Altered Perception Research Articles

Altered reward processing following sucrose bingeing in male and female mice

ABSTRACT Objectives: Binge eating disorder (BED) is the most prevalent eating disorder associated with multiple adverse health effects, especially mental health issues, including substance use disorders and mood and anxiety disorders. Given these high comorbidities, the objective of our study was to examine whether bingeing behavior would lead to altered perception of reinforcing properties of EtOH and changes in well-being. Methods: We used a sucrose bingeing model based on an intermittent access paradigm with a two-bottle choice, without fasting, in male and female mice. We examined the effect of 2-week sucrose paradigm on ethanol-reinforcing properties using a conditioned place preference test (CPP). Well-being, anxiety- and depressive-like behavioral tests were performed to assess emotional state following 2 and 8-week sucrose bingeing paradigm. Results: Mice with intermittent access to sucrose developed a binge-like behavior assessed by higher sucrose intake and escalation rate during the 1st hour of access, in comparison with mice with a continuous sucrose access. We show for the first time that sucrose bingeing in mice modifies positive reinforcing effect of EtOH in a CPP paradigm without marked alteration of emotional state. Interestingly, prolonging sucrose access for 8 weeks revealed an exacerbated bingeing behavior in female mice, and some signs of emotional state alterations in female with continuous access. Discussion : In sum, our findings broaden the understanding of behavioral alterations associated with bingeing, highlighting the need to investigate addictive-like properties of palatable food both in male and female mice.

Examining the association between depersonalisation traits and the bodily self in waking and dreaming

Depersonalisation (DP) is characterized by fundamental alterations to the sense of self that include feelings of detachment and estrangement from one’s body. We conducted an online study in healthy participants (n = 514) with DP traits to investigate and quantify the subjective experience of body and self during waking and dreaming, as the vast majority of previous studies focussed on waking experience only. Investigating dreams in people experiencing DP symptoms may help us understand whether the dream state is a ‘spared space’ where people can temporarily ‘retrieve’ their sense of self and sense of bodily presence. We found that higher DP traits—i.e. higher scores on the Cambridge Depersonalisation Scale (CDS)—were associated with more frequent dream experiences from an outside observer perspective (r = 0.28) and more frequent dream experiences of distinct bodily sensations (r = 0.23). We also found that people with higher CDS scores had more frequent dream experiences of altered bodily perception (r = 0.24), more frequent nightmares (r = 0.33) and higher dream recall (r = 0.17). CDS scores were negatively correlated with body boundary scores (r = − 0.31) in waking states and there was a negative association between CDS scores and the degree of trust in interoceptive signals (r = − 0.52). Our study elucidates the complex phenomenology of DP in relation to bodily selfhood during waking and dreaming and suggests avenues for potential therapeutic interventions in people with chronic depersonalisation (depersonalisation -derealisation disorder).

Assessment of a Clinical Test for Detection of Alteration in Visual Perception Due to Astigmatism.

Astigmatism blurs the retinal image of a circular spot along a particular orientation rendering it an elliptical shape. Astigmatic patients demonstrate adaptation to residual astigmatic blur that may affect their discrimination between oval and circular targets. The Wilkins Egg and Ball Test (WEBT) was created to detect altered visual perception due to residual astigmatic blur by discriminating a circle within a row of oval elements. This prospective, cross-sectional study examined the utility of WEBT in detecting uncorrected residual astigmatism on the perception of form symmetry in astigmatic and keratoconic participants as well as normal participants with induced astigmatism at four primary meridians. The mean search time (sT) and number of errors (noE) of 33 non-astigmatic controls (mean age: 24±5, range: 18-43, 6 males), 23 astigmatic participants (mean age: 36±12, range: 18-43, 6 males) and 13 keratoconic participants (N=22 eyes, mean age: 36±12, range: 18-58, 6 males) were measured under baseline, and 2.00 DC induced cylinder at four primary meridians, and for uncorrected, spherical-correction only, and fully corrected conditions, respectively. Mean sT and noE were converted to Z-scores, combined for each condition, and compared using repeated measures ANOVA with post-hoc analysis. Combined Z-scores for the controls were significantly worse (p<0.001) for all induced cylinder conditions. The induced 180° condition was significantly better than 45° and 90° conditions (p=0.04), but not the 135° condition. For both astigmatic and keratoconic cohorts, Z-scores of the uncorrected condition were significantly worse than the fully corrected condition (both p<0.01), but the fully corrected and spherical-only conditions did not differ significantly (p=0.06 and p=0.05, respectively). In accommodating young adults, WEBT detected altered visual perception due to overall blur, and moderate-high amounts of uncorrected induced astigmatism and keratoconus, but is not useful as a tool for detection of altered visual perception due to small residual astigmatic blur.

Silhouette showcards confirm altered obesity-associated body image perception in international cohort study of African-origin populations

ObjectivesGiven the increasing prevalence of obesity and need for effective interventions, there is a growing interest in understanding how an individual’s body image can inform obesity prevention and management. This...

Selena Quintanilla Memorial Sites

Selena Quintanilla, the Queen of Tejano Music, was gunned down by her fan club president on March 31, 1995. She was only twenty-three years old. She persists in public memory, resuscitated and resurrected in myriad ways. A short list includes the iconic film Selena (1997), the Netflix program Selena: The Series (2020), a Grammy Lifetime Achievement Award, and a Hollywood Walk of Fame star. In addition, fans keep the singer’s memory alive through impersonation acts, T-shirts, podcasts, Instagram accounts, annual concert events, and visits to commemorative locations associated with the star. This essay examines three memorial sites in Corpus Christi, Texas: the motel where Selena was murdered, the singer’s grave in Seaside Memorial Park, and the Selena Memorial on the Corpus Christi bayfront. Bridging conversations in memory studies, scholarship on public memorials, considerations of celebrity status, and performance theory, I suggest that these places have performative potential that enables diverse groups to engage in creating specific temporary “communitas.” I analyze the possibility of altered temporal perception at the motel, enactments of what I refer to as Latina mother-daughter pedagogies of postmemory at Selena’s grave, and the expression of queer Latinx love at the singer’s commemorative statue.

Sensitivity to speech-relevant features in hallucination-prone individuals

As hallucinations occur in the absence of an external stimulus, they constitute an intriguing model for how percepts are generated and for how perception can fail. This study explores whether hallucination proneness is linked to an altered perception of speech-related acoustic features. Involving 320 healthy adults with varying predispositions for hallucinations, participants evaluated ambiguous sound textures for their speech-likeness. Psychophysical reverse correlation revealed that higher hallucination proneness was associated with reduced weighting of speech-typical low-frequency acoustic energy. Temporal modulation discrimination capabilities were unrelated to hallucination proneness in a subset of 41 participants. Confidence judgments in individual trials were influenced by both acoustic evidence and individual hallucination proneness and schizotypy scores. Overall, these findings suggest that hallucination-prone individuals exhibit qualitative and quantitative changes in their perception of speech-relevant modulations, supporting the notion of altered perceptual priors and differential weighting of sensory evidence.

Photobiomodulation in the Treatment of Dysgeusia in Patients with Long COVID: A Single-Blind, Randomized Controlled Trial.

Objective: The aim of this study is to evaluate local and systemic photobiomodulation (PBM) in patients with COVID-19-related dysgeusia, with the expectation of improving taste dysfunction. Background: PBM has garnered attention as a potential therapy in long COVID, a condition characterized by many persistent symptoms following the acute phase of COVID-19. Among these symptoms, dysgeusia, or altered taste perception, can significantly affect patients' quality of life. Emerging research suggests that PBM may hold promise in ameliorating dysgeusia by modulating cellular processes and reducing inflammation. Further clinical studies and randomized controlled trials are essential to establish the efficacy and safety of PBM for the treatment of dysgeusia in long COVID, but initial evidence suggests that this noninvasive modality may offer a novel avenue for symptom management. Methods: Seventy patients experiencing dysgeusia were randomly assigned to receive active local and systemic PBM (n = 34) or simulated PBM (n = 36). Low-power laser (red wavelength) was used at 18 spots on the lateral borders of the tongue (3 J per spot), salivary glands (parotid, sublingual, and submandibular glands-3 J per spot), and over the carotid artery for 10 min (60 J). Alongside laser therapy, all patients in both groups received weekly olfactory therapy for up to 8 weeks. Results: Dysgeusia improved in both groups. At weeks 7 and 8, improvement scores were significantly higher in the PBM group than in the sham group (p = 0.048). Conclusions: Combined local and systemic PBM, as applied in this study, proved effective and could serve as a viable treatment option for alleviating dysgeusia in long-COVID patients. Clinical Trial Registration: RBR-2mfbkkk.

The Treatment of Growth Disorders in Childhood and Adolescence.

3% of all children are unusually short, and 3% are unusually tall. New approaches have broadened the range of therapeutic options in treating growth disorders. This review is based on publications retrieved by a selective review of the literature and on the authors' clinical experience. Pituitary growth hormone deficiency is treated with recombinant growth hormone. Long-acting preparations of this type became available recently, but their long-term safety and efficacy are still unknown. Vosoritide, a CNP analogue, has also been approved for the treatment of achondroplasia, and severe primary deficiency of insulin-like growth factor 1 (IGF-1) can be treated with recombinant IGF-1. In the treatment of excessively tall stature, new information on the safety of growth-attenuating treatment and an altered perception of above-average height in society have led to a change in management. There are new options for the treatment of rare causes of short stature, while new information on the safety of treatment strategies for excessive tallness have led to a reconsideration of surgical intervention. There is insufficient evidence on the benefits and risks of supraphysiological GH therapy and of newer treatment options for which there are as yet no robust data on adult height. Therefore, before any treatment is provided, physicians should give patients and their families detailed information and discuss their expectations from treatment and the goals that treatment can be expected to achieve.

Altered Perception of Environmental Volatility During Social Learning in Emerging Psychosis.

Paranoid delusions or unfounded beliefs that others intend to deliberately cause harm are a frequent and burdensome symptom in early psychosis, but their emergence and consolidation still remains opaque. Recent theories suggest that overly precise prediction errors lead to an unstable model of the world providing a breeding ground for delusions. Here, we employ a Bayesian approach to test for such an unstable model of the world and investigate the computational mechanisms underlying emerging paranoia. We modelled behaviour of 18 first-episode psychosis patients (FEP), 19 individuals at clinical high risk for psychosis (CHR-P), and 19 healthy controls (HC) during an advice-taking task designed to probe learning about others' changing intentions. We formulated competing hypotheses comparing the standard Hierarchical Gaussian Filter (HGF), a Bayesian belief updating scheme, with a mean-reverting HGF to model an altered perception of volatility. There was a significant group-by-volatility interaction on advice-taking suggesting that CHR-P and FEP displayed reduced adaptability to environmental volatility. Model comparison favored the standard HGF in HC, but the mean-reverting HGF in CHR-P and FEP in line with perceiving increased volatility, although model attributions in CHR-P were heterogeneous. We observed correlations between perceiving increased volatility and positive symptoms generally as well as with frequency of paranoid delusions specifically. Our results suggest that FEP are characterised by a different computational mechanism - perceiving the environment as increasingly volatile - in line with Bayesian accounts of psychosis. This approach may prove useful to investigate heterogeneity in CHR-P and identify vulnerability for transition to psychosis.

Atypical Impact of Action Effect Delay on Motor Performance in Autism.

Atypical sensory perception and motor impairments are primary features of autism spectrum disorder (ASD) that indicate atypical development and predict social and non-social challenges. However, their link is poorly understood. Sensory perception is often integrated with motor processes when a sensory effect is temporally contiguous with the motor response. Such sensory-motor coupling further improves motor behavior. Previous studies indicate alterations in sensory perception of action-effect temporal contiguity in ASD, which bares the question of how it may impact motor performance.People diagnosed with ASD and typically developed (TD) participants performed a speeded reaction-time task previously established to capture the facilitating impact of action's perceptual effect on motor response selection. The sensitivity of this mechanism to delays in the effect was measured, manipulating the action-effect temporal contiguity in a within-subject design.An immediate action effect (compared to a No-effect condition) facilitated response selection in the TD group. This facilitation effect was evident in the ASD group but did not show the typical sensitivity to the effect delay. While in the TD group, RT was shorter in the short (225ms) compared to the long (675ms) action effect delay condition, this distinguished pattern was absent in the ASD group.The findings provide supporting evidence that atypical motor performance in ASD results, at least in part, from an altered sensory perception of action effect temporal contiguity. We discuss the results in light of the reduced perceptual specialization account in ASD and its potential for undermining adaptive sensorimotor processes.

Nursing Experience Using Art Therapy to Help Women With Breast Cancer Face Changes in Body Image

The subject in this study was a female professional painter who underwent bilateral mastectomy because of bilateral breast cancer, experienced postoperative wound scarring, and developed alopecia due to the side effects of chemotherapy, which caused the patient to lose body image confidence and the motivation to engage in artistic creativity. The patient had shed tears early in the intervention and complained of difficulties with body image adjustment due to her altered appearance. Mastectomy patients must not only undergo drug treatment but also adjust psychologically to body image changes to decrease negative emotions. This was the author's motivation for involvement in this case. The nursing period was from 23 September to 30 December 2021. Physical, mental, spiritual, social, and family data were collected using observations and interviews. These data were evaluated and the main problems were determined to be disturbed body image related to altered body perception post-surgery, alopecia caused by chemotherapy, impaired physical mobility due to upper limb mobility limitations post-surgery, and nausea due to chemotherapy. The patient was encouraged to paint again and to use artistic creativity to comfort herself. Moreover, she was guided to express her innermost thoughts to face the impact of her changes in appearance. In addition, a care consultation channel was provided to facilitate experience sharing with other breast cancer patients, thus assisting the patient to cope with the mental impact of her treatments and face subsequent cancer treatments with a more positive attitude. Art therapy embraces a diverse variety of methods, including drawing and music. Art therapy is a valuable tool that facilitates both physical and mental healing. Based on this experience, nurses should include patients' close relatives when performing art therapy to facilitate shared care to overcome difficulties. We hope this nursing experience provides a practical reference for nurses.

Evolving or unchanged? Investigating perceptual profiles over time in psychosis and comparing with healthy controls

There is a growing body of evidence indicating altered perceptual profiles in psychosis, which can be assessed by evaluating exteroceptive (e.g., auditory and visual) and interoceptive (e.g., heartbeat and breathing) sensory processing through self-administered questionnaires. However, the unexplored question remains whether perceptual alterations depend on the phase of illness. In this observational, STROBE-compliant study, we adopted the Multidimensional Assessment of Interoceptive Awareness (MAIA; eight domains), Adult/Adolescent Sensory Profile (AASP; four domains), and Positive and Negative Symptoms Scale (PANSS) to measure interoception, exteroception, and symptom severity, respectively. Our primary aim was to compare MAIA, AASP, and PANSS differences in patients with psychosis (PSY patients) between post-acute (PSY-T1) and remission phases (PSY-T2). Student&amp;rsquo;s t-tests or Wilcoxon paired-sample tests were used based on the variable distribution. MAIA/AASP data were also collected from healthy controls (HCs). As a secondary aim, we examined MAIA/AASP differences between PSY-T1/T2 and HC using MANOVA and Mann&amp;ndash;Whitney tests. Bonferroni&amp;ndash;Holm correction was implemented. Data were collected from 23 PSY patients (55% females; mean age: 38.35 &amp;plusmn; 12.46 years) and 210 HC (46% females; mean age: 39.81 &amp;plusmn; 13.78 years). No differences were found between PSY-T1 and PSY-T2 (Bonferroni&amp;ndash;Holm P &gt; 0.05) for MAIA/AASP scores, while PANSS total and positive scores were higher in PSY-T1 compared to PSY-T2, with Bonferroni&amp;ndash;Holm p-values of 0.032 and 0.045, respectively. Although MAIA/AASP domains (noticing/body listening and low registration) were increased in PSY-T1 compared to HC, no differences were observed between PSY-T2 and HC. The heterogeneous results in the literature regarding perceptual profiles should be contextualized by considering that fluctuations in patients with psychosis can become significant when compared to the general population.

Laypersons' Esthetic Perception of Different Dentogingival Characteristics Based on Smile Dynamics: Cross-Sectional Study.

This study aimed to evaluate laypersons' esthetic perception of different dentogingival characteristics based on smile dynamics. Six voluntary models were selected, with only one presenting dentogingival characteristics within esthetic standards: white teeth, good alignment, and adequate gingival contour. Two videos were then produced. One video focused on the mouth, whereas the other focused on the entire face of the model, to ensure that the dynamics of the smile could be evaluated. For the evaluation, 200 laypeople were asked to rank the models from first to sixth place in their order of preference. Laypeople were required to justify their reasons for choosing the first and last places. The obtained data were subjected to descriptive and inferential statistical analyses. The results showed that smile and face dynamics influenced the perception of dentogingival characteristics and facial esthetics. No significant changes were observed. However, a gummy smile accompanied by dental alterations was observed in the video of the mouth and was masked by the facial set exposed in the video of the face. A diastema between the central incisors was decisive for negative evaluation of both the mouth and face. The standard model was rated as the most pleasing. Smiles and facial dynamics influence the perception of dentogingival characteristics. Smile and facial dynamics influence the perception of dentogingival alterations among Brazilian laypeople. Diastema is an alteration that interferes with the isolated evaluation of the lower third of the face and the facial set.

Can you believe your eyes? Positive schizotypy is associated with increased susceptibility to the Müller-Lyer illusion

Background and hypothesisVisual illusions provide a unique opportunity to understand cognitive and perceptual alterations in schizophrenia-spectrum conditions. Schizophrenia patients often exhibit increased susceptibility to the Müller-Lyer illusion. Here, we investigate susceptibility to the Müller-Lyer visual illusion in the general population with different levels of schizotypy. Study designWe assessed a population-based convenience sample (N = 263) on an online platform. In addition to basic demographics, participants completed the Müller-Lyer illusion, the Cardiff Anomalous Perceptions Scale (CAPS) to measure perceptual anomalies, and the Multidimensional Schizotypy Scale – Brief (MSS-B) for schizotypic traits. To evaluate what predicts susceptibility to the illusion, we fitted a large set of multilevel logistic regression models and performed model averaging over the coefficients. Study resultsWe found support for increased illusion susceptibility among individuals with high positive schizotypy. However, we did not find a comparable effect for anomalous perceptions alone, or for negative or disorganized schizotypy. ConclusionsThe increased Müller-Lyer effect in positive schizotypy might be specific to delusion-like beliefs and magical ideation. Further research is needed to clarify how a hierarchical Bayesian formulation of brain function (e.g. imbalances between bottom-up perceptual processing and substantial reliance on prior expectations) can account for the Müller-Lyer effect in schizophrenia-spectrum conditions.

Neural Mechanisms of Resting-State Networks and the Amygdala Underlying the Cognitive and Emotional Effects of Psilocybin

BackgroundSerotonergic psychedelics, such as psilocybin, alter perceptual and cognitive systems that are functionally integrated with the amygdala. These changes can alter cognition and emotions that are hypothesized to contribute to their therapeutic utility. However, the neural mechanisms of cognitive and subcortical systems altered by psychedelics are not well understood. MethodsWe used resting-state functional magnetic resonance images collected during a randomized, double-blind, placebo-controlled clinical trial of 24 healthy adults under 0.2 mg/kg psilocybin to estimate the directed (i.e., effective) changes between the amygdala and 3 large-scale resting-state networks involved in cognition. These networks are the default mode network, the salience network, and the central executive network. ResultsWe found a pattern of decreased top-down effective connectivity from these resting-state networks to the amygdala. Effective connectivity decreased within the default mode network and salience network but increased within the central executive network. These changes in effective connectivity were statistically associated with behavioral measures of altered cognition and emotion under the influence of psilocybin. ConclusionsOur findings suggest that temporary amygdala signal attenuation is associated with mechanistic changes to resting-state network connectivity. These changes are significant for altered cognition and perception and suggest targets for research investigating the efficacy of psychedelic therapy for internalizing psychiatric disorders. More broadly, our study suggests the value of quantifying the brain’s hierarchical organization using effective connectivity to identify important mechanisms for basic cognitive function and how they are integrated to give rise to subjective experiences.

Voluntary postural sway control and mobility in adults with low back pain.

Low back pain (LBP) is associated with altered somatosensory perception, which is involved in both involuntary and voluntary control of posture. Currently, there is a lack of methods and tools for assessing somatosensory acuity in patients with LBP. The purpose of this study was (1) to assess the reliability of the sway discrimination apparatus (SwayDA) (2) to evaluate the differences in somatosensory acuity between patients with LBP and pain-free individuals, and (3) to examine relationships between somatosensory acuity, severity of LBP, and mobility in patients with LBP. Twenty participants (10 patients with LBP and 10 matched asymptomatic controls) were recruited in a test-retest reliability test. Another 56 participants were recruited for this study with 28 individuals presenting with LBP and a further twenty-eight being asymptomatic. The SwayDA was custom-built to measure somatosensory perception during voluntary anterior-posterior (SwayDA-AP), medial-lateral to the dominant side (SwayDA-ML-D), and non-dominant side (SwayDA-ML-ND) postural sway control. Participants also completed mobility tests, including 10 times and 1-min sit-to-stand tests (10-STS, 1 m-STS). The area under the receiver operating characteristic curve (AUC) was calculated to quantify somatosensory acuity in discriminating different voluntary postural sway extents. The ICC (2.1) for the SwayDA-AP, SwayDA-ML-D, and SwayDA-ML-ND were 0.741, 0.717, and 0.805 with MDC95 0.071, 0.043, and 0.050. Patients with LBP demonstrated significantly lower SwayDA scores (tSwayDA-AP = -2.142, p = 0.037; tSwayDA-ML-D = -2.266, p = 0.027) than asymptomatic controls. The AUC values of the SwayDA-AP test were significantly correlated with ODI (rSwayDA-AP-ODI = -0.391, p = 0.039). Performances on the 1 m-STS and the 10-STS were significantly correlated with the AUC scores from all the SwayDA tests (-0.513 ≤ r ≤ 0.441, all p < 0.05). The SwayDA tests evaluated showed acceptable reliability in assessing somatosensory acuity during voluntary postural sway. Somatosensory acuity was diminished in patients with LBP compared to asymptomatic controls. In patients with LBP, lower somatosensory acuity was associated with increased LBP-related disability. Future research could focus on investigating the factors contributing to the decreased somatosensory perception and mobility in individuals with LBP.

Migrainous vertigo impairs adaptive learning as a function of uncertainty.

In this study, we examined whether vestibular migraine, as a source of increased perceptual uncertainty due to the associated dizziness, interferes with adaptive learning. The IOWA gambling task (IGT) was used to assess adaptive learning in both healthy controls and patients with migraine-related dizziness. Participants were presented with four decks of cards (A, B, C, and D) and requested to select a card over 100 trials. Participants received a monetary reward or a penalty with equal probability when they selected a card. Card decks A and B (high-risk decks) involved high rewards (win £100) and high penalties (lose £250), whereas C and D (low-risk decks; favorable reward-to-punishment ratio) involved lower rewards (win £50) and penalties (lose £50). Task success required participants to decide (i.e., adaptively learn) through the feedback they received that C and D were the advantageous decks. The study revealed that patients with vestibular migraine selected more high-risk cards than the control group. Chronic vestibular migraine patients showed delayed improvement in task performance than those with acute presentation. Only in acute vestibular migraine patients, we observed that impaired learning positively correlated with measures of dizzy symptoms. The findings of this study have clinical implications for how vestibular migraine can affect behavioural adaption in patients, either directly through altered perception or indirectly by impacting cognitive processes that can result in maladaptive behavior.

Two Cases of Alice in Wonderland Syndrome with a Right Occipital Lobe Lesion Caused by Isolated Cortical Venous Thrombosis.

Alice in Wonderland syndrome (AIWS) is extremely rare, occurring more often in young individuals than in older adults. Symptoms of this syndrome typically include an altered body image, size perception, and time perception. However, the pathophysiology and lesions responsible for this syndrome remain unclear. In most cases, specific lesions cannot be identified using computed tomography or magnetic resonance imaging. Two patients with isolated cortical venous thrombosis in the right occipital area experienced transient visual symptoms of AIWS. Furthermore, a literature search indicated that AIWS with visual distortions is associated with right occipital lobe lesions, supporting the findings of our study.

Digoxin‐induced retinal toxicity after acute kidney injury in a patient with dilated cardiomyopathy: A case report

Aims/Purpose: We would like to report a case of digoxin‐induced retinal toxicity.Methods: Observational case report. Clinical follow‐up was performed using optical coherence tomography and electroretinography.Results: A 50‐year‐old female patient was referred to our clinic with symptoms of blurred vision and a whitening of the central visual field. She had no prior ophthalmic history but had underlying diseases including hypertension, hyperlipidaemia, dilated cardiomyopathy, systemic lupus erythematosus and chronic kidney disease. She had been admitted to the department of nephrology due to acute renal impairment, presenting with flank pain and oliguria. At the initial examination, her best‐corrected visual acuity was 0.5 in the right eye and 0.4 in the left eye. The Ishihara colour vision test revealed 3/17 and 1/17 in the right and left eye, respectively. Optical coherence tomography showed blurring and thickening of the ellipsoid zone in both eyes. Electroretinography demonstrated decreased cone cell function. She had been taking digoxin 0.125 mg for dilated cardiomyopathy for the past 2 years. Following the onset of acute renal impairment, her serum digoxin level was found to be 2.95 ng/mL, more than twice the normal range [0.6–1.2]. Suspecting digoxin intoxication, we consulted with her cardiologist and decided to discontinue digoxin. 3 weeks after discontinuing the medication, she reported improvement in the whitening of central visual field. Her best‐corrected visual acuity improved to 0.7 in the right eye and 0.6 in the left eye, and the Ishihara colour vision test showed 16/17 in both eyes. OCT demonstrated normalization of the ellipsoid zone thickness, and ERG showed ongoing recovery of cone cell function.Conclusions: Digoxin toxicity is known to result in visual disturbances—including decreased visual acuity, blurry vision and central scotoma with altered colour perception—caused by direct dysfunction of photoreceptors. Symptoms are gradually recovered within days to months after discontinuation of the medication. When facing visual problems in a patient with comorbidities, it is important to elicit a complete history, with all drug and detailed complaints, and to include a drug adverse effect. If a drug intoxication was suspected, medical consultations should be obtained.

Brain mechanisms of temporal processing in impulsivity: Relevance to attention-deficit hyperactivity disorder.

In this article, we critique the hypothesis that different varieties of impulsivity, including impulsiveness present in attention-deficit hyperactivity disorder, encompass an accelerated perception of time. This conceptualisation provides insights into how individuals with attention-deficit hyperactivity disorder have the capacity to maximise cognitive capabilities by more closely aligning themselves with appropriate environmental contexts (e.g. fast paced tasks that prevent boredom). We discuss the evidence for altered time perception in attention-deficit hyperactivity disorder alongside putative underlying neurobiological substrates, including a distributed brain network mediating time perception over multiple timescales. In particular, we explore the importance of temporal representations across the brain for time perception and symptom manifestation in attention-deficit hyperactivity disorder, including a prominent role of the hippocampus and other temporal lobe regions. We also reflect on how abnormalities in the perception of time may be relevant for understanding the aetiology of attention-deficit hyperactivity disorder and mechanism of action of existing medications.