Electrodermal and central measures of the tonic orienting reflex (OR).

Sokolov described both phasic and tonic aspects of the Orienting Reflex (OR), but subsequent research and theory development has focussed primarily on the phasic OR at the expense of the tonic OR. The present study used prestimulus skin conductance level (SCL) during a dishabituation paradigm to model the tonic OR, examining its amplitude patterning over repeated standard stimulus presentations and a change stimulus. We expected sensitisation (increased amplitude) following the initial and change trials, and habituation (decrement) over the intervening trials. Prestimulus EEG alpha level was explored as a potential central measure of the tonic OR (as an inverse correlate), examining its pattern over stimulus repetition and change in relation to the SCL model. We presented a habituation series of innocuous auditory stimuli to two groups (each N = 20) at different ISIs (Long 13-15 s and Short 5-7 s) and recorded electrodermal and EEG data during two counterbalanced conditions; Indifferent: no task requirements; Significant: silent counting. Across groups and conditions, prestimulus SCLs and alpha amplitudes generally showed the expected trials patterns, confirming our main hypotheses. Findings have important implications for including the assessment of Sokolov's tonic OR in modelling central and autonomic nervous system interactions of fundamental attention and learning processes.

A randomized, double-blind, placebo-controlled, parallel-group 12-week pilot phase II trial of SaiLuoTong (SLT) for cognitive function in older adults with mild cognitive impairment.

INTRODUCTION: This study primarily aimed to evaluate the efficacy and safety of SaiLuoTong (SLT) on cognition in mild cognitive impairment (MCI). METHODS: Community-dwelling people with MCI aged ≥60 years were randomly assigned to 180 mg/day SLT or placebo for 12 weeks. RESULTS: Thirty-nine participants were randomized to each group (N = 78); 65 were included in the final analysis. After 12 weeks, the between-groups difference in Logical Memory delayed recall scores was 1.40 (95% confidence interval [CI]: 0.22 to 2.58; P = 0.010); Delis-Kaplan Executive Function System Trail Making Test Condition 4 switching and contrast scaled scores were 1.42 (95% CI: -0.15 to 2.99; P = 0.038) and 1.56 (95% CI: -0.09 to 3.20; P = 0.032), respectively; Rey Auditory Verbal Learning Test delayed recall was 1.37 (95% CI: -0.10 to 2.84; P = 0.034); and Functional Activities Questionnaire was 1.21 (95% CI: -0.21 to 2.63; P = 0.047; P < 0.001 after controlling for baseline scores). DISCUSSION: SLT is well tolerated and may be useful in supporting aspects of memory retrieval and executive function in people with MCI. Highlights: SaiLuoTong (SLT) improves delayed memory retrieval and executive function in people with mild cognitive impairment (MCI).SLT is well tolerated in people ≥ 60 years.The sample of community dwellers with MCI was well characterized and homogeneous.

A systematic review of the safety and efficacy on cognitive function of herbal and nutritional medicines in older adults with and without subjective cognitive impairment.

BACKGROUND: Subjective cognitive impairment (SCI) substantially increases dementia risk and is often conceptualised as the preclinical asymptomatic phase of the cognitive decline continuum. Due to the lack of pharmacological interventions available to treat SCI and reduce dementia risk, and the popularity of herbal and nutritional medicines, the primary aim of this review was to investigate the efficacy on cognitive function and safety of herbal and nutritional medicines (relative to a control) for older adults with and without SCI. The secondary aims were to describe the study characteristics and assess the methodological quality of included studies. METHOD: Five databases (Cochrane, MEDLINE, CINAHL, PsycInfo, and EMBASE) were searched from database inception with weekly alerts established until review finalisation on 18 September 2022. Articles were eligible if they included the following: study population of older adults with and without SCI, herbal and nutritional medicines as an intervention, evaluated cognitive outcomes and were randomised control trials. RESULTS: Data were extracted from 21/7666 eligible full-text articles, and the risk of methodological bias was assessed (with SCI = 9/21; without SCI = 12/21). Most studies (20/21) employed parallel, randomised, placebo-controlled designs and were 12 weeks in length. Herbal supplements were widely used (17/21), namely a form of Ginkgo biloba (8/21) or Bacopa monnieri (6/21). Measures of cognition varied across studies, with 14/21 reporting improvements in at least one domain of cognitive functioning over time, in the intervention group (compared to control). A total of 14/21 studies were deemed as having an overall high methodological risk of bias, 6/21 had some concerns, and only one study (using an SCI population) was assessed as having a low risk of methodological bias. CONCLUSIONS: Overall, this review found that there is a low quality of evidence regarding the efficacy of cognitive function and safety of herbal and nutritional medicines for older adults with and without SCI, due to a high risk of bias across studies. Additionally, further work needs to be done in classifying and understanding SCI and selecting appropriate trial primary outcomes before future studies can more accurately determine the efficacy of interventions for this population.

Effects of interstimulus interval and significance on electrodermal and central measures of the phasic orienting reflex (OR) in a dishabituation task.

Although the P300 event-related potential (ERP) is the most likely central measure of Sokolov's Orienting Reflex (OR), there are few systematic comparisons with the skin conductance response (SCR), the "gold standard" electrodermal OR measure. We examine habituation, stimulus significance, and inter-stimulus interval (ISI) effects in SCRs and components of the P300 from single-trial ERPs in an auditory dishabituation paradigm. Single trial ERP components were separated by temporal principal components analysis, and five components of the P300 were examined as potential phasic OR measures: P3a, P3b, Novelty P3, and two Slow Waves (SW1, SW2). Across the factors of ISI and significance, SCRs showed decrement over trials, recovery at a deviant, and dishabituation at the subsequent standard. This general pattern was not present in any of the components of the P300. SCRs were also larger to significant stimuli and at the long ISI; effects differed between P300 components. The electrodermal SCR showed the complete profile over trials expected of the phasic OR, and was enhanced by stimulus significance, confirming it as the model measure of Sokolov's phasic OR. Components of the P300 failed to match this profile, but instead appear to reflect different aspects of the stimulus processing involved in OR elicitation.

Frontocentral delta-beta amplitude coupling in endometriosis-related chronic pelvic pain.

OBJECTIVE: Endometriosis is associated with neuroplastic changes in cognitive control and pain processing networks. This was the first study to assess eyes-closed resting electroencephalogram (EEG) oscillatory amplitudes in women with endometriosis compared to healthy controls, and explore the relationship with chronic pelvic pain. METHODS: Women with endometriosis-related chronic pelvic pain and individually age-matched pain-free controls (N = 20 per group) documented pelvic pain for 28 days before having continuous EEG recorded during a 2 min eyes closed resting state. Natural frequency components were extracted for each group using frequency principal components analysis. Corresponding components were assessed for group differences and correlated with pain scores. RESULTS: Relative to controls, the endometriosis group had greater component amplitudes in delta (0.5 Hz) and beta (∼28 Hz), and reduced alpha (∼10 Hz). Delta and beta amplitudes were positively associated with pain severity, but only beta maintained this association after delta-beta amplitude coupling was controlled. CONCLUSIONS: Enhanced resting delta and beta amplitudes were seen in women with endometriosis experiencing chronic pelvic pain. This delta-beta coupling varied with pelvic pain severity, perhaps reflecting altered cholinergic tone and/or stress reactivity. SIGNIFICANCE: Endometriosis-related changes in central pain processing demonstrate a distinct neuronal oscillatory signature detectable at rest.

Child sex differences in the auditory equiprobable Go/NoGo task.

Our previous studies of the equiprobable auditory Go/NoGo task have been used to substantiate a perceptual/cognitive Processing Schema in young and older adults, and in children. The processes in the Schema are linked to PCA components derived separately from Go and NoGo ERPs. Here we investigated sex differences in the child Schema. Two groups of fourteen children (aged 8 to 13 years) were individually matched on age and presented with four stimulus blocks of the equiprobable Go/NoGo task, each containing 75 NoGo and 75 Go tones in random order. Separate NoGo and Go ERPs were obtained from each child and submitted to temporal Principal Components Analyses (PCAs). Each ERP was analysed in two epochs (-100-400 ms and 300-800 ms) to improve the cases:variables ratio. Four pairs of temporal PCAs, each with unrestricted VARIMAX rotation, separately quantified the NoGo and Go ERPs of each epoch in each group. After these pairs were combined in temporal order, four sets of similar components were extracted. Many identified components were differentially enhanced to either NoGo or Go, as in previous work with children. The Female group had NoGo component latencies that were systematically some 3.5% greater than in Males, but there were no sex differences in Go latencies. Females also displayed fewer NoGo commission and Go omission errors, and faster Go RT than Males. Females had larger NoGo N2b, and larger Go components from N2b through to the late positivity. These results, including their ERP component/behaviour correlations, can be integrated as a task-specific behavioural and ERP processing enhancement in girls that suggests their developmental advantage over boys in this age range.

Stimulus intensity effects and sequential processing in the passive auditory ERP.

Auditory stimulus intensity of innocuous tones is generally thought to have a direct effect on the amplitude of ERP components, but these effects have rarely been explored across a wide component range, or in multiple paradigms. Here we investigate component sensitivity to stimulus intensity differences in two studies. Study 1 (N = 36) employed a between-participants paradigm in which repeated trains of standard stimuli were presented as 50 or 80 dB SPL 1000 Hz tones. Study 2 (N = 18) used a within-participant presentation of alternating 60 and 80 dB SPL 1000 Hz tones. Electrode caps with 19 channels (referred to linked ears) generated ERPs covering the first 600 ms of each participant's EEG responses; these were submitted to separate temporal PCAs in each study. A similar series of components was obtained in each study: P1, N1a, N1b, N1c, P2, P3a, P3b, nP3, SW1, and SW2; an N2 was found in Study 2 only. Loud tones in Study 1 produced greater amplitudes in all components except SW1. In Study 2, Loud cf. Soft tones produced smaller P1 and nP3, larger N1 components, P2, and P3a, with no effect on N2, P3b, SW1 or SW2. These results indicate similar sequential processes underlying sensory processing in one- and two-stimulus paradigms, with the later stimulus intensity effects varying with paradigm.

Complementary medicines and therapies in clinical guidelines on pregnancy care: A systematic review.

BACKGROUND: There is a need for evidence-based guidance on complementary medicines and therapies (CMT) use during pregnancy due to high prevalence of use and lack of guidance on the balance of benefit and harms. AIM: Evaluate the extent to which current clinical practice guidelines relevant to Australian healthcare professionals make clear and unambiguous recommendations about CMT use in pregnancy, and synthesise these recommendations. METHODS: The search included EMBASE, PubMed, the National Health and Medical Research Council's Clinical Practice Guidelines Portal, and websites of Australian maternity hospitals and professional/not-for-profit organisations for published guidelines on pregnancy care. Data were synthesised narratively. Guidelines were appraised by two independent reviewers using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. FINDINGS: A total of 48 guidelines were found, of which 41% provided recommendations that were not limited to routine vitamin and mineral supplementation. There were wide variations in recommendations, particularly for vitamin D and calcium. There was some consensus on recommending ginger and vitamin B6 for nausea and vomiting, and additional supplementation for women with obesity. Guidelines generally scored poorly in the domains of editorial independence and rigour of development. DISCUSSION: There is a lack of guidance with regard to appropriate CMT use during pregnancy, which may result in less-than-optimal care. Inconsistency between guidelines may lead to variations in care. CONCLUSION: Guidelines should include clear and unambiguous guidance on appropriate CMT use during pregnancy, be based on a structured search of the evidence and informed by stakeholder engagement.

Development of children's performance and ERP components in the equiprobable Go/NoGo task.

Since the equiprobable Go/NoGo task lacks the dominant Go imperative of the usual Go/NoGo (with more Go than NoGo stimuli), it is generally regarded as involving little inhibition. However, children have relative difficulty with this task, and have a large frontal NoGo N2. We previously found that this 'child N2' does play an inhibitory role, with larger frontal N2b associated with fewer commission errors. Here we investigated age-related developmental differences in the N2b and other components in the equiprobable Go/NoGo task. Two groups of eighteen Younger children (aged 8.0 to 10.3 years) and eighteen Older children (aged 10.4 to 12.8 years), matched on sex, were presented with three stimulus blocks each containing 100 Go and 100 NoGo tone stimuli in random order. Four temporal PCAs, each with unrestricted VARIMAX rotation, separately quantified the Go and NoGo ERPs of each group, and similar components were extracted from each set. Most identified components were differentially enhanced to either Go or NoGo, as in adults, supporting a previously-proposed differential sequential processing schema. The Older group had Go component latencies that were systematically reduced by some 7.4% from the Younger group, and they displayed faster RT and fewer omission and commission errors. Between subjects in the Older group, larger frontocentral NoGo N2b was associated with fewer commission errors. Hence the NoGo N2b in this paradigm can be interpreted as an individual marker of inhibition in older, but not young, children.

Weight Gain and Lymphedema After Breast Cancer Treatment: Avoiding the Catch-22?

Background: Overweight and obesity are strongly implicated in breast cancer (BC) development and are also a risk factor for BC-related lymphedema (BCRL). Methods and Results: An online cross-sectional survey was conducted between November 2017 and January 2018. Analyses were restricted to women with localized BC, who provided information about BCRL (n = 238). Most women were not experiencing BCRL (55.46%). Mean self-reported weight at diagnosis was 68.55 kg for women without BCRL and 74.43 kg for women with BCRL (p = 0.0021). In this study, 50.9% with BCRL were overweight/obese at diagnosis (body mass index [BMI] ≥25) compared with 36.4% of women without BCRL (p = 0.003). For women without BCRL, 12.12% were classified as obese (BMI ≥30) versus 20.75% with BCRL. Women with BCRL were more likely to have gained >5% of body weight (p = 0.03), be currently overweight or obese (p = 0.004), and less active (48.11%) than they were at diagnosis than women without BCRL (33.33%) (p = 0.042). Having a structured exercise program, following a prescribed diet, and being accountable to someone else were identified as the main facilitators to successful weight loss and weight maintenance. Conclusions: Clinicians should consider obesity when personalizing axillary treatment and encourage lifestyle interventions and lymphedema screening after BC treatment.

Manual Acupuncture Plus Usual Care Versus Usual Care Alone in the Treatment of Endometriosis-Related Chronic Pelvic Pain: A Randomized Controlled Feasibility Study.

Objective: To determine the acceptability and feasibility of acupuncture for the treatment of endometriosis-related chronic pelvic pain. Design: A prospective, randomized controlled feasibility study. Setting: Outpatient setting in Sydney, Australia. Subjects: Participants who were aged 18-45 years, had a confirmed laparoscopic diagnosis of endometriosis in the past 5 years, and had regular menstrual periods and mean pelvic pain scores ≥4/10. Interventions: Sixteen acupuncture treatments delivered by registered acupuncturists using a standardized point protocol over 8 weeks, twice per week plus usual care compared with usual care alone. Outcome measures: Primary outcome measures were feasibility, safety, and acceptability of the acupuncture intervention. Secondary outcomes were changes in self-reported pelvic pain scores, changes in quality of life as measured by the Endometriosis Health Profile (EHP-30), changes in descending pain modulation, and changes in systemic inflammation (plasma interleukin [IL-6] concentrations). Results: Twenty-nine participants were eligible to participate, with 19 participants completing the trial. There was unequal withdrawals between groups; the acupuncture group had a withdrawal rate of 14% compared with 53% in usual care. Adverse events were uncommon (6.7%) and generally mild. A 1.9 point decrease in median nonmenstrual pain scores and a 2.0 decrease in median menstrual pain scores between baseline and end of trial were observed in the acupuncture group only. Improvements in all domains of the EHP-30 were seen in the acupuncture group, with no changes seen in usual care. There was no difference between baseline and end of treatment in IL-6 concentrations for either group. Conclusions: Acupuncture was an acceptable, well-tolerated treatment and it may reduce pelvic pain and improve quality of life; however, usual care was not an acceptable control group. Trial Registration: anzctr.org.au: ACTRN12617000053325. Prospectively registered January 11, 2017.

Sex differences in resting EEG in healthy young adults.

Resting EEG, measured in eyes-closed (EC) and eyes-open (EO) states, can provide insight into behavioural differences between groups. Surprisingly, differences in resting EEG between females and males have not been investigated systematically in previous literature. The present study utilised the four traditional EEG bands to confirm their baseline EC topographies and reactivity (EO minus EC) across groups, to clarify topographical differences between sexes, and to confirm alpha as a measure of arousal. Participants were eighty healthy young adults (40 female), with a mean age of 20.4 (range 18-26) years. Continuous resting EEG was recorded from 30 scalp sites during three 2-minute conditions (EO1, EC, EO2), and EOG-corrected. Data from each condition were divided into 60 sequential 2-second epochs. Accepted artefact-free epochs were Fourier Transformed, and absolute amplitudes in the delta (0.5-3.5 Hz), theta (4.0-7.5 Hz), alpha (8.0-13.0 Hz), and beta (13.5-29.5 Hz) bands were calculated. Across groups in EC, significant topographical differences were found between the band amplitudes, broadly compatible with previous reports. Females had greater overall amplitudes in delta, alpha and beta, enhanced midline activity in theta, and parietal and midline activity in the alpha and beta bands. From EC to EO, reactivity was apparent across the bands as significant reductions, particularly in the parietal region. For females compared to males, the reduction in parietal midline delta and theta, parietal alpha and parietal midline beta was significantly larger. Additionally, across groups, alpha activity was confirmed as an inverse measure of arousal. These findings indicate significant differences in neuronal activity between young adult females and males, and help our interpretation of alpha changes.

"We need a one-stop-shop": co-creating the model of care for a multidisciplinary memory clinic with community members, GPs, aged care workers, service providers, and policy-makers.

BACKGROUND: Timely diagnosis of dementia has a wide range of benefits including reduced hospital emergency department presentations, admissions and inpatient length of stay, and improved quality of life for patients and their carers by facilitating access to treatments that reduce symptoms, and allow time to plan for the future. Memory clinics can provide such services, however there is no 'gold standard' model of care. This study involved the co-creation of a model of care for a new multidisciplinary memory clinic with local community members, General Practitioners (GPs), policy-makers, community aged care workers, and service providers. METHODS: Data collection comprised semi-structured interviews (N = 98) with 20 GPs, and three 2-h community forums involving 53 seniors and community/local government representatives, and 25 community healthcare workers. Interviews and community forums were audio-recorded, transcribed verbatim, and coded by thematic analysis using Quirkos. RESULTS: GPs' attitudes towards their role in assessing people with dementia varied. Many GPs reported that they found it useful for patients to have a diagnosis of dementia, but required support from secondary care to make the diagnosis and assist with subsequent management. Community forum participants felt they had a good knowledge of available dementia resources and services, but noted that these were highly fragmented and needed to be easier to navigate for the patient/carer via a 'one-stop-shop' and the provision of a dementia key worker. Expectations for the services and features of a new memory clinic included diagnostic services, rapid referrals, case management, education, legal services, culturally sensitive and appropriate services, allied health, research participation opportunities, and clear communication with GPs. Participants described several barriers to memory clinic utilisation including transportation access, funding, awareness, and costs. CONCLUSION: This study demonstrates the importance of working with stakeholders to co-design models of care for people with dementia that take into account the local communities' needs. Findings pave the way for the development of a potential new "gold standard" memory clinic model of care and operationalise new national clinical guidelines.

Neuronal Correlates of Cognitive Control Are Altered in Women With Endometriosis and Chronic Pelvic Pain.

Endometriosis is a debilitating women's health condition and is the most common cause of chronic pelvic pain. Impaired cognitive control is common in chronic pain conditions, however, it has not yet been investigated in endometriosis. The aim of this study was to explore the neuronal correlates of cognitive control in women with endometriosis. Using a cross-sectional study design with data collected at a single time-point, event-related potentials were elicited during a cued continuous performance test from 20 women with endometriosis (mean age = 28.5 ± 5.2 years) and 20 age- and gender-matched controls (mean age = 28.5 ± 5.2 years). Event-related potential components were extracted and P3 component amplitudes were derived with temporal principal components analysis. Behavioral and ERP outcomes were compared between groups and subjective pain severity was correlated with ERP component amplitudes. No significant behavioral differences were seen in task performance between the groups (all p > 0.094). Target P3b (all p < 0.034) and SW (all p < 0.040), and non-target early P3a (eP3a; all p < 0.023) and late P3a (lP3a; all p < 0.035) amplitudes were smaller for the endometriosis compared to the healthy control group. Lower non-target eP3a (p < 0.001), lP3a (p = 0.013), and SW (p = 0.019) amplitudes were correlated with higher pain severity scores. Findings suggest that endometriosis-associated chronic pelvic pain is linked to alterations in stimulus-response processing and inhibitory control networks, but not impaired behavioral performance, due to compensatory neuroplastic changes in overlapping cognitive control and pain networks.

When to Do Surgery and When Not to Do Surgery for Endometriosis: A Systematic Review and Meta-analysis.

OBJECTIVE: We performed a systematic review and meta-analysis with the aim to answer whether operative laparoscopy is an effective treatment in a woman with demonstrated endometriosis compared with alternative treatments. Moreover, we aimed to assess the risks of operative laparoscopy compared with those of alternatives. In addition, we aimed to systematically review the literature on the impact of patient preference on decision making around surgery. DATA SOURCES: We searched MEDLINE, Embase, PsycINFO, ClinicalTrials.gov, CINAHL, Scopus, OpenGrey, and Web of Science from inception through May 2019. In addition, a manual search of reference lists of relevant studies was conducted. METHODS OF STUDY SELECTION: Published and unpublished randomized controlled trials (RCTs) in any language describing a comparison between surgery and any other intervention were included, with particular reference to timing and its impact on pain and fertility. Studies reporting on keywords including, but not limited to, endometriosis, laparoscopy, pelvic pain, and infertility were included. In the anticipated absence of RCTs on patient preference, all original research on this topic was considered eligible. TABULATION, INTEGRATION, AND RESULTS: In total, 1990 studies were reviewed. Twelve studies were identified as being eligible for inclusion to assess outcomes of pain (n = 6), fertility (n = 7), quality of life (n = 1), and disease progression (n = 3). Seven studies of interest were identified to evaluate patient preferences. There is evidence that operative laparoscopy may improve overall pain levels at 6 months compared with diagnostic laparoscopy (risk ratio [RR], 2.65; 95% confidence interval [CI], 1.61-4.34; p <.001; 2 RCTs, 102 participants; low-quality evidence). Because the quality of the evidence was very low, it is uncertain if operative laparoscopy improves live birth rates. Operative laparoscopy probably yields little or no difference regarding clinical pregnancy rates compared with diagnostic laparoscopy (RR, 1.29; 95% CI, 0.99-1.92; p = .06; 4 RCTs, 624 participants; moderate-quality evidence). It is uncertain if operative laparoscopy yields a difference in adverse outcomes when compared with diagnostic laparoscopy (RR, 1.98; 95% CI, 0.84-4.65; p = .12; 5 RCTs, 554 participants; very-low-quality evidence). No studies reported on the progression of endometriosis to a symptomatic state or progression of extent of disease in terms of volume of lesions and locations in asymptomatic women with endometriosis. We found no studies that reported on the timing of surgery. No quantitative or qualitative studies specifically aimed at elucidating the factors informing a woman's choice for surgery were identified. CONCLUSION: Operative laparoscopy may improve overall pain levels but may have little or no difference with respect to fertility-related or adverse outcomes when compared with diagnostic laparoscopy. Additional high-quality RCTs, including comparing surgery to medical management, are needed, and these should report adverse events as an outcome. Studies on patient preference in surgical decision making are needed (International Prospective Register of Systematic Review registration number: CRD42019135167).

Efficacy of Cognition Support Formula® on cognitive function in older adults with subjective cognitive impairment: a protocol for a 26-week, randomised, double-blind, placebo-controlled trial.

BACKGROUND: Due to an ageing population in Australia there has been an increase in the number of older adults with subjective cognitive impairment (SCI), a self-reported decline in cognitive function associated with an increased risk of mild cognitive impairment and dementia. There is no current, recommended treatment for SCI; therefore, the effectiveness of a supplement approved by the Therapeutic Goods Association that has the potential to enhance cognitive function in an at-risk cohort should be tested. The primary aim of this proposed research is to determine the efficacy of 6 months of treatment with BioCeuticals Cognition Support Formula® (containing Bacopa monniera (brahmi), Ginkgo biloba, Panax ginseng and alpha-lipoic acid) on cognition in older adults with SCI (utilising the CogState® one card learning and identification tests as co-primary outcome measures of visual short-term memory and attention; mean speed (ms), accuracy (%), and total number of hits, misses, and anticipations) compared with placebo. The secondary aims are to assess an improvement in other cognitive domains (executive functioning, processing speed, and working memory), evaluate safety, adverse effects, and determine efficacy on mood, fatigue, and neurocognition. It is expected that improvements across the study timepoints in the co-primary outcomes in the active treatment group (compared with placebo) will be evident. METHOD: One-hundred and twenty participants will be recruited for the randomised, double-blind, placebo-controlled study. Participants will be randomly assigned to one of the treatment groups (active or placebo) at a 1:1 ratio, and will be required to complete a series of cognitive (using CogState®), mood (using the Depression, Anxiety, Stress Scale (DASS-42) and Short Health Anxiety Inventory (SHAI)), and fatigue (using the Functional Assessment of Chronic Illness Therapy Fatigue Scale (FACIT-F)) tasks at baseline (0 months), the midpoint (3 months), and the endpoint (6 months). These tasks will be evaluated between timepoints (baseline vs. midpoint, midpoint vs. endpoint, and baseline vs. endpoint). Neurocognition will be measured by electroencephalography at baseline and at the endpoint in half of the participants. Adverse effects will be documented over the 6-month trial period. DISCUSSION: This is the first study to test the efficacy of Cognition Support Formula® on cognition in older adults with SCI. As people with SCI have an increased risk of dementia, and there are limited treatments options for this population, it is important to assess a supplement that has the potential to enhance cognitive function. TRIAL REGISTRATION: Universal Trial Number (UTN), U1111-1196-9548. Australian New Zealand Clinical Trials Registry, ACTRN12617000945325 . Registered on 30 June 2017.

Sequential processing in young and older adults in the equiprobable auditory Go/NoGo task.

OBJECTIVE: We recently proposed a sequential processing schema for the equiprobable auditory Go/NoGo task, based on a principal components analysis (PCA) of event-related potentials (ERPs) from a university student sample. Here we sought to replicate the schema, and use it to explore processing in well-functioning older adults. METHODS: We compared behavioural responding and ERPs of 20 independent-living older adults (Mage=68.2years) to data from a sex- and handedness-matched group of university students (Mage=20.4years). ERPs had substantial latency differences between the groups, and hence were subjected to separate group temporal PCAs. RESULTS: Component latencies were systematically increased in the older group by some 26%, with no significant increase in RT or error rates. Despite some differences in their identified components, each group displayed differential component responsivity to Go versus NoGo; this was reduced in the older participants. CONCLUSION: The results support our processing schema, and provide insight into the processing stages in well-functioning older adults. SIGNIFICANCE: Understanding the perceptual and cognitive processing stages in normal ageing is a pre-requisite for research on mild cognitive impairment and dementia. This study may also provide a simple paradigm and schema suitable for further exploration of functionality in ageing.

Caffeine Effects on ERP Components and Performance in an Equiprobable Auditory Go/NoGo Task.

Background: Research has reliably demonstrated that caffeine produces a general increase in physiological arousal in humans, but we previously failed to obtain the expected arousal-based changes in manually quantified event-related potential (ERP) components in response to the stimuli in a simple Go/NoGo task. Methods: A single oral dose of caffeine (250 mg) was used in a randomized double-blind placebo-controlled repeated-measures cross-over study. Adult participants (N=24) abstained from caffeine for 4 hours before each of two sessions, approximately 1 week apart. An equiprobable auditory Go/NoGo task was used, with a random mix of 75 tones at 1,000 Hz and 75 at 1,500 Hz. All tones were 50 ms duration (rise/fall time 5 ms) at 60 dB SPL, with a fixed stimulus-onset asynchrony of 1100 ms. Principal component analysis (a form of factor analysis) was used to quantify orthogonal ERP components. Results: ERP components reflected the different sequential processing of each stimulus type in this paradigm, replicating previous results. Caffeine was associated with a reduction in reaction time and fewer omission errors. The major ERP effects of caffeine were apparent as a slightly enhanced Processing Negativity and larger P3b amplitudes to Go stimuli. There were few effects on components to NoGo stimuli. Conclusions: The results confirm our previous findings that caffeine improves aspects of the differential processing related to response production and task performance, but may be interpreted as supporting the simple amplification of ERP component amplitudes predicted by the general arousal induced by caffeine.