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Impairment of mental alertness

MedGen UID:
737460
•Concept ID:
C1621860
•
Finding
Synonyms: Impaired alertness; Obtundation
SNOMED CT: Impaired alertness (704426000); Impairment of mental alertness (704426000)

Definition

A mental state of reduced level of consciousness, with decreased response to stimuli, including pain. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVImpairment of mental alertness

Professional guidelines

PubMed

Sleep-deprived motor vehicle operators are unfit to drive: a multidisciplinary expert consensus statement on drowsy driving.
Czeisler CA, Wickwire EM, Barger LK, Dement WC, Gamble K, Hartenbaum N, Ohayon MM, Pelayo R, Phillips B, Strohl K, Tefft B, Rajaratnam SMW, Malhotra R, Whiton K, Hirshkowitz M
Sleep Health 2016 Jun;2(2):94-99. Epub 2016 May 10 doi: 10.1016/j.sleh.2016.04.003. PMID: 28923267
Use of antiepileptic drugs in the treatment of epilepsy in people with intellectual disability.
Alvarez N, Besag F, Iivanainen M
J Intellect Disabil Res 1998 Dec;42 Suppl 1:1-15. PMID: 10030426
Treatment-resistant schizophrenia--the role of clozapine.
Meltzer HY
Curr Med Res Opin 1997;14(1):1-20. doi: 10.1185/03007999709113338. PMID: 9524789

Recent clinical studies

Etiology

Chronic Stress and Steatosis of Muscles, Bones, Liver, and Pancreas: A Review.
Stefanaki C, Paltoglou G, Mastorakos G, Chrousos GP
Horm Res Paediatr 2023;96(1):66-73. Epub 2022 Feb 10 doi: 10.1159/000522540. PMID: 35144259
A Review: Mealtime Difficulties following Frontotemporal Lobar Degeneration.
Lewis C, Walterfang M, Velakoulis D, Vogel AP
Dement Geriatr Cogn Disord 2018;46(5-6):285-297. Epub 2018 Nov 13 doi: 10.1159/000494210. PMID: 30423586
Efficacy of melatonin with behavioural sleep-wake scheduling for delayed sleep-wake phase disorder: A double-blind, randomised clinical trial.
Sletten TL, Magee M, Murray JM, Gordon CJ, Lovato N, Kennaway DJ, Gwini SM, Bartlett DJ, Lockley SW, Lack LC, Grunstein RR, Rajaratnam SMW; Delayed Sleep on Melatonin (DelSoM) Study Group
PLoS Med 2018 Jun;15(6):e1002587. Epub 2018 Jun 18 doi: 10.1371/journal.pmed.1002587. PMID: 29912983Free PMC Article
Court-visited obstetrical and fertility procedures.
Matevosyan NR
Arch Gynecol Obstet 2012 May;285(5):1195-203. Epub 2012 Jan 21 doi: 10.1007/s00404-012-2216-7. PMID: 22271237
Effects of caffeine on human behavior.
Smith A
Food Chem Toxicol 2002 Sep;40(9):1243-55. doi: 10.1016/s0278-6915(02)00096-0. PMID: 12204388

Diagnosis

INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury, Part II: Attention and Information Processing Speed.
Ponsford J, Velikonja D, Janzen S, Harnett A, McIntyre A, Wiseman-Hakes C, Togher L, Teasell R, Kua A, Patsakos E, Welch-West P, Bayley MT
J Head Trauma Rehabil 2023 Jan-Feb 01;38(1):38-51. doi: 10.1097/HTR.0000000000000839. PMID: 36594858
Attentional network changes in subjective cognitive decline.
Esmaeili M, Nejati V, Shati M, Vatan RF, Chehrehnegar N, Foroughan M
Aging Clin Exp Res 2022 Apr;34(4):847-855. Epub 2021 Oct 27 doi: 10.1007/s40520-021-02005-8. PMID: 34705251
A Review: Mealtime Difficulties following Frontotemporal Lobar Degeneration.
Lewis C, Walterfang M, Velakoulis D, Vogel AP
Dement Geriatr Cogn Disord 2018;46(5-6):285-297. Epub 2018 Nov 13 doi: 10.1159/000494210. PMID: 30423586
Efficacy of melatonin with behavioural sleep-wake scheduling for delayed sleep-wake phase disorder: A double-blind, randomised clinical trial.
Sletten TL, Magee M, Murray JM, Gordon CJ, Lovato N, Kennaway DJ, Gwini SM, Bartlett DJ, Lockley SW, Lack LC, Grunstein RR, Rajaratnam SMW; Delayed Sleep on Melatonin (DelSoM) Study Group
PLoS Med 2018 Jun;15(6):e1002587. Epub 2018 Jun 18 doi: 10.1371/journal.pmed.1002587. PMID: 29912983Free PMC Article
Effects of caffeine on human behavior.
Smith A
Food Chem Toxicol 2002 Sep;40(9):1243-55. doi: 10.1016/s0278-6915(02)00096-0. PMID: 12204388

Therapy

The Impact of Shift Work on Sleep, Alertness and Performance in Healthcare Workers.
Ganesan S, Magee M, Stone JE, Mulhall MD, Collins A, Howard ME, Lockley SW, Rajaratnam SMW, Sletten TL
Sci Rep 2019 Mar 15;9(1):4635. doi: 10.1038/s41598-019-40914-x. PMID: 30874565Free PMC Article
Efficacy of melatonin with behavioural sleep-wake scheduling for delayed sleep-wake phase disorder: A double-blind, randomised clinical trial.
Sletten TL, Magee M, Murray JM, Gordon CJ, Lovato N, Kennaway DJ, Gwini SM, Bartlett DJ, Lockley SW, Lack LC, Grunstein RR, Rajaratnam SMW; Delayed Sleep on Melatonin (DelSoM) Study Group
PLoS Med 2018 Jun;15(6):e1002587. Epub 2018 Jun 18 doi: 10.1371/journal.pmed.1002587. PMID: 29912983Free PMC Article
Alcohol Consumption and Impairment of Surgeons: A Case for Total Abstinence?
O'Connor M
J Law Med 2017;24(3):556-64. PMID: 30137749
Wake-promoting pharmacotherapy for psychiatric disorders.
Dell'Osso B, Dobrea C, Cremaschi L, Arici C, Altamura AC
Curr Psychiatry Rep 2014 Dec;16(12):524. doi: 10.1007/s11920-014-0524-2. PMID: 25312027
Modulation of cognitive performance and mood by aromas of peppermint and ylang-ylang.
Moss M, Hewitt S, Moss L, Wesnes K
Int J Neurosci 2008 Jan;118(1):59-77. doi: 10.1080/00207450601042094. PMID: 18041606

Prognosis

Case 317.
Suthar PP, Jhaveri M, Mafraji M
Radiology 2023 May;307(3):e220788. doi: 10.1148/radiol.220788. PMID: 37093748
Impact of personality functioning and pathological traits on mental wellbeing of older patients with personality disorders.
Veenstra MS, van Dijk SDM, Bouman R, van Alphen SPJB, van Asselt ADIT, van den Brink RHS, Voshaar RCO
BMC Psychiatry 2022 Mar 24;22(1):214. doi: 10.1186/s12888-022-03857-8. PMID: 35331179Free PMC Article
Fatigue and depression in multiple sclerosis: pharmacological and non-pharmacological interventions.
Brenner P, Piehl F
Acta Neurol Scand 2016 Sep;134 Suppl 200:47-54. doi: 10.1111/ane.12648. PMID: 27580906
Laboratory assessments in the course of Parkinson's disease: a clinician's perspective.
Müller T, Baas H, Kassubek J, Riederer P, Urban PP, Schrader C, Reichmann H, Woitalla D, Gerlach M
J Neural Transm (Vienna) 2016 Jan;123(1):65-71. Epub 2015 Nov 14 doi: 10.1007/s00702-015-1481-6. PMID: 26573521
Fibrofog and fibromyalgia: a narrative review and implications for clinical practice.
Kravitz HM, Katz RS
Rheumatol Int 2015 Jul;35(7):1115-25. Epub 2015 Jan 13 doi: 10.1007/s00296-014-3208-7. PMID: 25583051

Clinical prediction guides

Chronic Stress and Steatosis of Muscles, Bones, Liver, and Pancreas: A Review.
Stefanaki C, Paltoglou G, Mastorakos G, Chrousos GP
Horm Res Paediatr 2023;96(1):66-73. Epub 2022 Feb 10 doi: 10.1159/000522540. PMID: 35144259
Impact of personality functioning and pathological traits on mental wellbeing of older patients with personality disorders.
Veenstra MS, van Dijk SDM, Bouman R, van Alphen SPJB, van Asselt ADIT, van den Brink RHS, Voshaar RCO
BMC Psychiatry 2022 Mar 24;22(1):214. doi: 10.1186/s12888-022-03857-8. PMID: 35331179Free PMC Article
A comparison of stages of attention for social and nonsocial stimuli in schizophrenia: An ERP study.
Catalano LT, Wynn JK, Lee J, Green MF
Schizophr Res 2021 Dec;238:128-136. Epub 2021 Oct 14 doi: 10.1016/j.schres.2021.10.008. PMID: 34655914
Fibrofog and fibromyalgia: a narrative review and implications for clinical practice.
Kravitz HM, Katz RS
Rheumatol Int 2015 Jul;35(7):1115-25. Epub 2015 Jan 13 doi: 10.1007/s00296-014-3208-7. PMID: 25583051
Sleep loss and sleepiness: current issues.
Balkin TJ, Rupp T, Picchioni D, Wesensten NJ
Chest 2008 Sep;134(3):653-660. doi: 10.1378/chest.08-1064. PMID: 18779203

Recent systematic reviews

How to Tackle Mental Fatigue: A Systematic Review of Potential Countermeasures and Their Underlying Mechanisms.
Proost M, Habay J, De Wachter J, De Pauw K, Rattray B, Meeusen R, Roelands B, Van Cutsem J
Sports Med 2022 Sep;52(9):2129-2158. Epub 2022 May 11 doi: 10.1007/s40279-022-01678-z. PMID: 35543922
The Attention Network Test in Parkinson and Lewy Body Disease: A Systematic Review.
Yang J, Pourzinal D, Rheinberger T, Copland DA, McMahon KL, Byrne GJ, Dissanayaka NN
Cogn Behav Neurol 2022 Mar 3;35(1):1-13. doi: 10.1097/WNN.0000000000000292. PMID: 35239595
The neuropsychiatric effects of vitamin C deficiency: a systematic review.
Plevin D, Galletly C
BMC Psychiatry 2020 Jun 18;20(1):315. doi: 10.1186/s12888-020-02730-w. PMID: 32552785Free PMC Article
Sleep-deprived motor vehicle operators are unfit to drive: a multidisciplinary expert consensus statement on drowsy driving.
Czeisler CA, Wickwire EM, Barger LK, Dement WC, Gamble K, Hartenbaum N, Ohayon MM, Pelayo R, Phillips B, Strohl K, Tefft B, Rajaratnam SMW, Malhotra R, Whiton K, Hirshkowitz M
Sleep Health 2016 Jun;2(2):94-99. Epub 2016 May 10 doi: 10.1016/j.sleh.2016.04.003. PMID: 28923267
How reliable is the classification of cognitive impairment across different criteria in early and late stages of multiple sclerosis?
Fischer M, Kunkel A, Bublak P, Faiss JH, Hoffmann F, Sailer M, Schwab M, Zettl UK, Köhler W
J Neurol Sci 2014 Aug 15;343(1-2):91-9. Epub 2014 May 27 doi: 10.1016/j.jns.2014.05.042. PMID: 24950898

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