Nature benefits revisited: Differences in gait kinematics between nature and urban images disappear when image types are controlled for likeability.

Exposure to urban environments requires more cognitive processing than exposure to nature; an effect that can even be measured analysing gait kinematics whilst people walk towards photographic images. Here, we investigated whether differences in cognitive load between nature and urban scenes are still present when scenes are matched for their liking scores. Participants were exposed to images of nature and urban scenes that had been matched a priori for their liking scores by an independent participant sample (n = 300). Participants (N = 44) were either asked to memorise each image during walking or to rate each image for its visual discomfort after each walk. Irrespective of experimental task, liking score but not environment type predicted gait velocity. Moreover, subjective visual discomfort was predictive of gait velocity. The positive impact of nature described in the literature thus might, at least in part, be due to people's aesthetic preferences for nature images.

Walking on Visual Illusions.

In nature, sensory and physical characteristics of the environment tend to match; for example, a surface that looks bumpy is bumpy. In human-built environments, they often don't. Here, we report observations from people exploring if mismatch between visual and physical characteristics affected their perceived walking experience. Participants walked across four flat floors, each comprising of a visual illusion: two patterns perceived as alternating 3D "furrows and ridges," the Primrose Field illusion, and a variant of the Cafe Wall illusion as a control pattern without perceived 3D effects. Participants found all patterns intriguing to look at; some describing them as "playful" or "gentle." More than half found some of the patterns uncomfortable to walk on, aversive, affecting walking stability, and occasionally even evoking fear of falling. These experiences raise crucial research questions for the vision sciences into the impact of architectural design on well-being and walkability.

Avoidance of tobacco health warnings? An eye-tracking approach.

AIMS: Among three eye-tracking studies, we examined how cigarette pack features affected visual attention and self-reported avoidance of and reactance to warnings. DESIGN: Study 1: smoking status × warning immediacy (short-term versus long-term health consequences) × warning location (top versus bottom of pack). Study 2: smoking status × warning framing (gain-framed versus loss-framed) × warning format (text-only versus pictorial). Study 3: smoking status × warning severity (highly severe versus moderately severe consequences of smoking). SETTING: University of Bristol, UK, eye-tracking laboratory. PARTICIPANTS: Study 1: non-smokers (n = 25), weekly smokers (n = 25) and daily smokers (n = 25). Study 2: non-smokers (n = 37), smokers contemplating quitting (n = 37) and smokers not contemplating quitting (n = 43). Study 3: non-smokers (n = 27), weekly smokers (n = 26) and daily smokers (n = 26). MEASUREMENTS: For all studies: visual attention, measured as the ratio of the number of fixations to the warning versus the branding, self-reported predicted avoidance of and reactance to warnings and for study 3, effect of warning on quitting motivation. FINDINGS: Study 1: greater self-reported avoidance [mean difference (MD) = 1.14; 95% confidence interval (CI) = 0.94, 1.35, P < 0.001, ηp2  = 0.64] and visual attention (MD = 0.89, 95% CI = 0.09, 1.68, P = 0.03, ηp2  = 0.06) to long-term warnings, but not for reactance (MD = 0.14, 95% CI = -0.04, 0.32, P = 0.12, ηp2  = 0.03). Increased visual attention to warnings on the upper versus lower half of the pack (MD = 1.8; 95% CI = 0.33, 3.26, P = 0.02, ηp2  = 0.08). Study 2: higher self-reported avoidance of (MD = 0.70; 95% CI = 0.59,0.80, P < 0.001, ηp2  = 0.61) and reactance to (MD = 0.37; 95% CI = 0.27, 0.47, P < 0.001, ηp2  = 0.34) loss-framed warnings but little evidence of a difference for visual attention (MD = 0.52; 95% CI = -0.54, 1.58, P = 0.30, ηp2  = 0.01). Greater visual attention, avoidance and reactance to pictorial versus text-only warnings (all Ps < 0.001, ηp2  > 0.25). Study 3: greater self-reported avoidance of (MD = 0.37; 95% CI = 0.25, 0.48, P < 0.001, ηp2  = 0.33) and reactance to (MD = 0.14; 95% CI = 0.05, 0.23, P = 0.003, ηp2  = 0.11) highly severe warnings but findings were inconclusive as to whether there was a difference in visual attention (MD = -0.55; 95% CI = -1.5, 0.41, P = 0.24, ηp2  = 0.02). CONCLUSIONS: Subjective and objective (eye-tracking) measures of avoidance of health warnings on cigarette packs produce different results, suggesting these measure different constructs. Visual avoidance of warnings indicates low-level disengagement with warnings, while self-reported predicted avoidance reflects higher-level engagement with warnings.

Using smartphone accelerometry to assess the relationship between cognitive load and gait dynamics during outdoor walking.

Research has demonstrated that an increase in cognitive load can result in increased gait variability and slower overall walking speed, both of which are indicators of gait instability. The external environment also imposes load on our cognitive systems; however, most gait research has been conducted in a laboratory setting and little work has demonstrated how load imposed by natural environments impact gait dynamics during outdoor walking. Across four experiments, young adults were exposed to varying levels of cognitive load while walking through indoor and outdoor environments. Gait dynamics were concurrently recorded using smartphone-based accelerometry. Results suggest that, during indoor walking, increased cognitive load impacted a range of gait parameters such as step time and step time variability. The impact of environmental load on gait, however, was not as pronounced, with increased load associated only with step time changes during outdoor walking. Overall, the present work shows that cognitive load is related to young adult gait during both indoor and outdoor walking, and importantly, smartphones can be used as gait assessment tools in environments where gait dynamics have traditionally been difficult to measure.

Psychiatric framing affects positive but not negative schizotypy scores in psychology and medical students.

When testing risk for psychosis, we regularly rely on self-report questionnaires. Yet, the more that people know about this condition, the more they might respond defensively, in particular with regard to the more salient positive symptom dimension. In two studies, we investigated whether framing provided by questionnaire instructions might modulate responses on self-reported positive and negative schizotypy. The O-LIFE (UK study) or SPQ (New Zealand study) questionnaire was framed in either a "psychiatric", "creativity", or "personality" (NZ only) context. We tested psychology students (without taught knowledge about psychosis) and medical students (with taught knowledge about psychosis; UK only). We observed framing effects in psychology students in both studies: positive schizotypy scores were lower after the psychiatric compared to the creativity instruction. However, schizotypy scores did not differ between the creativity and personality framing conditions, suggesting that the low scores with psychiatric framing reflect defensive responding. The same framing effect was also observed in medical students, despite their lower positive schizotypy scores overall. Negative schizotypy scores were not affected by framing in either study. These results highlight the need to reduce response biases when studying schizotypy, because these might blur schizotypy-behaviour relationships.

A method for detecting characteristic patterns in social interactions with an application to handover interactions.

Social interactions are a defining behavioural trait of social animals. Discovering characteristic patterns in the display of such behaviour is one of the fundamental endeavours in behavioural biology and psychology, as this promises to facilitate the general understanding, classification, prediction and even automation of social interactions. We present a novel approach to study characteristic patterns, including both sequential and synchronous actions in social interactions. The key concept in our analysis is to represent social interactions as sequences of behavioural states and to focus on changes in behavioural states shown by individuals rather than on the duration for which they are displayed. We extend techniques from data mining and bioinformatics to detect frequent patterns in these sequences and to assess how these patterns vary across individuals or changes in interaction tasks. To illustrate our approach and to demonstrate its potential, we apply it to novel data on a simple physical interaction, where one person hands a cup to another person. Our findings advance the understanding of handover interactions, a benchmark scenario for social interactions. More generally, we suggest that our approach permits a general perspective for studying social interactions.

Neural mechanisms underlying visual attention to health warnings on branded and plain cigarette packs.

AIMS: To (1) test if activation in brain regions related to reward (nucleus accumbens) and emotion (amygdala) differ when branded and plain packs of cigarettes are viewed, (2) test whether these activation patterns differ by smoking status and (3) examine whether activation patterns differ as a function of visual attention to health warning labels on cigarette packs. DESIGN: Cross-sectional observational study combining functional magnetic resonance imaging (fMRI) with eye-tracking. Non-smokers, weekly smokers and daily smokers performed a memory task on branded and plain cigarette packs with pictorial health warnings presented in an event-related design. SETTING: Clinical Research and Imaging Centre, University of Bristol, UK. PARTICIPANTS: Non-smokers, weekly smokers and daily smokers (n = 72) were tested. After exclusions, data from 19 non-smokers, 19 weekly smokers and 20 daily smokers were analysed. MEASUREMENTS: Brain activity was assessed in whole brain analyses and in pre-specified masked analyses in the amygdala and nucleus accumbens. On-line eye-tracking during scanning recorded visual attention to health warnings. FINDINGS: There was no evidence for a main effect of pack type or smoking status in either the nucleus accumbens or amygdala, and this was unchanged when taking account of visual attention to health warnings. However, there was evidence for an interaction, such that we observed increased activation in the right amygdala when viewing branded as compared with plain packs among weekly smokers (P = 0.003). When taking into account visual attention to health warnings, we observed higher levels of activation in the visual cortex in response to plain packaging compared with branded packaging of cigarettes (P = 0.020). CONCLUSIONS: Based on functional magnetic resonance imaging and eye-tracking data, health warnings appear to be more salient on 'plain' cigarette packs than branded packs.

Iconic Gestures for Robot Avatars, Recognition and Integration with Speech.

Co-verbal gestures are an important part of human communication, improving its efficiency and efficacy for information conveyance. One possible means by which such multi-modal communication might be realized remotely is through the use of a tele-operated humanoid robot avatar. Such avatars have been previously shown to enhance social presence and operator salience. We present a motion tracking based tele-operation system for the NAO robot platform that allows direct transmission of speech and gestures produced by the operator. To assess the capabilities of this system for transmitting multi-modal communication, we have conducted a user study that investigated if robot-produced iconic gestures are comprehensible, and are integrated with speech. Robot performed gesture outcomes were compared directly to those for gestures produced by a human actor, using a within participant experimental design. We show that iconic gestures produced by a tele-operated robot are understood by participants when presented alone, almost as well as when produced by a human. More importantly, we show that gestures are integrated with speech when presented as part of a multi-modal communication equally well for human and robot performances.

How visual perceptual grouping influences foot placement.

Everybody would agree that vision guides locomotion; but how does vision influence choice when there are different solutions for possible foot placement? We addressed this question by investigating the impact of perceptual grouping on foot placement in humans. Participants performed a stepping stone task in which pathways consisted of target stones in a spatially regular path of foot falls and visual distractor stones in their proximity. Target and distractor stones differed in shape and colour so that each subset of stones could be easily grouped perceptually. In half of the trials, one target stone swapped shape and colour with a distractor in its close proximity. We show that in these 'swapped' conditions, participants chose the perceptually groupable, instead of the spatially regular, stepping location in over 40% of trials, even if the distance between perceptually groupable steps was substantially larger than normal step width/length. This reveals that the existence of a pathway that could be traversed without spatial disruption to periodic stepping is not sufficient to guarantee participants will select it and suggests competition between different types of visual input when choosing foot placement. We propose that a bias in foot placement choice in favour of visual grouping exists as, in nature, sudden changes in visual characteristics of the ground increase the uncertainty for stability.

Selection in spatial working memory is independent of perceptual selective attention, but they interact in a shared spatial priority map.

We examined the relationship between the attentional selection of perceptual information and of information in working memory (WM) through four experiments, using a spatial WM-updating task. Participants remembered the locations of two objects in a matrix and worked through a sequence of updating operations, each mentally shifting one dot to a new location according to an arrow cue. Repeatedly updating the same object in two successive steps is typically faster than switching to the other object; this object switch cost reflects the shifting of attention in WM. In Experiment 1, the arrows were presented in random peripheral locations, drawing perceptual attention away from the selected object in WM. This manipulation did not eliminate the object switch cost, indicating that the mechanisms of perceptual selection do not underlie selection in WM. Experiments 2a and 2b corroborated the independence of selection observed in Experiment 1, but showed a benefit to reaction times when the placement of the arrow cue was aligned with the locations of relevant objects in WM. Experiment 2c showed that the same benefit also occurs when participants are not able to mark an updating location through eye fixations. Together, these data can be accounted for by a framework in which perceptual selection and selection in WM are separate mechanisms that interact through a shared spatial priority map.

Treacherous Pavements: Paving Slab Patterns Modify Intended Walking Directions.

Current understanding in locomotion research is that, for humans, navigating natural environments relies heavily on visual input; in contrast, walking on even ground in man-made obstacle and hazard-free environments is so highly automated that visual information derived from floor patterns should not affect locomotion and in particular have no impact on the direction of travel. The vision literature on motion perception would suggest otherwise; specifically that oblique floor patterns may induce substantial veering away from the intended direction of travel due to the so-called aperture problem. Here, we tested these contrasting predictions by letting participants walk over commonly encountered floor patterns (paving slabs) and investigating participants' ability to walk "straight ahead" for different pattern orientations. We show that, depending on pattern orientation, participants veered considerably over the measured travel distance (up to 8% across trials), in line with predictions derived from the literature on motion perception. We argue that these findings are important to the study of locomotion, and, if also observed in real world environments, might have implications for architectural design.

Effects of first exposure to plain cigarette packaging on smoking behaviour and attitudes: a randomised controlled study.

BACKGROUND: Plain packaging requires tobacco products to be sold in packs with a standard shape, method of opening and colour, leaving the brand name in a standard font and location. We ran a randomised controlled trial to investigate the impact of plain packaging on smoking behaviour and attitudes. METHODS: In a parallel group randomised trial design, 128 daily smokers smoked cigarettes from their usual UK brand, or a plain Australian brand that was closely matched to their usual UK brand for 24 hours. Primary outcomes were number of cigarettes smoked and volume of smoke inhaled per cigarette. Secondary outcomes were self-reported ratings of motivation to quit, cigarette taste, experience of using the pack, experience of smoking, attributes of the pack, perceptions of the health warning, changes in smoking behaviour, and views on plain packaging. RESULTS: There was no evidence that pack type had an effect on either of the primary measures (ps > 0.279). However, smokers using plain cigarette packs rated the experience of using the pack more negatively (-0.52, 95% CI -0.82 to -0.22, p = 0.001), rated the pack attributes more negatively (-1.59, 95% CI -1.80 to -1.39, p < 0.001), and rated the health warning as more impactful (+0.51, 95% CI 0.24 to 0.78, p < 0.001). CONCLUSIONS: Plain cigarette packs reduce ratings of the experience of using the cigarette pack, and ratings of the pack attributes, and increase the self-perceived impact of the health warning, but do not change smoking behaviour, at least in the short term. TRIAL REGISTRATION: Current Controlled Trials ISRCTN52982308. Registered 27 June 2013.

Plain packaging of cigarettes and smoking behavior: study protocol for a randomized controlled study.

BACKGROUND: Previous research on the effects of plain packaging has largely relied on self-report measures. Here we describe the protocol of a randomized controlled trial investigating the effect of the plain packaging of cigarettes on smoking behavior in a real-world setting. METHODS/DESIGN: In a parallel group randomization design, 128 daily cigarette smokers (50% male, 50% female) will attend an initial screening session and be assigned plain or branded packs of cigarettes to smoke for a full day. Plain packs will be those currently used in Australia where plain packaging has been introduced, while branded packs will be those currently used in the United Kingdom. Our primary study outcomes will be smoking behavior (self-reported number of cigarettes smoked and volume of smoke inhaled per cigarette as measured using a smoking topography device). Secondary outcomes measured pre- and post-intervention will be smoking urges, motivation to quit smoking, and perceived taste of the cigarettes. Secondary outcomes measured post-intervention only will be experience of smoking from the cigarette pack, overall experience of smoking, attributes of the cigarette pack, perceptions of the on-packet health warnings, behavior changes, views on plain packaging, and the rewarding value of smoking. Sex differences will be explored for all analyses. DISCUSSION: This study is novel in its approach to assessing the impact of plain packaging on actual smoking behavior. This research will help inform policymakers about the effectiveness of plain packaging as a tobacco control measure. TRIAL REGISTRATION: Current Controlled Trials ISRCTN52982308 (registered 27 June 2013).

Avoidance of cigarette pack health warnings among regular cigarette smokers.

BACKGROUND: Previous research with adults and adolescents indicates that plain cigarette packs increase visual attention to health warnings among non-smokers and non-regular smokers, but not among regular smokers. This may be because regular smokers: (1) are familiar with the health warnings, (2) preferentially attend to branding, or (3) actively avoid health warnings. We sought to distinguish between these explanations using eye-tracking technology. METHOD: A convenience sample of 30 adult dependent smokers participated in an eye-tracking study. Participants viewed branded, plain and blank packs of cigarettes with familiar and unfamiliar health warnings. The number of fixations to health warnings and branding on the different pack types were recorded. RESULTS: Analysis of variance indicated that regular smokers were biased towards fixating the branding rather than the health warning on all three pack types. This bias was smaller, but still evident, for blank packs, where smokers preferentially attended the blank region over the health warnings. Time-course analysis showed that for branded and plain packs, attention was preferentially directed to the branding location for the entire 10s of the stimulus presentation, while for blank packs this occurred for the last 8s of the stimulus presentation. Familiarity with health warnings had no effect on eye gaze location. CONCLUSION: Smokers actively avoid cigarette pack health warnings, and this remains the case even in the absence of salient branding information. Smokers may have learned to divert their attention away from cigarette pack health warnings. These findings have implications for cigarette packaging and health warning policy.

Abnormal inhibition of return in mild cognitive impairment: is it specific to the presence of prodromal dementia?

Although there is some evidence that amnestic mild cognitive impairment (aMCI) can be characterized by significant deficits in visuospatial function, the cross-sectional design of the majority of these studies renders it impossible to determine whether such deficits occur in aMCI as a result of, or accompany, amnestic dysfunction per se or whether they are the result of disproportionately poorer performance in a sub-group of patients for whom aMCI represents prodromal dementia. Similarly, whether the absence of aMCI-related functional deficit stems from the masking of dementia-specific abnormality by the preserved performance of those with a different cause of aMCI cannot be ascertained. Here we report the outcome of a cross-sectional and 2.5-year longitudinal evaluation follow-up, computer-based study of visuospatial attention, specifically attentional disengagement and inhibition of return and the mean (RTSPEED) and intra-individual variability (IIVRT) of their component reaction times, in 45 patients with aMCI and 31 cognitively healthy older adults. Reduced inhibition of return (p = 0.01 and p = 0.037 in response to 400 and 800 ms cue to target interval conditions), slowed RTSPEED (p = 0.038 and p = 0.03 in response to 400 and 800 ms cue), and raised IIVRT at baseline testing (p = 0.003, p = 0.026, p = 0.013 in response to 200, 400 and 800 ms cue) were associated with the development of dementia within the 2.5-year follow-up period, whereas the performance of patients with aMCI who did not develop dementia did not differ significantly from that of the cognitively healthy controls. Attentional disengagement appeared insensitive to the presence of prodromal dementia or amnestic dysfunction per se. The results indicate that those patients for whom aMCI represents prodromal dementia may experience, in addition to amnestic dysfunction, a decline in the functional integrity of some fundamental aspects of visual information processing, an effect potentially capable of increasing disease burden and reducing quality of life.

Line bisection by eye and by hand reveal opposite biases.

The vision-for-action literature favours the idea that the motor output of an action-whether manual or oculomotor-leads to similar results regarding object handling. Findings on line bisection performance challenge this idea: healthy individuals bisect lines manually to the left of centre and to the right of centre when using eye fixation. In case that these opposite biases for manual and oculomotor action reflect more universal compensatory mechanisms that cancel each other out to enhance overall accuracy, one would like to observe comparable opposite biases for other material. In the present study, we report on three independent experiments in which we tested line bisection (by hand, by eye fixation) not only for solid lines, but also for letter lines; the latter, when bisected manually, is known to result in a rightward bias. Accordingly, we expected a leftward bias for letter lines when bisected via eye fixation. Analysis of bisection biases provided evidence for this idea: manual bisection was more rightward for letter as compared to solid lines, while bisection by eye fixation was more leftward for letter as compared to solid lines. Support for the eye fixation observation was particularly obvious in two of the three studies, for which comparability between eye and hand action was increasingly adjusted (paper-pencil versus touch screen for manual action). These findings question the assumption that ocular motor and manual output are always inter-changeable, but rather suggest that at least for some situations ocular motor and manual output biases are orthogonal to each other, possibly balancing each other out.

Using eye movements to explore switch costs in working memory.

Updating object locations in working memory (WM) is faster when the same object is updated twice in a row compared to updating another object. In analogy to repetition priming effects in perceptual attention, this object-switch cost in WM is thought of as being due to the necessity to shift attention internally from one object to another. However, evidence for this hypothesis is only indirect. Here, we used eye tracking and a classic model of perceptual attention to get a more direct handle on the different processes underlying switch costs in spatial WM. Eye-movement data revealed three different contributors to switch costs. First, overt attention was attracted initially towards locations of the previously updated object. Second, longer fixation periods preceded eye movements between locations of different objects as compared to (previous and new) locations of the same object, most likely due to disengaging and reorienting focal attention between objects. Third, longer dwell times at the to-be-updated location preceded manual responses for switch updates as compared to repeats, probably indicating increased uncertainty between competing sources of activity after the actual attention shift. Results can easily be interpreted with existing (perceptual) attention models that propose competitive activation in an attention map for target objects.

Visual attention to health warnings on plain tobacco packaging in adolescent smokers and non-smokers.

AIMS: Previous research with adults indicates that plain packaging increases visual attention to health warnings in adult non-smokers and weekly smokers, but not daily smokers. The present research extends this study to adolescents aged 14-19 years. DESIGN: Mixed-model experimental design, with smoking status as a between-subjects factor and pack type (branded or plain pack) and eye gaze location (health warning or branding) as within-subjects factors. SETTING: Three secondary schools in Bristol, UK. PARTICIPANTS: A convenience sample of adolescents comprising never-smokers (n = 26), experimenters (n = 34), weekly smokers (n = 13) and daily smokers (n = 14). MEASUREMENTS: Number of eye movements to health warnings and branding on plain and branded packs. FINDINGS: Analysis of variance, irrespective of smoking status revealed more eye movements to health warnings than branding on plain packs, but an equal number of eye movements to both regions on branded packs (P = 0.033). This was observed among experimenters (P < 0.001) and weekly smokers (P = 0.047), but not among never-smokers or daily smokers. CONCLUSION: Among experimenters and weekly smokers, plain packaging increases visual attention to health warnings and away from branding. Daily smokers, even relatively early in their smoking careers, seem to avoid the health warnings on cigarette packs. Adolescent never-smokers attend the health warnings preferentially on both types of packs, a finding which may reflect their decision not to smoke.

Dealing with illumination in visual scenes: effects of ageing and Alzheimer's disease.

Various visual functions decline in ageing and even more so in patients with Alzheimer's disease (AD). Here we investigated whether the complex visual processes involved in ignoring illumination-related variability (specifically, cast shadows) in visual scenes may also be compromised. Participants searched for a discrepant target among items which appeared as posts with shadows cast by light-from-above when upright, but as angled objects when inverted. As in earlier reports, young participants gave slower responses with upright than inverted displays when the shadow-like part was dark but not white (control condition). This is consistent with visual processing mechanisms making shadows difficult to perceive, presumably to assist object recognition under varied illumination. Contrary to predictions, this interaction of "shadow" colour with item orientation was maintained in healthy older and AD groups. Thus, the processing mechanisms which assist complex light-independent object identification appear to be robust to the effects of both ageing and AD. Importantly, this means that the complexity of a function does not necessarily determine its vulnerability to age- or AD-related decline.We also report slower responses to dark than light "shadows" of either orientation in both ageing and AD, in keeping with increasing light scatter in the ageing eye. Rather curiously, AD patients showed further slowed responses to "shadows" of either colour at the bottom than the top of items as if they applied shadow-specific rules to non-shadow conditions. This suggests that in AD, shadow-processing mechanisms, while preserved, might be applied in a less selective way.

Intra-individual reaction time variability in amnestic mild cognitive impairment: a precursor to dementia?

We used an exogenous target detection cueing paradigm to examine whether intra-individual reaction time variability (IIV) or phasic alerting varied significantly between patients with amnestic mild cognitive impairment (aMCI) (n = 45) and healthy older adult controls (n = 31) or between those with aMCI who, within a 2.5 year follow-up period, developed dementia (n = 13) and those who did not (n = 26). Neither IIV, nor simple reaction time, differentiated aMCI from healthy aging, indicating that raised IIV and overall response slowing are not general characteristics of aMCI. However, within the aMCI group, IIV did differentiate between those who converted to dementia and those who remained with a diagnosis of aMCI (non-converters), being significantly more variable in those who later developed dementia. Furthermore, there was no difference in IIV between non-converters and healthy controls. High IIV appears related to an increased probability that an individual with aMCI will become demented within 2.5 years, rather than to amnestic dysfunction per se. In contrast, phasic alerting performance significantly differentiated aMCI from healthy aging, but failed to discriminate those with aMCI who developed dementia from those who did not. In addition, those patients with aMCI who did not develop dementia still showed a significantly poorer phasic alerting effect compared to healthy aging. The phasic alerting abnormality in aMCI compared to healthy aging does not appear specifically related to the performance of those patients for whom aMCI represents the prodromal stages of dementia.