RESUMEN
Background: A combination of green tea, rhodiola and magnesium with B vitamins has previously been reported to significantly increase EEG resting state theta, attenuate subjective stress, anxiety and mood disturbance, and heighten subjective and autonomic arousal under acute psychosocial laboratory stress. Here we examine the capacity of green tea and rhodiola extract administered in combination or in isolation with magnesium and B vitamins to moderate spectral brain activity during attentional task performance under stress. Materials and Methods: One-hundred moderately stressed adults received oral supplementation of (i) Mg + B vitamins + green tea + rhodiola; (ii) Mg + B vitamins + rhodiola; (iii) Mg + B vitamins + green tea; or (iv) placebo, in a double-blind, randomised, placebo-controlled, parallel-group design (Clinicaltrials.gov: NCT03262376; 25/0817). Participants completed an attention switching and emotionally threatening attentional bias task after stress induction (Trier Social Stress Test). Spectral alpha and theta brain activity and event related potentials (ERPs) were recorded during cognitive task performance by electroencephalogram (EEG; BioSemi ActiveTwo 64 channel). Results: The combined treatment of Mg + B vitamins + green tea + rhodiola significantly increased frontal midline theta vs. placebo and rhodiola in isolation during the attention switching task, specifically in anticipation of a change in task performance parameter. The combined treatment also significantly increased contralateral theta activation in relation to viewing emotionally threatening images in the left (vs. placebo and rhodiola in isolation) and right parietal (vs. placebo) regions. Further, this treatment demonstrated significantly heightened ipsilateral left parietal theta activation in relation to viewing emotionally threatening images. The combined treatment attenuated a decrease in alpha power during the attentional bias task evident in comparator treatments, but this did not reach significance. No significant effects of treatments on behavioural performance or ERP were found. Conclusion: The combination of Mg + B vitamins + green tea + rhodiola increased spectral theta brain activity during the execution of two attentional tasks suggestive of a potential to increase attentional capacity under conditions of stress. Further examination of these ingredients in relation to attentional performance under stress is warranted to ascertain if functional benefits suggested by theta activation can be shown behaviourally.
RESUMEN
BACKGROUND: Even though early dietary management of phenylketonuria (PKU) successfully prevents severe neurological impairments, deficits in cognitive functioning are still observed. These deficits are believed to be the result of elevated levels of phenylalanine throughout life. Research on cognitive functioning in adults with PKU (AwPKU) often focuses on domains shown to be compromised in children with PKU, such as attention and executive functions, whereas other cognitive domains have received less attention. This systematic review aimed to provide an overview of cognitive functioning across domains examined in early treated (ET) AwPKU. METHODS: A systematic search was performed in Ovid MEDLINE(R), PsycINFO, Web of Science, Cochrane, Scopus, Embase, ScienceDirect, and PubMed for observational studies on cognitive performance in ET AwPKU. RESULTS: Twenty-two peer-reviewed publications, reporting on outcomes from 16 studies were reviewed. Collectively, the results most consistently showed deficits in vigilance, working memory and motor skills. Deficits in other cognitive domains were less consistently observed or were understudied. Furthermore, despite reports of several associations between cognitive performance and phenylalanine (Phe) levels throughout life the relationship remains unclear. Inconsistencies in findings across studies could be explained by the highly heterogeneous nature of study samples, resulting in large inter- and intra-variability in Phe levels, as well as the use of a variety of tests across cognitive domains, which differ in sensitivity. The long-term cognitive outcomes of early and continuous management of PKU remain unclear. CONCLUSIONS: To better understand the development of cognitive deficits in ET AwPKU, future research would benefit from 1) (inter)national multicentre-studies; 2) more homogeneous study samples; 3) the inclusion of other nutritional measures that might influence cognitive functioning (e.g. Phe fluctuations, Phe:Tyrosine ratio and micronutrients such as vitamin B12); and 4) careful selection of appropriate cognitive tests.
