Effect of caffeinated gum on a battery of rugby-specific tests in trained university-standard male rugby union players.

BACKGROUND: Caffeine has been shown to enhance strength, power and endurance, characteristics that underpin performance in rugby. Caffeinated gum has attracted interest as a novel vehicle for delivering caffeine, because absorption of caffeine from gum is quick. Rapid absorption of caffeine may be useful during rugby matches when there is limited time for supplementation such as at half-time or when substitutes enter play. The purpose of this study was to determine whether a low dose of caffeine in gum improves performance in a battery of rugby-specific tests. METHODS: In a double-blind, randomized, placebo-controlled, crossover design, 17 male university-standard rugby players (mass: 85.6 ± 6.3 kg; height: 179.4 ± 6.2 cm; age: 20.4 ± 1.2 years) chewed caffeinated gum (200 mg caffeine) or a placebo gum on two occasions separated by a week. After a standardized warm-up, gum was chewed for 5 min. Subsequently, participants performed three countermovement jumps, followed by an Illinois agility test, 6 × 30 m repeated sprints, and the Yo-Yo IR-2 test; each test was separated by short rest periods. RESULTS: Caffeinated gum enhanced countermovement jump by 3.6% (caffeine: 43.7 ± 7.6 cm vs. placebo: 42.2 ± 6.2 cm; d = 0.22, 95% CI [0.006, 0.432]; p = 0.044). There was a greater resistance to fatigue during the 6 × 30 m repeated sprint test (fatigue index caffeine: 102.2 ± 0.9% vs. placebo: 103.3 ± 1.2%; d = 1.03, 95% CI [0.430, 1.613]; p = 0.001), and performance on the Yo-Yo IR2 was improved by 14.5% (caffeine: 426 ± 105 m, placebo: 372 ± 91 m; d = 0.55, 95% CI [0.130, 0.957]; p = 0.010). Caffeine gum had no significant effect on the Illinois agility test (caffeine 16.22 ± 1.08 s vs. placebo 15.88 ± 1.09 s; d = - 0.31, 95% CI [- 0.855, 0.240]; p = 0.271). CONCLUSIONS: In university-standard rugby players, a low dose of caffeine (200 mg) supplied in chewing gum enhanced performance on the Yo-Yo IR-2 test and the countermovement jump test and reduced fatigue index during repeated sprints. These improvements in a battery of rugby-specific tests may transfer to enhanced performance in rugby matches.

Comprehensive analysis suggests simple processes underlying EEG/ERP - demonstration with the go/no-go paradigm in ADHD.

BACKGROUND: Current basic or more advanced methods for analysis of averaged EEG/ERP are based on assumptions on the underlying processes, which are not necessarily precise. NEW METHOD: In this work we present the findings of a method which obviates such assumptions and aims at a comprehensive analysis of the averaged EEG/ERP signal. RESULTS: For the sake of demonstration we chose the established go/no-go paradigm in the context of ADHD. Our analysis method characterized two spatiotemporally distinct neurophysiologic processes which underlie the sampled signal: one which may be related to attention and the other which may be more related to perception. COMPARISON WITH EXISTING METHOD(S): We show how these processes accord with and provide insight on the waveforms reported in the literature. CONCLUSIONS: Finally we suggest that application of our method on averaged EEG/ERP data sampled from other paradigms may point at a similarly parsimonious set of underlying neurophysiologic processes which underlie the signal.

Introducing a novel approach of network oriented analysis of ERPs, demonstrated on adult attention deficit hyperactivity disorder.

OBJECTIVE: Introducing a network-oriented analysis method (brain network activation [BNA]) of event related potential (ERP) activities and evaluating its value in the identification and severity-grading of adult ADHD patients. METHODS: Spatio-temporal interrelations and synchronicity of multi-sited ERP activity peaks were extracted in a group of 13 ADHD patients and 13 control subjects for the No-go stimulus in a Go/No-go task. Participants were scored by cross-validation against the most discriminative ensuing group patterns and scores were correlated to neuropsychological evaluation scores. RESULTS: A distinct frontal-central-parietal pattern in the delta frequency range, dominant at the P3 latency, was unraveled in controls, while central activity in the theta and alpha frequency ranges predominated in the ADHD pattern, involving early ERP components (P1-N1-P2-N2). Cross-validation based on this analysis yielded 92% specificity and 84% sensitivity and individual scores correlated well with behavioral assessments. CONCLUSIONS: These results suggest that the ADHD group was more characterized by the process of exerting attention in the early monitoring stages of the No-go signal while the controls were more characterized by the process of inhibiting the response to that signal. SIGNIFICANCE: The BNA method may provide both diagnostic and drug development tools for use in diverse neurological disorders.

The effects of subjectively significant stimuli on subsequent cognitive brain activity.

OBJECTIVE: To study brain activity modulation by preceding subjectively significant stimuli. Brain activity related to emotional and cognitive processing has been typically traced with fMRI's temporal resolution of seconds. In this study, the time course of activation in the brain areas involved was traced with millisecond temporal resolution. METHODS: Electrophysiological brain activity was recorded while 12 normal subjects performed an auditory cued attention task, with subjectively significant verbal distracters. Verbal distracters, administered at different times between the cue and the target in one third of the trials, were first names, whose subjective significance was individually assessed after the experiment using a validated questionnaire. Intracranial sources of scalp-recorded electrical activity were estimated and statistical comparisons were conducted to assess the effects and interactions of (1) cue validity; and (2) subjective significance of distracters, on brain activity evoked by the targets. RESULTS: Significant cue validity effects were found. Language-related areas were most involved following neutral distracters. Emotion-related areas were most involved following subjectively significant distracters. Thus, cue validity and distracter effects seem to have distinct effects. SIGNIFICANCE: The results indicate an effect of subjectively significant distracters on subsequent brain activity with an interaction between cognitive and emotional processes.

Implementation of a dedicated hospital subcutaneous insulin prescription chart: effect on glycaemic control.

A dedicated subcutaneous insulin prescription chart incorporating glucose monitoring results, forced functions, and management guidelines was introduced to facilitate better hospital diabetes control. Point of care capillary blood glucose monitoring charts for 99 people with diabetes from the period before the introduction of the new chart, and 106 after its introduction were reviewed. A total of 12,649 blood glucose levels (BGLs) were collected for glucometric analysis. Following the introduction of the chart, there was an increase in the number of BGLs performed daily from 4.5 ± 1.2 to 4.9 ± 1.3 (p = 0.05). There was an increase in the proportion of BGLs within the ideal range of 4-9.9 mmol/L (51.8% vs. 54.1%, p = 0.01). There was a reduction in hypoglycaemic events (proportion of BGLs <4 mmol/L in the whole population decreased from 5.2% to 3.4% (p < 0.001), proportion of BGLs <4 mmol/L for each patient decreased from 5.6 ± 9.2% to 2.9 ± 5.4% (p = 0.01), proportion of days where patient had a BGL <4 mmol/L decreased from 17.6 ± 22.6% to 11.4 ± 18.8% (p = 0.03)), despite an increase in the use of supplemental insulin (14.2 ± 35.7 vs. 29.4 ± 51.4 u nits/patient, p = 0.02). We conclude that the use of a dedicated hospital subcutaneous insulin prescription chart can reduce hypoglycaemia and improve some measures of glycaemic control.

Convergent evolution of 'creepers' in the Hawaiian honeycreeper radiation.

Natural selection plays a fundamental role in the ecological theory of adaptive radiation. A prediction of this theory is the convergent evolution of traits in lineages experiencing similar environments. The Hawaiian honeycreepers are a spectacular example of adaptive radiation and may demonstrate convergence, but uncertainty about phylogenetic relationships within the group has made it difficult to assess such evolutionary patterns. We examine the phylogenetic relationships of the Hawaii creeper (Oreomystis mana), a bird that in a suite of morphological, ecological and behavioural traits closely resembles the Kauai creeper (Oreomystis bairdi), but whose mitochondrial DNA (mtDNA) and osteology suggest a relationship with the amakihis (Hemignathus in part) and akepas (Loxops). We analysed nuclear DNA sequence data from 11 relevant honeycreeper taxa and one outgroup to test whether the character contradiction results from historical hybridization and mtDNA introgression, or convergent evolution. We found no evidence of past hybridization, a phenomenon that remains undocumented in Hawaiian honeycreepers, and confirmed mtDNA and osteological evidence that the Hawaii creeper is most closely related to the amakihis and akepas. Thus, the morphological, ecological and behavioural similarities between the evolutionarily distant Hawaii and Kauai creepers represent an extreme example of convergent evolution and demonstrate how natural selection can lead to repeatable evolutionary outcomes.

A questionnaire for quantifying subjective significance of names: physiological validation with PAT.

A questionnaire was developed in order to assess the subjective significance of names. Autonomic activation by the names was measured physiologically - by the PAT (peripheral arterial tonus) signal, and correlated with affective significance as revealed by the questionnaire. The final version of the questionnaire included 22 dichotomous and 24 rating questions. Subjective significance to the participant of first names was defined as subjective significance of persons in the participant's life that bear the name. Three reliable factors affecting questionnaire scores were found: (1) general subjective significance (26 items); (2) recency of contact (8 items); and (3) negative impact (12 items). These 3 factors accounted for 98% of the variance in questionnaire scores, and correlated in the expected direction with autonomic response measures. This questionnaire can serve psychological and social studies of relationships and personality.

The prevalence of congenital and early-onset hearing loss in Jordanian and Israeli infants.

The objective of the study was to investigate the prevalence of congenital and early-onset hearing loss, and the influence of the known risk factors for hearing loss on infants in Jordan and Israel. Subjects were a total of nearly 17,000 infants from both countries, including infants with and without risk factors for hearing loss. The hearing screening protocol included distortion product otoacoustic emission, followed in case of repeated OAE referral or high risk (HR) infant by diagnostic auditory brainstem responses. The results indicate that the prevalence and severity of hearing loss amongst Jordanian infants (1.37%) is remarkably higher as compared to the Israeli infants (0.48%). The overall prevalence of bilateral SNHL was seven times more in the Jordanian infants, 18 times in non-risk, and three times in the HR infants relative to the Israeli infants. Risk factors including family history, hyperbilirubinemia, bacterial meningitis, and associated syndromes were more prevalent amongst Jordanian infants. This unique study underscores the importance of sharing and exchanging information to create empirical data to guide health-care providers in adapting protocols to the local constraints in developing countries.

Neurophysiological correlates of subjective significance.

OBJECTIVE: The neural substrates of emotional response have traditionally been studied using universal sets of emotionally loaded stimuli, regardless of their subjective significance for the individual subject. Related brain activity has been typically traced with fMRI's temporal resolution of seconds. In this study, unique brain responses to subjectively significant stimuli were analyzed and traced with millisecond temporal resolution. METHODS: Electrical brain activity (event related potentials) was recorded from 16 normal subjects, to subjectively significant auditory stimuli and its brain sources were imaged. Subjective significance of the stimuli was individually assessed for each subject. RESULTS: Unique and significant brain activity to subjectively significant stimuli began as early as 200 ms after stimulus onset, with increased brain activity in the vicinity of several brain areas, including frontal gyri, Broca's area, Wernicke's area, insula, precuneus and cingulate gyri. The time course of activity in these areas was traced and found concurrent. CONCLUSIONS: Although the subjectively significant stimuli of this study were not divided according to their positive or negative affective valence, they elicited a distinct brain response compared to neutral stimuli, with a uniform pattern across subjects. SIGNIFICANCE: These results demonstrate that subjectively significant stimuli are associated with characteristic brain activity, that studying the neural substrate and time course of processing subjectively significant stimuli is feasible and that the neurophysiological manifestations of emotions are attainable.

Ear advantage and attention: an ERP study of auditory cued attention.

The neurophysiological manifestations of left ear advantage to tonal stimuli and its interaction with attention have rarely been studied. Cued attention is a behavioral paradigm to assess the behavioral benefits and costs of allocating attention. In this task a cue predicts the location of a subsequent target to which the subject responds. In most cases the cue correctly predicts the target (valid cues) but at times it does not (invalid cues). Cued attention is a spatial paradigm with stimuli presented to either side. The objectives of this study were: (1) to find the neurophysiological correlates of the ear advantage phenomenon and (2) to assess the interaction of the stimulated side (right vs. left ear advantage) with attention, in a cued attention task. Significant effects on event-related potentials (ERPs) in the cued attention task indicated left ear and right hemisphere advantage. Effects were mostly confined to the right hemisphere. The results indicate interactions among left ear advantage, attention and dominant hand utilization. Ear advantage and attention may involve the same neural mechanisms. In spite of the left ear advantage effect on ERP components, hand dominance determines the final behavioral results (reaction times).

Time course of motor excitability before and after a task-related movement.

AIMS OF THE STUDY: The time course of motor excitability during a task-related unilateral right thumb movement was studied using sub-threshold transcranial magnetic stimulation (TMS) to the contralateral left motor cortex. The level of stimulation evoked a motor evoked potential (MEP) in the thumb when the subject was at rest in approximately 10% of the trials. METHODS: Subjects made a brief right thumb movement to the predictable omission of regularly presented tone bursts allowing experimental definition of TMS relative to the cue to move. Motor cortical excitability was characterized by amplitude and/or probability of eliciting MEPs. RESULTS: There were four periods of altered motor excitability during task performance compared to a control resting state: a first period of weak facilitation before movement between -500 to -200 ms, a second period without increased excitability approximately 150 ms before movement onset when MEPs amplitude was below that seen in rest, a third period of strong facilitation between -100 ms before movement and +200 ms after facilitation and a fourth period of weak facilitation between +200 to +500 ms. CONCLUSION: These results show that during performance of a task requiring a motor response, motor cortical excitability is increased above resting for hundreds of millisecond before and after the response, except for a transient period between 75 and 150 ms prior to movement onset. The temporal pattern of these excitability changes is compatible with multiple excitatory and inhibitory inputs interacting on motor cortex.

Otoacoustic emissions and brainstem evoked potentials in compound carriers of connexin 26 mutations.

This study compares the effects of mutations in the gap junction protein connexin 26 (Cx26), on outer hair cells (OHCs), inner hair cells (IHCs) and auditory nerve/brainstem among carriers of these mutations. One hundred and twenty eight individuals, from a village with widespread consanguinity and congenital deafness, due to three Cx26 mutations, were selected among relatives of deaf persons, and divided into non-carriers, carriers of one mutation, homozygous to one mutation, or compound heterozygous carriers of two different mutations. Distortion product otoacoustic emissions (DPOAEs), auditory brainstem responses (ABRs) and audiometric evaluation were compared in these genetic groups. Hearing loss among homozygotes and compound heterozygotes was comparable and ranged from mild to profound. Most ABRs from these groups showed no responses or partial responses (peaks III, V) with prolonged latencies, but some individuals had all peaks at normal latencies. DPOAEs were absent, except sporadic responses. Carriers of one mutation had significantly smaller DPOAEs compared to non-carriers, although normal pure tone audiograms and ABRs were found in these groups. In conclusion, based on DPOAEs, Cx26 mutations may impact OHC function among carriers of one or two Cx26 mutations. IHC/nerve impairment among homozygotes and compound heterozygotes is variable. OHCs may be more susceptible to Cx26 mutations compared to IHCs and the auditory nerve and brainstem pathway activated by them.

Preparatory slow potentials and event-related potentials in an auditory cued attention task.

OBJECTIVES: To examine reaction times and event-related potentials (ERPs) in an auditory cued attention task varying motor requirements, cue validity, and cue location. METHODS: Subjects (n=13) listened to cue-target stimulus pairs. Verbal cues (monaural, binaural) indicated the ear to receive a target tone 1.5s later. Cues correctly (valid) or incorrectly (invalid) predicted target ear, or were uninformative (neutral). In separate conditions subjects either responded by pressing one of two buttons, or did not respond to targets. ERPs for cues and targets (P50, N100, P200, late slow wave), and negative slow potentials between cues and targets were assessed. RESULTS: Target reaction times for valid cues were significantly shorter than for invalid cues, with intermediate values for neutral cues. When no motor response was required larger ERPs were seen to both cues and targets. Negative slow potentials had larger amplitudes before target presentation when subjects responded to targets; and were larger following neutral, vs. valid/invalid, cues. ERPs (N100, P200) to invalidly cued targets were significantly larger and a subsequent late slow wave was more positive, relative to validly cued targets. CONCLUSIONS: Expectancy for targets begins shortly after cue presentation, and is affected by both motor requirements and the information content of the cue. ERP amplitudes to targets are modulated by the correspondence between cue information and actual target location.

The effects of a connexin 26 mutation--35delG--on oto-acoustic emissions and brainstem evoked potentials: homozygotes and carriers.

The purpose of this study was to examine whether outer hair cells (OHCs), inner hair cells and the brainstem auditory pathway are impaired due to a mutation in a gap junction protein, connexin 26 (Cx26), 35delG. Fifty-six individuals, from a village with widespread consanguinity and profound, non-syndromic congenital deafness, due to 35delG mutation, were selected among relatives of deaf people. The individuals were either non-carriers (n=20), heterozygous (n=20) or homozygous (n=16) for the mutation. Distortion product oto-acoustic emissions (DPOAEs) and auditory brainstem evoked potentials (ABEPs) in mutation non-carriers, in heterozygotes (carriers) and in subjects homozygous for the mutation were compared in addition to audiometric evaluation. Most deaf homozygotes had no DPOAEs, except some sporadic responses at 1000, 8000 and 10000 Hz. This was also observed in audiometry which showed profound hearing loss in most cases. Two cases were unique: one had moderate to severe hearing loss and the other had severe to profound hearing loss. A significant difference was found between non-carriers and carriers of 35delG: non-carriers had larger DPOAE responses than heterozygotes at all frequencies. The prevalence of responses got lower with higher frequencies in both groups, but between 6000 and 10000 Hz 50-70% of the carriers had no DPOAE responses, compared to 30-60% of non-carriers. In both groups responses diminished with age, but no significant interaction was found between age and the genetic group. ABEPs among homozygotes were variable: in most homozygotes ABEPs were absent or partial (waves III, V) with prolonged latencies, but two subjects had ABEPs within normal limits, in one ear. ABEPs were normal with no differences between carriers and non-carriers. We suggest that OHC function is affected by the 35delG mutation in Cx26. In addition, the hearing of carriers of this mutation may be impaired at very high frequencies (8000-10000 Hz), which are not assessed in routine audiometry or ABEP testing.

Echo suppression in the human cortex is affected by the spatial and temporal proximity of the primary sound and echo.

Echo suppression in the human auditory cortex was studied with auditory middle latency evoked potentials (AMEP) using virtual reality acoustic stimuli, including distance and elevation cues, presented by earphones. The purpose of the study was to assess the effect of proximity of the source sound and echo on the degree of echo suppression. Sixteen subjects were presented with source-echo pairs in which the preceding source sound was always at the vertex, and the echo varied among ten positions on the coronal plane. Positions varied in elevation, distance and time lag between source and echo. The psychoacoustic location judgment of the fused source-echo pair was closer to the source sound (more echo suppression) the nearer the echo drew to the source in its elevation and time. The equivalent dipole magnitudes of the cortical components of AMEP were significantly reduced (more suppression) with shorter echo lags and when echo elevation was similar to that of the source sound. The distances used in this study did not significantly affect echo suppression. These results indicate that echo suppression in the auditory cortex is more pronounced the closer are the primary sound and echo in locational attributes and timing. As source sound and echo draw apart, echo suppression in the cortex decreases and the perceived localization of the fused source-echo is more biased toward the echo.

Influence of task-related ipsilateral hand movement on motor cortex excitability.

OBJECTIVE: The time course of the right motor cortex excitability in relation to a task-related voluntary right thumb twitch was studied using sub-threshold transcranial magnetic stimulation (TMS) to the right motor cortex. METHODS: Motor excitability was studied in 8 adult subjects who made a brief right thumb twitch to the predictable omission of every fifth tone in a series of tones 2.5 s apart. This paradigm avoided an overt sensory cue, while allowing experimental control of TMS timing relative to both movement and the cue to move. Motor excitability was characterized by several measures of motor evoked potentials (MEPs) recorded from the left thenar eminence in response to TMS over the right scalp with a 9 cm coil: probability of eliciting MEPs, incidence of MEPs and amplitude of MEPs. RESULTS: All subjects showed suppression of motor excitability immediately following a voluntary right thumb twitch (ipsilateral response), and up to 1 s after it. However, two distinctly different effects on motor excitability were observed before the response: two subjects showed excitation, beginning about 500 ms before response until 300 ms after it, followed by the post-movement suppression; 6 subjects displayed pre-movement suppression, beginning about 600 ms before the response and persisting for the duration. CONCLUSIONS: The net effect of an ipsilateral response on motor cortex can be either inhibitory or excitatory, changing with time relative to the response. These findings are compatible with two separate processes, inhibitory and excitatory, which interact to determine motor excitability ipsilateral to the responding hand.

The mode of short-term memory encoding as indicated by event-related potentials in a memory scanning task with distractions.

OBJECTIVE: Auditory event-related potentials (ERPs) were recorded during the performance of a memory scanning task, with and without distracters between the memorized items and the probe. The effect of distracters with different phonological/semantic characteristics was tested, to indicate the encoding mode in short-term memory. METHODS: Three types of sets ('memorized sets') were presented to the subject before the probe: 4 memorized digits, two memorized digits with two distracter digits and two memorized digits with two noise distracters. Potentials in response to the set items were averaged separately according to stimulus type and position in the set. Potentials in response to the probe were averaged according to the preceding stimulus sequence: 4 memorized digits, two distracter digits or two noise distracters. RESULTS: The early components (N1, P2) differed between distracter items and memorized items, indicating lower attention allocation to distracter items. In contrast, the late components (N2, P3) indicated similar processing of distracters and memorized items. Behavioral measures indicated shorter scanning times of sets with distracters. The early ERP components in response to the probe (P2, N2) indicated differences among probes according to the preceding combinations of memorized items and distracters. The late component (P3) indicated different speeds (latencies) of scanning and comparison for series with compared to without distracters, but similar processing resource allocation (amplitudes). Processing was prolonged when the distracter items were phonological. CONCLUSIONS: This study shows that distracters affect both the memorization process and the scanning and comparison in short-term memory. The stronger distraction by stimuli that are phonologically similar to the memorized items supports phonological processing in short-term memory.