Key result
Inhalation of 30% nitrous oxide during prolonged cold-water immersion persistently aggravated impairments in basic and higher-order cognitive abilities, including short-term memory and learning.
Why the study?
Divers face cognitive deterioration from cold temperatures and inert gas narcosis, but their behavioral effects have commonly been assessed in isolation and during short-term provocations.
RCT (n=14)
Single-blind
Alternated among subjects
No
Answers are grounded in this paper and cite their sources.
Combined cold-narcosis exposure persistently impairs diver cognition beyond cold alone; leaves open whether findings extend to hyperbaric conditions.
Divers are at enhanced risk of suffering from acute cognitive deterioration because of the low ambient temperatures and the narcotic action of inert gases inspired at high pressures. Yet, the behavioral effects of cold and inert gas narcosis have commonly been assessed in isolation and during short-term provocations. We therefore evaluated the interactive influence of mild hypothermia and narcosis engendered by a subanesthetic dose of nitrous oxide (N 2 O; a normobaric intervention analog of hyperbaric nitrogen) on cognitive function during prolonged iterative exposure. Fourteen men partook in two ∼12-h sessions (separated by ≥4 days), wherein they performed sequentially three 120-min cold (20°C) water immersions (CWIs), while inhaling, in a single-blinded manner, either normal air or a normoxic gas mixture containing 30% N 2 O. CWIs were separated by a 120-min rewarming in room-air breathing conditions. Before the first CWI and during each CWI, subjects performed a finger dexterity test, and the Spaceflight Cognitive Assessment Tool for Windows (WinSCAT) test assessing aspects of attention, memory, learning, and visuospatial ability. Rectal and skin temperatures were, on average, reduced by ∼1.2 °C and ∼8 °C, respectively ( P < 0.001). Cooling per se impaired ( P ≤ 0.01) only short-term memory (∼37%) and learning (∼18%); the impairments were limited to the first CWI. N 2 O also attenuated ( P ≤ 0.02) short-term memory (∼37%) and learning (∼35%), but the reductions occurred in all CWIs. Furthermore, N 2 O invariably compromised finger dexterity, attention, concentration, working memory, and spatial processing ( P < 0.05). The present results demonstrate that inert gas narcosis aggravates, in a persistent manner, basic and higher-order cognitive abilities during protracted cold exposure.
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Moes et al. (2024) conducted an RCT in Healthy (n=14). 30% nitrous oxide (N2O) vs. Normal air was evaluated on Cognitive function (short-term memory and learning) (~37% reduction in short-term memory and ~35% reduction in learning, p=≤0.02). Inhalation of 30% nitrous oxide during prolonged cold-water immersion persistently aggravated impairments in basic and higher-order cognitive abilities, including short-term memory and learning.
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