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A systematic review of research investigating the physiological and psychological effects of combining Ginkgo biloba and Panax ginseng into a single treatment in humans: Implications for research design and analysis.
Reay, JL, van Schaik, P, Wilson, CJ
Brain and behavior. 2019;(3):e01217
Abstract
BACKGROUND AND PURPOSE The traditional herbal supplements Panax ginseng and Ginkgo biloba are self-medicated by members of the general public and prescribed by healthcare professionals in some EU countries for numerous health complaints. Clinical evidence is mixed and mechanisms of action are not fully understood. There is clinical interest into the synergistic effects of combining both herbs. METHODS We systematically review the literature investigating the effects of combination treatments on physiological and psychological outcomes in humans. We identified all studies meeting inclusion criteria: (a) written in English; (b) peer-reviewed; (c) conducted in humans; (d) including either a proprietary Panax ginseng/Ginkgo biloba treatment or a study preparation containing both; (e) placebo-controlled; (f) utilizing standardized extracts. We critically discuss each trial; calculate standardized effect sizes where possible and provide recommendations for research design and analysis. RESULTS Eight studies were identified and all investigated a proprietary combination treatment, Gincosan® . Studies are of high quality and robust; however, practice effects, choice of statistical model, and reliance upon null-hypothesis significance testing hinder generalized estimates of effect. The most consistent results are benefits to aspects of the circulatory/cardiovascular system in patient populations and "secondary memory" performance in patient and healthy populations. Two studies demonstrate synergy in healthy populations following a single dose; however, synergy in patient populations and following repeated dosing has not yet been directly tested. CONCLUSIONS A Panax ginseng and Ginkgo biloba combination treatment can improve aspects of physiological and cognitive function in humans; however, evidence for synergy requires further investigation and future research should directly investigate synergy following repeated dosing.
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Demystifying wine tasting: Cognitive psychology's contribution.
Parr, WV
Food research international (Ottawa, Ont.). 2019;:230-233
Abstract
Over recent decades, cognitive psychology has made a significant contribution to our understanding of wine-tasting phenomena. At the most fundamental level the discipline's contribution has made us aware that even an apparently 'simple' judgment, such as noting that a wine's odour reflects over-ripe fruit, involves not just our nose but sophisticated cognitive processing. With its information-processing model of how people interact with their surrounding world, and its methodologies and theories regarding how we perceive, conceptualise, remember, image, make judgments, and communicate our experiences, cognitive psychology has markedly advanced our understanding of wine tasting and wine tasters. This review highlights notable wine sensory research outcomes that make evident the importance of a taster's cognitive processes in their wine analysis and appreciation. These include data providing evidence for colour-flavour perceptual bias, prototypical thinking, knowledge-based wine judgments, the close links between olfactory memory, autobiographical memory and emotion, and the notion of wine expertise. Further, it will be argued that such data demonstrate how a consensus model, still dominant in much wine sensory analysis, is limited at best and inappropriate for sensory analysis of complex products such as wine in many contexts. Critical to this argument is appreciating that differences amongst tasters, reflecting each individual's physiology, experience and knowledge, are valid data in themselves rather than 'error in the machine' as they were conceptualised within traditional consensus models of sensory analysis. The article terminates with reference to a promise for even greater understanding of wine tasting phenomena that the future offers by links between cognitive psychology's behavioural data and recent technological advances in neuropsychology and neurophysiology (e.g., cerebral imaging techniques).
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The attention-enhancing effects of spearmint extract supplementation in healthy men and women: a randomized, double-blind, placebo-controlled, parallel trial.
Falcone, PH, Nieman, KM, Tribby, AC, Vogel, RM, Joy, JM, Moon, JR, Slayton, CA, Henigman, MM, Lasrado, JA, Lewis, BJ, et al
Nutrition research (New York, N.Y.). 2019;:24-38
Abstract
Previous studies have demonstrated that chronic supplementation with a proprietary spearmint extract (PSE) can improve cognitive performance in individuals 50-70 years of age with age-related memory issues. In the present study, our hypothesis was that chronic supplementation of PSE would improve cognitive performance in young, active individuals. Using a randomized, double-blind, placebo-controlled, parallel design, healthy, recreationally active men and women (N = 142) received 900 mg of PSE or placebo (PLA) daily for 90 days. Cognition was assessed via cognitive test battery (CNS Vital Signs) that resulted in 10 cognitive domains. Sleep, mood, and quality of life were assessed via validated questionnaires. Measurements were evaluated on days 0, 7, 30, and 90 of supplementation. Significant (P < .05) treatment effects were observed for sustained attention, wherein PSE improved sustained attention vs PLA at day 30 (PSE: 33.3 ± 0.54 vs PLA: 31.2 ± 0.98; P = .001) and day 90 (PSE: 34.0 ± 0.44 vs PLA: 32.7 ± 0.75; P = .007). Significant (P < .05) treatment × visit interactions were observed for complex attention, wherein PSE improved complex attention compared to PLA at day 7 (PSE: 8.0 ± 2.22 vs PLA: 7.6 ± 0.57; P = .016). Significant (P < .05) improvements were observed in 2 individual tests: the shifting attention test and the 4-part continuous performance test. No significant differences were observed in mood, sleep, or quality of life. The current study demonstrates that chronic supplementation with 900 mg of PSE improves cognitive performance in a young, active population, further supporting PSE as an efficacious nootropic.
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Thiazide therapy is not related to any changes in cognitive function in older hypertensive patients with or without dementia: a 26-week follow-up study.
Kocyigit, SE, Soysal, P, Ates Bulut, E, Dokuzlar, O, Isik, AT
Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society. 2019;(1):16-22
Abstract
AIM: The study aimed to evaluate the effect of thiazide diuretics, a first-line antihypertensive therapy, on cognitive function in elderly hypertensive patients with or without cognitive impairment. METHODS This retrospective and observational study assessed 286 elderly patients with hypertension. Patients were divided based on thiazide diuretic usage and then into dementia and non-dementia groups. The comprehensive geriatric assessment was performed for all patients. All participants were re-evaluated after a 26-week period. RESULTS In total, 133 patients, including 62 with dementia, took thiazide. There were no significant differences between baseline and follow-up laboratory findings, comprehensive geriatric assessment parameters, including detailed neurocognitive assessment, or electrolytes in the thiazide group, the non-thiazide group, and the dementia group (P > 0.05). CONCLUSION Thiazide therapy does not show any effect on cognitive function in older hypertensive adults regardless of dementia status.
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Anxiety and anhedonia in depression: Associations with neuroticism and cognitive control.
Liao, A, Walker, R, Carmody, TJ, Cooper, C, Shaw, MA, Grannemann, BD, Adams, P, Bruder, GE, McInnis, MG, Webb, CA, et al
Journal of affective disorders. 2019;:1070-1078
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Abstract
BACKGROUND Despite the fact that higher levels of anxiety and anhedonia in Major Depressive Disorder (MDD) are linked to poorer treatment outcomes, mechanisms contributing to these clinical presentations remain unclear. Neuroticism, impaired cognitive control, and blunted reward learning may be critical processes involved in MDD and may help to explain symptoms of anxiety and anhedonia. METHODS Using baseline data from patients with early-onset MDD (N = 296) in the Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) trial, we conducted a path analysis to model relationships between neuroticism, cognitive control, and reward learning to levels of anxiety and anhedonia. RESULTS Neuroticism was positively associated with both anhedonia (standardized coefficient = 0.26, p < .001) and anxiety (standardized coefficient = 0.40, p < .001). Cognitive control was negatively associated with anxiety (standardized coefficient = -0.18, p < .05). Reward learning was not significantly associated with either anxiety or anhedonia. LIMITATIONS Extraneous variables not included in the model may have even more influence in explaining symptoms of anxiety and anhedonia. Restricted range in these variables may have attenuated some of the hypothesized relationships. Most important, because this was a cross-sectional analysis in a currently depressed sample, we cannot draw any causal conclusions without experimental and longitudinal data. CONCLUSIONS These cross-sectional findings suggest that neuroticism may contribute to anxiety and anhedonia in patients with early onset and either chronic or recurrent MDD, while enhanced cognitive control may protect against anxiety.
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The impact of homocysteine, B12, and D vitamins levels on functional neurocognitive performance in HIV-positive subjects.
Falasca, K, Di Nicola, M, Di Martino, G, Ucciferri, C, Vignale, F, Occhionero, A, Vecchiet, J
BMC infectious diseases. 2019;(1):105
Abstract
BACKGROUND The correlation among high levels of total homocysteine, low levels of B12vitamin, and neurocognitive impairment in HIV negative patients has been the main research topic in some of the latest reviews. The aim of this study was to examine if the alteration of homocysteine, B12 vitamin, and D vitamins plasma levels was present in HIV-positive, and their relationship with cognitive function. METHODS 57 HIV infected were enrolled and underwent the serum measurement of homocysteine, B12, and D vitamins. The neurocognitive evaluation investigated 5 cognitive domains, through a neuropsychological battery test RESULTS Homocysteine was found to be elevated in 70.2% of cases, B12 vitamin mean levels were low in 8 participants (14.0%), and 8 patients had D hypovitaminosis (14.0%). Abnormal homocysteine levels were associated with worse performance of verbal fluency (p = 0.003) and worse executive function (Stroop E test p = 0.040). The 25-OH D hypovitaminosis was associated with worse performances in executive functions in three different tests: Stroop E (p = 0.049), Trail B (p = 0.035), and Wais Digit Span (p = 0.042). Pathological levels of B12 Vitamin were also associated to worse performances in executive functions (Trail B Test and Wais Digit Span respectively p = 0.002 and 0.029) and with a lower speed in psychomotor processing (Peg Board Test on dominant hand, p = 0.014). CONCLUSIONS In this study serum homocysteine, B12, and D vitamin levels are associated with neurocognitive performances; in fact low performance neurocognitive was correlated with hyperhomocysteine and low B12vitamin, and D vitamin levels. Evidence of the alteration of these parameters could facilitate the early identification of a neurocognitive impairment.
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Nociceptive Primitive Reflexes in Neurologically and Cognitively Healthy Aging Subjects.
Camarda, C, Torelli, P, Pipia, C, Azzarello, D, Battaglini, I, Sottile, G, Cilluffo, G, Camarda, R
The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques. 2019;(2):199-208
Abstract
BACKGROUND To assess the prevalence of three nociceptive primitive reflexes (nPR), i.e., glabellar tap, snout reflex, and palmomental reflex, in neurologically and cognitively healthy (NCH) aging subjects. OBJECTIVE To investigate whether nPR are cross-sectionally associated with white matter hyperintensities (WMH), lacunes, atrophy of the caudate nuclei, and global brain atrophy. METHODS A total of 1246 NCH subjects aged 45-91 years were included in the study and underwent standard brain MRI. Atrophy of the caudate nuclei and global brain atrophy were assessed through the bicaudate ratio (BCr) and lateral ventricles to brain ratio (LVBr), respectively. WMH were assessed through visual rating scales. Lacunes were also rated. Association of nPR with vascular risk factors/diseases and imaging findings was evaluated using logistic regression analysis. RESULTS nPR were exhibited by 33.1% of subjects and increased with age. Subjects with nPR performed less than subjects without nPR in tests evaluating global cognition, executive functions, attention, and language. Snout reflex was the most common nPR, followed by glabellar tap and palmomental reflex. Glabellar tap was associated with parieto-temporal WMH, BCr, and LVBr; snout reflex was associated with frontal lacunes, temporal WMH, BCr, and LVBr; palmomental reflex was associated with parieto-occipital WMH, basal ganglia lacunes, BCr, and LVBr. CONCLUSIONS This study demonstrates that in NCH aging individuals, nPR are associated with WMH, lacunes, BCr, and LVBr and are probably a warning sign of incipient cognitive decline. Therefore, NCH subjects presenting nPR should manage their vascular risk factors/vascular diseases rigorously in order to prevent or delay progression of small vessel disease, and future neurological and cognitive disabilities.
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Effects of Folic Acid and Vitamin B12, Alone and in Combination on Cognitive Function and Inflammatory Factors in the Elderly with Mild Cognitive Impairment: A Single-blind Experimental Design.
Ma, F, Zhou, X, Li, Q, Zhao, J, Song, A, An, P, Du, Y, Xu, W, Huang, G
Current Alzheimer research. 2019;(7):622-632
Abstract
BACKGROUND Folate and vitamin B12 are well-known as essential nutrients that play key roles in the normal functions of the brain. Inflammatory processes play at least some role in the pathology of AD. Effective nutritional intervention approaches for improving cognitive deficits that reduce the peripheral inflammatory cytokine levels have garnered special attention. OBJECTIVE The present study aimed to determine whether supplementation with folic acid and vitamin B12, alone and in combination improves cognitive performance via reducing levels of peripheral inflammatory cytokines. METHODS 240 participants with MCI were randomly assigned in equal proportion to four treatment groups: folic acid alone, vitamin B12 alone, folic acid plus vitamin B12 or control without treatment daily for 6 months. Cognition was measured with WAIS-RC. The levels of inflammatory cytokines were measured using ELISA. Changes in cognitive function or blood biomarkers were analyzed by repeatedmeasure analysis of variance or mixed-effects models. This trial has been registered with trial number ChiCTR-ROC-16008305. RESULTS Compared with control group, the folic acid plus vitamin B12 group had significantly greater improvements in serum folate, homocysteine, vitamin B12 and IL-6, TNF-α, MCP-1. The folic acid plus vitamin B12 supplementation significantly changed the Full Scale IQ (effect size d = 0.169; P = 0.024), verbal IQ (effect size d = 0.146; P = 0.033), Information (d = 0.172; P = 0.019) and Digit Span (d = 0.187; P = 0.009) scores. Post hoc Turkey tests found that folic acid and vitamin B12 supplementation was significantly more effective than folic acid alone for all endpoints. CONCLUSIONS The combination of oral folic acid plus vitamin B12 in MCI elderly for six months can significantly improve cognitive performance and reduce the levels of inflammatory cytokines in human peripheral blood. The combination of folic acid and vitamin B12 was significantly superior to either folic acid or vitamin B12 alone.
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Lycopene and cognitive function.
Crowe-White, KM, Phillips, TA, Ellis, AC
Journal of nutritional science. 2019;:e20
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Abstract
Decreases in cognitive function related to increases in oxidative stress and inflammation occur with ageing. Acknowledging the free radical-quenching activity and anti-inflammatory action of the carotenoid lycopene, the aim of the present review was to assess if there is evidence for a protective relationship between lycopene and maintained cognitive function or between lycopene and development or progression of dementia. A systematic literature search identified five cross-sectional and five longitudinal studies examining these outcomes in relation to circulating or dietary lycopene. Among four studies evaluating relationships between lycopene and maintained cognition, three reported significant positive relationships. Neither of the two studies reporting on relationship between lycopene and development of dementia reported significant results. Of four studies investigating circulating lycopene and pre-existing dementia, only one reported significant associations between lower circulating lycopene and higher rates of Alzheimer's disease mortality. Acknowledging heterogeneity among studies, there is insufficient evidence and a paucity of data to draw firm conclusions or tease apart direct effects of lycopene. Nevertheless, as low circulating lycopene is a predictor of all-cause mortality, further investigation into its relationship with cognitive longevity and dementia-related mortality is warranted.
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Can Slow-Wave Sleep Enhancement Improve Memory? A Review of Current Approaches and Cognitive Outcomes.
Zhang, Y, Gruber, R
The Yale journal of biology and medicine. 2019;(1):63-80
Abstract
Slow-wave sleep (SWS) is involved in the overnight consolidation of declarative memories. Recent efforts using auditory stimulation, slow-oscillatory transcranial direct current stimulation (so-tDCS), and pharmacological agents have targeted sleep slow-waves as a method for enhancing cognitive performance. However, no studies thus far have integrated current evidence to provide a preliminary review of the effects of SWS enhancement on memory and other cognitive outcomes. The objective of this review was to synthesize the results of recent experimental studies that have used auditory stimulation, electrical, and pharmacological methods to boost both SWS and cognitive performance. A systematic review was done to identify and consolidate all currently existing empirical studies in this area. We found that each stimulation method could enhance slow-wave power and/or SWS duration in human subjects. Closed-loop, in-phase auditory stimulation enhanced verbal declarative memory in healthy adults. Electrical stimulation using so-tDCS showed some efficacy in promoting verbal declarative memory, picture recognition memory, and location memory. Interleukin-6 and sodium oxybate enhanced declarative verbal memory, while tiagabine and sodium oxybate improved some non-memory measures of cognitive performance. There is some evidence that so-tDCS can also improve certain cognitive outcomes in clinical populations. Overall, future studies should recruit larger sample sizes drawn from more diverse populations, and determine clinical significance and effect sizes of each enhancement methodology.