Physiology & Behavior 73 (2001) 585 – 592

Cognitive demand and blood glucose

Andrew B. Scholey*, Susan Harper, David O. Kennedy
Human Cognitive Neuroscience Unit, Division of Psychology, University of Northumbria, Newcastle upon Tyne, NE1 8ST, UK
Received 14 September 2000; received in revised form 22 January 2001; accepted 19 March 2001

Abstract

Previous research has identified that glucose administration can enhance cognitive performance, especially during more intense cognitive
processing. There appears to be a reciprocal relationship between falling glucose levels and cognitive performance, particularly under
conditions of cognitive demand. The present placebo-controlled, double-blind, balanced, crossover study examined the possibility that a high
cognitive load may produce changes in blood glucose levels. A secondary aim was to examine the effects of glucose on tasks of varying
cognitive demand. The effects of a glucose drink on participants’ performance of a serial subtraction task (computerised Serial Sevens), a
somatically matched control task (key-pressing), a short interval Word Memory task and a Word Retrieval (Verbal Fluency) task were
assessed. The change in blood glucose during the demanding computerised Serial Sevens was compared to the change occurring during the
key-pressing control. Glucose consumption significantly improved performance on Serial Sevens, with a trend for improved performance on
Word Retrieval and no effect on the Word Memory task. Compared with the control task, Serial Sevens resulted in a significant reduction in
blood glucose in both drink conditions. This accelerated decay was significantly greater following glucose than placebo. It is suggested that
the amount of cognitive load associated with task performance is an index of its sensitivity to enhancement by glucose. Furthermore, a period
of intense cognitive processing leads to a measurable decrease in levels of peripherally measured blood glucose, which may be linked to
increased neural energy expenditure. However, the relative contribution of central and peripheral (e.g. cardiac) activity to this effect has yet to
be determined. D 2001 Elsevier Science Inc. All rights reserved.

Keywords: Glucose; Cognition; Cognitive demand; Cognitive load; Mental effort

1. Introduction [28]. It seems plausible that the degree of cognitive demand

There is a wealth of evidence documenting the beneficial
effects of a glucose drink on cognitive performance in
healthy young adults. This effect has been reported as a
direct consequence of a glucose load or in relation to the
extent of change in blood glucose following the drink.
While a great deal of research in this field has focused on
declarative verbal memory, a number of reports have
emerged documenting glucose-related enhancement in other
cognitive domains. These include beneficial effects on
reaction times [23], rapid visual information processing
[5,8], the Stroop paradigm [5], Porteus maze and Block
Design tasks [7], the Brown –Peterson working memory
task [17], driving simulator performance [15], face recog-
nition [20], serial subtractions [14] and kinaesthetic memory
* Corresponding author. Tel.: +44-191-227-4468; fax: +44-191-227-
3190.
E-mail address: a.scholey@unn.ac.uk (A.B. Scholey).
is a key factor in a task’s susceptibility to enhancement by
glucose and other metabolic substrates [7,8,14,21,22,29,30].
To assess this, Kennedy and Scholey [14] directly compared
the effects of a glucose drink on three tasks of differing
cognitive demand (as measured by subjective ratings and by
the level of physiological arousal engendered). Glucose
significantly improved performance only on the task which
was rated as being the most (subjectively) cognitively
demanding and which elicited the highest level of physio-
logical arousal.
Following a glucose load, blood glucose levels rise,
peak, then fall back to baseline levels over the subsequent
hour or so. A number of studies have identified a clear
association between the rate at which glucose levels fall and
better cognitive performance. Arousal-linked mechanisms
certainly contribute to the post-apex fall in blood glucose
during cognitive processing. However, it is possible that the
phenomenon also involves an increased uptake of blood
glucose by active brain substrates. Most previous research in
the field has relied on inference to examine the relationship

0031-9384/01/$ – see front matter D 2001 Elsevier Science Inc. All rights reserved.
PII: S 0 0 3 1 - 9 3 8 4 ( 0 1 ) 0 0 4 7 6 - 0
586 A.B. Scholey et al. / Physiology & Behavior 73 (2001) 585–592
between performance and glucose, either by correlating the
extent of the change in blood glucose with cognitive
measures [14] or by comparing performance of participants
allocated to groups on the basis whether their change in
blood glucose levels lay at the extremes of the sample
distribution [5,7,8,24].
Donohoe and Benton’s [8] results are directly relevant to
the present experiment. In their study, following a glucose
or placebo drink, participants sat quietly or performed the
demanding rapid visual information processing task for 10
min. Subsequently, those in the demand condition had
significantly lower blood glucose levels than those who
had sat quietly. From the data presented, it is not possible
to ascertain the extent to which this effect would have
been evident if the two drink conditions had been con-
sidered separately. Nevertheless, the findings are consis-
tent with the notion that there is increased glucose
utilisation during more intense cognitive processing. It is
possible that increased neural activity contributes to these
effects. Such an interpretation is not without problems
however. Firstly, cognitive demand is itself associated with
arousal, including increased heart rate [3,6,14,32], and
secondly, task performance involves somatic energy
expenditure at the very least by the musculature involved
in response generation. Both of these processes will
inevitably involve cellular uptake of glucose, and while
the former is more difficult to control for, the latter can be
partially addressed by the inclusion of an appropriately
matched control task.
Serial Sevens involves the repeated subtraction of seven
from a given starting number. Previous work in our labo-
ratory has shown that glucose significantly enhances per-
formance on this task [14] and that the degree of fall in
blood glucose correlates with individuals’ performance.
Furthermore, Serial Sevens was rated as highly demanding
by participants and performance of the task was associated
with an increase in heart rate — although a control task in
which participants counted upwards at the same rate did not
elicit this response [14]. In the present study, a computerised
form of the task was implemented in which responses were
made via the numeric keypad of a desktop computer. This
allowed the use of a somatically matched control task with a
negligible cognitive load — a similar number of repeated
key-presses over the same task period — thus going some
way to overcoming one of the drawbacks of earlier experi-
ments described above.
A second complication of previous investigations relates
to the timing of task performance with respect to a glucose
load. Such studies have tended to use an interval of 20 min
between drink consumption and any cognitive processing.
At this time point, typically, peoples’ blood glucose levels
are still rising. It was felt that any impact of cognitive load
on glucose levels may be more pronounced if superimposed
onto falling blood glucose. For this reason, in the present
study, a longer glucose-task interval of 45 min was used for
this aspect of the experiment.
The aims of this study were therefore twofold. The
primary aim was to assess the effects of cognitive demand
on blood glucose levels both in the presence and absence of
a glucose load. This was achieved by direct comparison of
the change in blood glucose levels during Serial Sevens
with the change occurring during the somatically matched
control task. A secondary aim was to further examine the
effects of a glucose drink on three tasks of differing
cognitive demand. One of these was the cognitively
demanding computerised Serial Sevens task described
above. The other two tasks (Word Memory and Verbal
Fluency) have been reported to be susceptible to glucose
administration, but here task parameters were deliberately
changed to reduce task demands.
2. Methods
2.1. Participants
Eleven male and nine female volunteers (mean age 22.7
years, range 20 – 30) took part in the study. Prior to partic-
ipation, each gave informed consent and completed a
medical health form as approved by the University of
Northumbria Division of Psychology Ethics Board.
2.2. Cognitive measures
2.2.1. Computerised Serial Sevens
Serial Sevens involves presenting a participant with a
starting number from which they must subtract 7, then
subtract 7 from the resultant number and so on. The original
(verbal) Serial Sevens test [12] has appeared in a number of
forms and is sensitive to both lowered [31] and raised [14]
blood glucose levels.
A computerised version of the Serial Sevens test was
implemented. A randomly generated starting number
between 800 and 999, which disappeared at the first
key-press, was displayed on the monitor of a desktop
computer. Responses were made in the form of three-digit
numbers, which were recorded via the numeric keypad.
Each key-press resulted in an asterisk being displayed in
the first, second or third position, as appropriate, in a box
on the screen. Pressing the ‘enter’ key signaled the end of
each response and cleared the three asterisks in the box
ready for the next three-digit number. We have preliminary
(unpublished) data suggesting that performance remains
reasonably stable over several minutes; thus, the task may
draw increasingly on cognitive resources over time. It was
therefore felt that any effect on blood glucose may be
more pronounced after a period of cognitive processing.
For this reason, the duration of the task was increased from
the 2 min used in previous studies to 5 min following the
first key press.
The task was scored for both total number of subtractions
and number of errors. In the case of a mistake, subsequent
 A.B. Scholey et al. / Physiology & Behavior 73 (2001) 585–592
responses were scored as positive if they were correct in
relation to the new number.
2.2.2. Serial Sevens control
A control task was devised to involve a similar amount of
somatic/peripheral energy expenditure as the Serial Sevens
but with a minimal cognitive load. The computer generated
a metronome tone at a rate of 20 beeps per minute.
Participants were required to make four key presses at each
tone — the number ‘5’ in the centre of the numeric keypad
three times followed by the ‘enter’ key. Again, the task
duration was 5 min following the first key-press. This
frequency was based on the results of Kennedy and Scholey
[14] where 15 – 20 responses per minute were typically
generated in a verbal version of the task. The present form
therefore involved similar, or slightly greater, somatic
energy expenditure.
2.2.3. Word retrieval
A 2-min Word Retrieval (Verbal Fluency) Task was
utilised. A relatively easy form of the task was used where
participants were asked to generate (out loud) as many
words as they could beginning with either the letter ‘‘S’’
or the letter ‘‘A’’. This task has been described as assessing
‘‘access to and retrieval of information stored in long-term
memory’’ [11].
2.2.4. Word memory
Participants were presented with a sheet containing one
of two lists of 15 words, which were matched for frequency
and concreteness. Again, task parameters were designed to
minimise the cognitive load. Participants were allowed 5
min to study this list. Recall consisted of writing down as
many of the words from the list as possible within 1 min.
The task was scored as number of correctly recalled words.
2.3. Physiological measures
2.3.1. Blood glucose
Blood samples were taken with ‘Boehringer Soft Touch’
single-use blood sampling lancets (Boehringer, Germany).
Blood glucose levels were measured using a Lifescan One
Touch system (Johnson and Johnson, UK), which uses an
enzymatic method similar to that reported to be both
accurate and consistent [18].
2.3.2. Drinks
On each visit, participants received either a glucose or a
placebo drink (depending on the condition to which they
were allocated). The glucose drink was made up of 25 g
glucose powder dissolved in 250 ml of water and 25 ml
‘Summer Magic,’ no added sugar, apple and blackcurrant
squash. The placebo drink was similar but with 30 mg of
saccharine substituting for the glucose. The two drinks were
similar in taste and ‘mouth feel.’
587
Previous research has found that 25 g of glucose is a
suitable dose to produce enhanced performance on both
memory and non-memory cognitive tasks (e.g. [Ref. 14]).
2.3.3. Procedure
Participants attended two sessions, one for each of the
two drink conditions, which took place 1 week apart,
and for each participant at the same time of day.
Sessions lasted approximately 1 hour and were con-
ducted on an individual basis in the same environment
and by the same experimenter (who was blind to
participants’ drink condition) throughout the study. All
testing took place between 09:00 and 13:00 h and
participants were requested to fast from midnight on
the nights before testing.
On arrival at the first session, participants were randomly
allocated to one of two drink conditions (glucose or pla-
cebo), and the first blood glucose reading was taken. The
participant then consumed the glucose or saccharine drink,
studied the word list for 5 min and sat quietly until 40 min
following the drink. The second blood glucose sample was
taken and, starting at 45 min following the first blood
glucose reading, the participant completed either the com-
puterised Serial Sevens task or the key-pressing control task
for 5 min. Immediately following this, a third blood glucose
reading was taken and the participant completed the other
task (Control/Serial Sevens) for 5 min. This was directly
followed by a fourth and final blood glucose measurement,
then the test phase of the Word Memory task (60 s) and the
Word Retrieval (Verbal Fluency) task (2 min). The second
visit was similar except that participants were in the oppo-
site drink condition. At the end of their second visit, each
participant was thanked and debriefed.
The order of word lists, letters used for Verbal
Fluency and whether computerised Serial Sevens pre-
ceded or followed the key-pressing control were balanced
across participants.
2.3.4. Statistics
The blood glucose level data from the placebo and
glucose conditions were analysed by two-way analysis of
variance (ANOVA), the factors being measurement [first
(baseline), second, third and fourth]  condition [Placebo/
Glucose] with repeated measures on both factors. Appro-
priate preplanned comparisons were made using the Bon-
ferroni t statistic.
The effects of drink on performance scores for Serial
Sevens (both number of responses and errors), Word
Retrieval (responses) and Word Memory (words) were
compared by two-way ANOVA, drink order (glucose first/
placebo first)  drink (glucose/placebo) with the latter as a
within-subjects factor.
To assess the effects of computerised Serial Sevens and
the key-pressing control on blood glucose levels, the pre-task
blood glucose level was subtracted from the corresponding
post-task level for each drink condition. The resulting
588 A.B. Scholey et al. / Physiology & Behavior 73 (2001) 585–592
measures were subjected to a two-way ANOVA, drink
(glucose/placebo)  task (Serial Sevens/control). Order
effects on this measure were considered separately using
two-way ANOVAs, task order  drink order [1].
3. Results
3.1. Blood glucose levels
There were significant main effects of condition (glu-
cose/placebo) [ F(1,19) = 19.52, P < .001] and of measure-
ment [first (baseline), second, third and fourth reading]
[ F(1,19) = 24.41, P < .001]. There was also a significant
condition  measurement interaction [F(3,57) = 23.25,
P < .001; Fig. 1].
Planned Bonferroni t tests comparing blood glucose
readings between the placebo and glucose conditions at
each of the four sampling times confirmed glucose absorp-
tion. While there was no significant difference between
baseline glucose levels [t(57) = 0.36, n.s.], glucose readings
following the drink were significantly elevated in the
glucose condition compared to the placebo at the second
[t(57) = 10.85, P < .01], third [t(57) = 6.06, P < .01] and
fourth [t(57) = 7.07, P < .01] readings.
Fig. 1. Blood glucose levels immediately before, 40 min and two later time-
points following consumption of a placebo (6) or glucose (.) drink. Each
point represents mean ± standard error ( ** P < .01 compared to the placebo
condition at the corresponding time point). Timing of the placebo/glucose
drink and the 5-min tasks used to assess the impact of cognitive load are
indicated. The order in which Serial Sevens or the control task were
performed as Tasks A and B was balanced across participants.
3.2. Effects of glucose on cognitive measures
There was a significant effect of glucose on performance
of the Serial Sevens task [ F(1,18) = 7.95, P=.011]. Individ-
uals generated significantly more responses when in the
glucose condition than when in the placebo condition (see
Fig. 2a). The number of errors made during Serial Sevens
did not differ significantly between the two conditions
[ F(1,18) = 2.05, P = .17]. However, the glucose condition
was associated with numerically fewer errors (mean = 4.85
compared with 6.15 in the placebo condition), ruling out the
possibility of a condition-specific ‘‘speed-accuracy trade-
off’’ on this measure.
For the Verbal Fluency task, there was a strong trend for
an increased number of responses in the glucose condition
compared with the placebo condition [ F(1,18) = 3.98,
P = .061; see Fig. 2b]. There was also a significant inter-
action between performance and drink order on this measure
[ F(1,18) = 4.95, P = .039]. There were no other similar
significant interactions with drink order. There was no
significant difference between the placebo condition and
the glucose condition on Word Memory performance
[ F(1,18) = 0.28, P = .603; see Fig. 2c].
3.3. Effects of cognitive demand on blood glucose levels
There were no significant task order or drink order
interactions with any of the task-related blood glucose
measures. There was a significant main effect of task on
the change in blood glucose [ F(1,18) = 11.38, P = .003]. The
magnitude of fall in blood glucose during 5 min of Serial
Sevens was significantly greater than the fall during the 5
min of the key-pressing control task regardless of the type of
drink consumed. There was also a significant main effect of
drink condition [ F(1,18) = 8.59, P = .009]. The change in
blood glucose was greater in the glucose condition than in
the placebo condition irrespective of task. These data are
presented graphically in Fig. 3.
4. Discussion
These findings confirm that glucose administration is
capable of enhancing cognitive performance in healthy young
adults. Furthermore, they lend support to the notion that more
cognitively demanding tasks are most affected by glucose.
The results also demonstrate that a high cognitive load can
itself result in a significant uptake of blood glucose — an
effect which can be detected by the extent of change in
peripheral blood.
The significant improvement of computerised Serial
Sevens performance (Fig. 2a) is consistent with previous
findings from our laboratory [14], where the number of
verbally generated responses was similarly increased by
glucose administration. The results reported here suggest
that the computerised version of the task may be a useful
 A.B. Scholey et al. / Physiology & Behavior 73 (2001) 585–592 589

with drink order. However, improved performance on this

measure is consistent with reports of a similar trend on the
same task [14], suggesting that the ability to access
information from long-term memory may, in some circum-
stances, be susceptible to enhancement by glucose — an
effect which has been identified previously in the elderly
[16]. It seems possible that if the task parameters were
changed slightly, it would be more sensitive to glucose.
Indeed, Donohoe and Benton [7] reported a highly signifi-
cant ( P < .001) effect of glucose on a Verbal Fluency task
with higher demands (utilising three letters of relatively
lower frequency each for 1 min).
The lack of a significant improvement in Word Memory
scores (Fig. 2c) appears to be somewhat at odds with certain
reports. However, closer inspection of the literature sug-
gests a number of reasons for this discrepancy. Not all
studies have reported a direct effect of glucose on verbal
memory. For example, the effect has not always been
observed in young adults [2] and, when present, it appears
to be less pronounced in younger than elderly participants
[10]. Those reports of positive effects of glucose on verbal
recall have tended to rely on relatively large groups of
participants to achieve significance at a levels of .05. On
the other hand, previous studies have used different
amounts of glucose. For example, Benton and Owens [4]
used a 50 g drink and found an association between blood
glucose and word recall scores.
In the Word Memory task used in the present study,
overlearning of target material was deliberately allowed
during the 5-min presentation phase, possibly resulting in
ceiling performance. The results do raise the possibility that
it is the level of demand rather than the type of cognitive
domain measured by a task which is the primary factor in
determining its susceptibility to enhancement by glucose.

Fig. 2. Cognitive performance for the placebo (white bars) and glucose
(black bars) conditions. (a) Number of subtractions performed during
computerised Serial Sevens; (b) number of words generated during the Word
Retrieval (Verbal Fluency) task; (c) number of words recalled in the Word
Memory task. Each bar depicts mean ± standard error. There was a
significant effect of condition on Serial Sevens performance ( * P < .05
compared to the corresponding placebo score) and a trend for enhanced
performance in the Verbal Fluency task ( + P = .060). There was no difference
between conditions for scores on the Word Memory task ( P = .603).
Fig. 3. Effects of a task with a high cognitive load on blood glucose levels
for the placebo (white bars) and glucose (black bars) condition. The graph
tool for the automated assessment of the effects of cogni-
represents the change between pre- and posttask blood glucose levels
tive demand. The trend for improved performance on the during a control (key-pressing) task and computerised Serial Sevens. Each
Word Retrieval (Verbal Fluency) task presented in Fig. 2b bar depicts mean ± standard error ( ** P < .01 compared to the correspond-
is difficult to interpret due to the significant interaction ing placebo condition; *** P < .005 between tasks).
590 A.B. Scholey et al. / Physiology & Behavior 73 (2001) 585–592
Foster et al. [9] reported a significant main effect of
glucose, using a relatively low N (10 per group), on free
recall using a modified California Verbal Learning Task.
Interestingly, during learning of target material, they
required participants to simultaneously perform self-gener-
ated alternation of motor sequences (where subjects may
have believed that performance was being assessed), and
the mnemonic load of the task was deliberately increased to
prevent ceiling effects. Additionally, Messier and Gagnon
[19] identify complex, rather than simple, verbal declara-
tive memory as the impairment which is most amenable to
reversal by glucose. This is consistent with studies of
rodent spatial working memory; glucose did not increase
the level of rats’ spontaneous alternation in a three-arm
radial maze [25], whereas performance on a more difficult
four-arm plus version was enhanced by both systemic and
central injection of glucose [26,27]. While not wishing to
overinterpret the present data, comparing the trend for a
glucose-associated improvement in the Verbal Fluency task
(involving retrieval of past-learned material) with the non-
significant effect on Word Memory (involving the retrieval
of recently overlearned material) supports the contention
that it is the cognitive demand rather than the cognitive
domain of a task which dictates its susceptibility to
enhancement by glucose.
How well is this notion supported by findings from
investigations into the effects of a glucose drink on
performance in non-mnemonic arenas? Glucose has been
shown to enhance performance on later (but not earlier)
phases of driving simulator performance [15], choice (but
not simple) reaction time [23], later rather than earlier
periods of rapid visual information processing [5,8], incon-
gruent (i.e. more difficult) trials of the Stroop paradigm [5],
more difficult examples of the Porteus maze and Block
Design tasks [7] and more demanding (Serial Sevens) but
not easier (Serial Threes) serial subtractions [14]. Such
findings are consistent with the idea that the degree and/or
duration of cognitive demand is an important factor con-
tributing to the extent to which task performance may be
enhanced by glucose.
The matter is not straightforward. Clearly, for facilitation
to occur, there must be ‘room for improvement’ due either
to a cognitively impaired sample population or to the task
parameters themselves. Studies need to be performed into
the effects of glucose on relatively pure cognitive domains,
where task demands can be systematically titrated, as well
as comparing cognitive domains where the demand associ-
ated with individual tasks can be matched.
The main focus of the present study was an examination
of the effects of cognitive demand on blood glucose levels.
Glucose levels fell more rapidly during Serial Sevens than
during the key-pressing control and fell to a greater extent in
the glucose than the placebo condition (Fig. 3). There are a
number of processes which contribute to these effects.
Firstly, from Fig. 3, it is clear that glucose levels are falling
during the 5 min of the task (demanding or not) in both
conditions (placebo and glucose). The relatively modest fall
in the control-placebo condition may simply reflect chance
fluctuations in glucose levels possibly coupled with uptake
by musculature involved in generating the 400 key-presses
during the 5 min of the control task. The significantly
greater fall in blood glucose levels in the control-glucose
condition is almost certainly a consequence of these mech-
anisms coupled with the cellular uptake of glucose pro-
moted by the endocrine factors involved in regulating blood
glucose (including insulin secreted in response to the
glucose load). This effect will be augmented to some degree
by the uptake of glucose by cardiac muscle since part of the
physiological response to glucose ingestion itself includes
an increase in heart rate [14].
Moving to the Serial Sevens-placebo condition, the fall
in blood glucose level is of a significantly greater magni-
tude than in the control-placebo condition. This may be a
manifestation of several processes which constitute a
compound response to cognitively loaded processing.
These include increased heart rate [14], other physiological
indices of arousal and possibly the delivery of glucose to
active brain mechanisms. The fact that this change in
blood glucose is greatest in the Serial Sevens-glucose
condition must be a reflection of these processes coupled
with the additional glucoregulatory endocrine effects.
Given this pattern of results, it is tempting to tentatively
speculate that cognitive demand may also result in an
elevated rate of neural glucose metabolism, which in turn
facilitates task performance.
Interestingly, this magnitude of change in blood glucose
due to a high cognitive load is similar to that presented by
Donohoe and Benton [8] where the difference between the
quiet control and the cognitive demand condition was in the
order of 0.5 –0.7 mmol/l glucose (Donohoe and Benton [7],
p. 417, Fig. 2). In the present study, the change due to
cognitive demand was 0.4 mmol/l (combining the placebo
and glucose data) — a comparable figure despite differences
in the task used, the amount of glucose consumed, the
timing of the task relative to the temporal haemodynamics
of glucose, and the fact that no somatic matching of a
control task was attempted in their study. There are numer-
ous methodological factors, which may contribute to the
similarity in these results, and clearly we are some way from
quantifying such effects.
The idea of increased utilisation of glucose during
intense cognitive processing is consistent with previous
work, which has identified an association between the extent
to which an individual’s glucose levels fall and their
cognitive performance [7,8,14]. The notion that there may
be a direct neural component to this effect is supported to
some extent by findings from brain imaging, especially
positron emission tomography (PET). For example, it was
shown that increasing the load of a working memory task
(N-back) resulted in an overall increase in the uptake of
labelled glucose as measured by PET [13]. The relative
contribution of peripheral and central mechanisms to glu-
 A.B. Scholey et al. / Physiology & Behavior 73 (2001) 585–592
cose uptake associated with cognitive demand needs further
investigation before firm conclusions can be drawn.
It should be reiterated that Serial Sevens is associated
with an increase in heart rate over and above that seen in a
somatically matched control task [14]. This increased
cardiac muscle activity will inevitably contribute to the
accelerated decay of glucose observed in the present
experiment. Additionally, there are a number of physiolog-
ical responses during arousal which may modulate cogni-
tive performance. As well as heart rate changes, these
include the release of ACTH, vasopressin, opioid peptides,
and adrenal catecholamines. Of these, the action of adrena-
line may further complicate interpretation of these data.
Adrenaline release results in a breakdown of hepatic
glycogen stores and a subsequent increase in blood glucose
[33]. There is clearly a dynamic balance between release
and uptake of blood glucose. It would appear that the
arousal processes associated with intense cognitive process-
ing might shift this balance in favour of mechanisms which
deplete blood glucose. Future studies examining the inter-
action of glucose levels with tasks, which similarly raise
cardiac activity and/or arousal in the absence of a cognitive
load, may prove informative.
The mechanisms underlying the cognition-enhancing
effects of glucose are unknown. Several authors have
suggested that the cholinergic system may be involved in
many of the observed cognitive effects of glucose. We have
previously speculated that cholinergic modulation is
unlikely to account for all of the observed cognitive effects
of glucose [14]. In conclusion, glucose administration
preferentially facilitated performance of the task with the
highest cognitive demand. This demand was itself associ-
ated with an accelerated decay in blood glucose levels,
particularly in the glucose condition. Whatever the mech-
anisms underlying such effects, these results do lend
support to the increasing body of evidence that, under
conditions of cognitive demand, there may be a reciprocal
relationship between task performance and falling blood
glucose levels.
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