◽

pp. 1717-1725

Author(s):

Rocio Del Pino ◽

Maria Díez-Cirarda ◽

Javier Peña ◽

Naroa Ibarretxe-Bilbao ◽

Natalia Ojeda

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Executive Functions ◽

Cognitive Performance ◽

Verbal Memory ◽

Visual Memory ◽

Cognitive Domain ◽

Semantic Fluency ◽

Pi Method ◽

Premorbid Intelligence

Background: The estimation of premorbid intelligence (PI) is needed for an accurate diagnosis. Objective: This study aimed to estimate the cognitive performance taking into account the PI in Parkinson’s disease (PD) compared to healthy controls (HC); and to analyze the discrepancies between the current and the predicted cognitive performance based on the PI. Method: Semantic fluency, verbal and visual memory, and executive functions were assessed in 39 PD and 162 HC. A linear regression model was used to analyze the discrepancies between the predicted cognitive performance and the current raw scores through PI variables (Word Accentuation Test (WAT), Pseudo-Words (PW) Reading subtest from PROLEC-R, age, and years of education). ROC analyses were performed to assess their diagnostic properties. Results: Significant differences were found in the raw cognitive scores between patients and HC [semantic fluency (t = 6.07; p < 0.001), verbal memory (t = 6.63; p < 0.001), and executive functions (t = 2.57; p = 0.013), and in visual memory (t = 1.97; p = 0.055 marginally significant)]. Compared to HC, PD patients presented higher discrepancies between the predicted cognitive performance and the raw scores in semantic fluency, verbal memory, visual memory, executive functions (AUC = 0.78, 0.78; 0.64, 0.61, respectively). Conclusion: The magnitude of the discrepancies scores between the current and the predicted cognitive performance based on PI indicates the presence of cognitive decline in the specific cognitive domain in PD patients. This study underlines the usefulness of premorbid measures and variables, such as WAT, PW, age, and years of education, to more accurately estimate the cognitive performance in PD.

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Abstract P317: Cognitive Impairment in Coronary Artery Disease Patients: Do Exercise Tolerance and Cerebral Oxygenation During Exercise Matter?

Circulation ◽

10.1161/circ.125.suppl_10.ap317 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Vincent Gremeaux ◽

Joffrey Drigny ◽

Mathieu Gayda ◽

Martin Juneau ◽

Louis Bherer ◽

...

Keyword(s):

Cardiac Output ◽

Executive Functions ◽

Cognitive Performance ◽

Exercise Tolerance ◽

Maximal Exercise ◽

Digit Span ◽

Output Measurement ◽

Stable Coronary Heart Disease ◽

Significant Difference ◽

Nirs Signal

Introduction: Cardiovascular diseases have been associated with impaired cognitive performances, especially in functions. In contrast, it is clearly established that regular physical activity maintained throughout life protects against age-related cognitive decline. Purpose: to assess maximal oxygen uptake (VO2max), cardiac output, and cerebral hemodynamic changes, assessed by Near-Infrared Spectroscopy (NIRS), during a graded maximal exercise tests, and cognitive performance at rest in patients with stable coronary heart disease (CHD) and healthy matched adults. Methods: Ten stable CHD patients (67.1±10.5 years) and 9 age-matched controls (62.2± 11.4 years) were included in this pilot study. Measurements included: body composition (bioelectrical impedance), complete blood analysis in a fasting state, cognitive performance using validated neuropsychological tests, graded maximal exercise testing on ergocycle with gas exchange analysis, non-invasive cardiac output measurement (cardiac bioimpedance) and NIRS signals measurement at the left prefrontal brain level (oxyhaemoglobin: O2Hb, deoxyhaemoglobin: HHb ; total haemoglobin: THb, and differential haemoglogin: Hbdiff). Results: Several cognitive performance items were lower in the CHD group, especially regarding executive functions (Backward digit span score, p<0.05; trail making test B, p=0.05; Stroop test (inhibition/flexibility), p<0.05). There was no difference between CHD and controls in VO2 max (29.7±8.5 Vs 32±6.3 ml/kg/min) and maximal cardiac output (15.5±3.9 Vs 17±2.6 l/min), whereas cardiac output and cardiac index at the ventilatory threshold were lower in CHD (5.75±1 Vs 7.06±0.6 l/min/m2, p<0.05, and 11.2±2.2 Vs 14.1±2.8 l/min, p<0.01, respectively). There was a significant difference in the kinetics of NIRS signal with higher amplitude for CHD patients vs. controls for O2Hb (p<0.01); THb (p<0.05) and Hbdiff (p<0.05). Significant higher amplitude were also found for O2Hb, THb, Hbdiff (p<0.0001) in younger (62 years) participants. HHb (p<0.0001) and Hbdiff (p<0.01) amplitude was higher for fit (≥120% theoretical VO2max) vs. less fit (<120%) participants. Discussion: Compared to age-matched controls, our sample of stable fit CHD patients had a comparable maximal exercise tolerance and cardiac output, with higher NIRS cerebral signals amplitude for O2Hb, THb and Hbdiff. This latter parameter thus does not seem to influence cognitive performance at rest, that was lower in CHD patients, especially in executive functions. However, an important inter-individual variability of cerebral NIRS signal amplitude was observed, with age and fitness appearing as major contributors. We plan to recruit a larger sample of subjects to assess more clearly relationships between exercise, tolerance hemodynamic parameters and cognitive performance.

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Passive heat acclimation does not modulate processing speed and executive functions during cognitive tasks performed at fixed levels of thermal strain

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2021-0243 ◽

2021 ◽

Author(s):

Hadiatou Barry ◽

Philippe Gendron ◽

Christine Gagnon ◽

Louis Bherer ◽

Daniel Gagnon

Keyword(s):

Reaction Time ◽

Executive Functions ◽

Cognitive Performance ◽

Core Temperature ◽

Processing Speed ◽

Heat Exposure ◽

Thermal Strain ◽

Heat Acclimation ◽

Cognitive Tasks ◽

Time Control

Purpose: This study evaluated if passive controlled hyperthermia heat acclimation (HA) modulates cognitive performance during passive heat stress. Methods: Eight healthy adults (25 ± 4 years) underwent 7 consecutive days of hot water immersion (core temperature ≥38.6°C) and a 7-day time-control period. On days 1 and 7 of HA, participants performed a digital Stroop test at baseline, when core temperature reached 38.6°C, and after 60 minutes at a core temperature ≥38.6°C to evaluate reaction time during tasks targeting processing speed (reading and counting) and executive functions (inhibition and switching). On days 1 and 7 of the time-control intervention, participants performed the Stroop test with equivalent amounts of time separating each task as for HA. Results: During day 1 of HA, reaction time was quicker during the reading (-44 ms [-71, -17], P<0.01) and counting (-39 ms [-76, -2], P=0.04) tasks when rectal temperature reached 38.6°C, but after a further 60 minutes of heat exposure, reaction time only remained quicker during the reading task (-56 ms [-83, -29], P<0.01). Changes in reaction time during heat exposure were unaffected by subsequent HA (interaction, all P≥0.09). Conclusion: Seven days of HA does not modulate processing speed and executive functions during passive heat exposure. Novelty: - Whether heat acclimation (HA) to improve cognitive performance during heat exposure remains understudied. - We tested the hypothesis that HA modulates reaction time during cognitive tasks performed at matched levels of thermal strain. - Despite classical signs of HA, reaction time during heat exposure was unaffected by HA.

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Fish intake, n-3 fatty acid body status, and risk of cognitive decline: a systematic review and a dose–response meta-analysis of observational and experimental studies

Nutrition Reviews ◽

10.1093/nutrit/nuab078 ◽

2021 ◽

Author(s):

Rena I Kosti ◽

Maria I Kasdagli ◽

Andreas Kyrozis ◽

Nicola Orsini ◽

Pagona Lagiou ◽

...

Keyword(s):

Systematic Review ◽

Fatty Acid ◽

Executive Functions ◽

Cognitive Decline ◽

Cognitive Performance ◽

Dose Response ◽

Experimental Studies ◽

Fish Intake ◽

Risk Of Bias ◽

The Impact

Abstract Context Randomized controlled trials (RCTs) testing supplementation with eicosapentaenoic (EPA) and docosahexaenoic (DHA) fatty acids have failed to provide evidence supporting a suggested inverse association between fish intake and dementia risk. Objective Dose–response analyses were conducted to evaluate associations between fish intake, all-cause dementia or Alzheimer’s Disease (AD), and the effect of EPA/DHA supplementation on cognitive performance. Data Sources PubMed, Scopus and Web of Science databases were searched for original research evaluating either associations between fish intake and dementia or AD, or the impact of EPA and/or DHA supplementation on the risk of cognitive decline. Data Extraction Data were collected on study characteristics and methods; number of cases/deaths (for observational studies); categories of exposure; model covariates; risk estimates from the most-adjusted model; type and dosage of supplementation (from RCTs); fatty acid levels in blood; and differences in cognition test results before and after supplementation. Risk of bias was assessed through the ROBINS-E and RoB2.0 tools for observational and experimental studies, respectively. Data Analysis Weighted mixed-effects models were applied, allowing for the inclusion of studies with 2 levels of exposure. Based on findings with low/moderate risk of bias, fish intake of up to 2 portions (250 g) per week was associated with a 10% reduction (95% confidence interval [CI]: 0.79, 1.02, Ν = 5) in all-cause dementia and a 30% reduction (95% CI: 0.54, 0.89, Ν = 3) in AD risk. Changes in EPA and DHA body status had a positive impact on participants’ executive functions, but not on their overall cognitive performance. Conclusion The protection offered by fish intake against cognitive decline levels off at intakes higher than 2 portions/week and likely relates to the impact of EPA and DHA on the individual’s executive functions, although there remain questions about the mechanisms linking the short- and long-term effects. Systematic Review Registration PROSPERO registration no. CRD42019139528.

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