Short report Phasic and tonic alerting in mild cognitive impairment: A preliminary study ☆ Diana Martella a , Salvadora Manzanares b , Guillermo Campoy c , Javier Roca d , Carmen Antúnez b , Luis J. Fuentes c, ⁎ a Basque Center on Cognition, Brain and Language, Paseo Miketelegi, 20009 Donostia-San Sebastián, Spain b Unidad de Demencias, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain c Departamento de Psicología Básica y Metodología, Facultad de Psicología, Universidad de Murcia, Campus de Espinardo, 30100 Murcia, Spain d Departamento de Psicología Evolutiva y de la Educación, Facultad de Psicología, Universidad de Valencia, Avenida Blasco Ibáñez, 21, 46010 Valencia, Spain abstract article info Article history: Received 23 July 2013 Received in revised form 7 November 2013 Accepted 11 November 2013 Available online 16 November 2013 Section Editor: Christian Humpel Keywords: Mild cognitive impairment Attention Network Test Tonic alerting Vigilance Sensitivity In this preliminary study we assessed the functioning of the different attentional networks in mild cognitive im- pairment (MCI) patients, taking as theoretical framework the Posner's cognitive neuroscience approach. Two groups of participants were tested in a single short experiment: 20 MCI patients (6 amnestic, 6 non-amnestic and 8 multiple-domain) and 18 healthy matched controls (HC). For attentional assessment we used a version of the Attention Network Test (the ANTI-V) that provided not only a score of the orienting, the executive, and the alerting networks and their interactions, but also an independent measure of vigilance (tonic alerting). The results showed that all subtypes of MCI patients exhibited a selective impairment in the tonic component of alerting, as indexed by a decrease in the d′ sensitivity index, and their performance in executive network increased up to the HC group level when phasic alerting was provided by a warning tone. Our findings suggest that a core attentional deficit, especially the endogenous component of alerting, may significantly contribute to the behavioral and cognitive deficits associated with MCI. © 2013 Elsevier Inc. All rights reserved. 1. Introduction It is amply assumed that mild cognitive impairment (MCI) refers to the transitional stage between the cognitive changes of normal aging and mild dementia (Hwang et al., 2012; Petersen et al., 2001), and is characterized by a heterogeneous syndrome that sometimes signals the presence of Alzheimer's disease (AD) (Aretouli et al., 2013). Although the memory deficit is amply accepted as part of the cognitive deterioration exhibited by both MCI and AD patients, impairment of executive functions in general, and attentional functions in particular has also been reported (Aretouli et al., 2013; Fernández et al., 2011; Fuentes et al., 2010; Saunders and Summers, 2011; Tales et al., 2011). Given that attention can affect other cognitive processes, such as mem- ory and language, the identification of different patterns of attentional deficit could be a useful diagnostic marker and promote attention- dependent intervention strategies. In previous studies, we highlighted the relevance of taking a theoret- ical background for neuropsychological testing (Fernández et al., 2011; Fuentes et al., 2010). Regarding attentional deficits we used the cogni- tive neuroscience approach developed by Posner and his colleagues (Posner and Petersen, 1990) that distinguishes three attention-related neural networks. The orienting network serves the functions of endoge- nous and exogenous selection of information among several sensory inputs. The executive network is involved in the ability to control our own behavior in order to achieve intended goals, resolving conflict among alternative responses. And the alerting network is involved in achieving (phasic alerting) and maintaining (tonic alerting or vigilance) a general state of activation of the cognitive system. Importantly, the three networks can be easily assessed in one single experiment through the Attention Network Test (ANT). The original ANT (Fan et al., 2002) and subsequent versions of the test, such as the ANTI (Attention Network Test for Interactions; Callejas et al., 2004), consist in a combination of the Posner's cueing task and the Eriksen's flanker task. The flanker task serves to assess responses to conflict, a function of the executive network. The test shows a central arrow, the target, pointing to the right or to the left. The target is flanked by two arrows on both sides and may be pointing either in the same direction (congruent condition) or the opposite direction (incongruent condi- tion). Participants are told to respond to the direction of central arrow and ignore the distracters. A conflict score can be computed by subtracting reaction times (RTs) in the congruent condition from RTs in the incongruent condition. The cueing task serves to assess attention Experimental Gerontology 49 (2014) 35–39 ☆ This study was supported by the Spanish Ministry of Economy and Competitivity (Projects CSD2008-00048, PSI2010-09551-E, and PSI2011-23340). ⁎ Corresponding author at: Universidad de Murcia, Facultad de Psicología, Campus de Espinardo, 30100 Murcia, Spain. E-mail address: lfuentes@um.es (L.J. Fuentes). 0531-5565/$ – see front matter © 2013 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.exger.2013.11.001 Contents lists available at ScienceDirect Experimental Gerontology journal homepage: www.elsevier.com/locate/expgero