Flicker Fusion Test Research Articles

Exploring the influence of music on cognitive performance in female assembly line workers at a medical device manufacturing unit.

The significance of enhancing working conditions for the physical health and performance of workers, particularly female workers, underscores the need for research in this domain and the examination of interventions such as music. Previous studies have yielded diverse outcomes regarding the influence of music on individuals' performance; hence, further research in this area appears imperative. The aim of this study is to explore the impact of music on the cognitive and task performance of female assembly operation operators. This study is an interventional (quasi-experimental) study that involved 81 participants from the female workforce of the medical equipment assembly unit in Isfahan, Iran. The evaluation encompassed task performance, working memory using N-Back test, sustained attention using continues performance test (CPT), degree of sleepiness, and mental fatigue using Flicker Fusion test, along with physiological parameters such as heart rate and blood oxygen level. Participants underwent testing both in the presence of classical music and in a condition without music playback. The provision of background music enhanced the workers' sustained attention and working memory. It led to improved task performance and a reduction in drowsiness. Concerning physiological parameters, it resulted in a slight decrease in heart rate at the end of the work shift and a marginal increase in participants' blood oxygen levels. Background music enhanced working memory (p-value = 0.001), sustained attention (p-value = 0.001), and improved the task performance of workers(p-value = 0.005). Additionally, likely due to increased relaxation, it led to a decrease in heart rate (p-value = 0.001) and an increase in blood oxygen levels (p-value = 0.016). Music also played a role in reducing participants' sleepiness (p-value = 0.001).

Assessment of Three Clinical Tests for Evaluation of Concussion/Mild Traumatic Brain Injury

A focus of both basic and clinical research on concussion/mild traumatic brain injury has been to ascertain which test, or combination of tests, is best for its detection. In the present retrospective analysis, three potential clinical tests were evaluated to determine which one, or combination, best differentiated between visually-symptomatic concussed (n=52) versus asymptomatic non-concussed (n=24) patients. The three tests were: distance horizontal vergence facility, peripheral visual motion, and critical flicker fusion. Each test was found to differentiate the two groups. The peripheral visual motion test was the best, with a sensitivity of 93.8% and a specificity of 83.3%. When this test was combined with the distance horizontal vergence facility test, specificity remained the same whereas sensitivity increased to 94.4%. Addition of the critical flicker fusion test did not affect these values. Thus, of the three, the combination of the peripheral visual motion and distance horizontal vergence facility tests has a high probability of assisting in concussion detection and diagnosis.

0518 Sleep Facilitation by Artificial Carbonated Bathing in Healthy Elderly; EEG, Core, Proximal, and Distal Temperature Evaluations

Abstract Introduction Bathing, especially with hot spring with various mineral compositions, is known to facilitate / improve sleep by warming the body. Artificial carbonated bathing (ACB) is known to keep the body warm too. Previous our study examined that ACB before sleep more specifically affected body temperature and sleep on healthy young subjects. In this study, we evaluated the effects of usual (plain hot water; PH) and artificial carbonated bathing, on sleep using clinical thermometers and EEG in healthy elderly subjects. Methods Nine healthy elderly women (average age 71.3 years old) were divided into 2 groups ACB (858 ppm, Awacomachi, Danrei Co.) and PH with a week interval. Subjects soaked in the bath (38 C degree) deep enough their chests touched the water for 10 min. From the time they finished bathing to the next morning, we measured their distal skin temperature (top side of the foot), proximal skin temperature (lower part of the clavicle) and EEG using a single channel portable device (Brain wave sensor, Proassist Co.). Subjects were told to sleep from 23:00-6:00. As the same time, subjects were examined with visual analog scale (VAS) and clinical flicker fusion test (CFF). Results There was no significant difference in body temperature (proximal, distal, distal-proximal temperature gradient: DPG) before and during sleep between ACB and PH. The condition of the ACB tended to have less light sleep compared to PH (150min vs 201min, p=0.08), but there was no significant difference in the SWS (44.1min vs 39.1min, ns), EEG delta power analysis, VAS and CFF. In the previous study, bathing was performed for 15 min at a water temperature of 40 C degree, but this condition was considered to be a high risk for the elderly. The reason why there was no significant difference in body temperature. The effects of ACB were not fully demonstrated due to changes in hot water temperature and bathing time. Conclusion The effect of ACB on the body temperature of healthy elderly people could not be confirmed. However, a tendency to reduce light sleep was observed. Support This work was supported by JSPS KAKENHI Grant Number JP19K11294

Motion perception, form discrimination and visual motor integration abilities in mTBI patients

Although former studies demonstrated that patients with mild traumatic brain injuries (mTBI) have abnormal visual motion sensitivityand motor difficulties (Spiegel et al., 2016), little is known about the effect of mTBI on form perception and visual motor integration. The aim of this study was to evaluate temporal resolution, motion, form, form-from motion perception and visual motor integration in mTBI patients. Eleven mTBI patients (2 females, mean age 22.8 years) and ten age-matched controls (4 females) participated in the study. Motion perception was evaluated with the motion coherence test (MC). Temporal resolution was evaluated with the critical flicker fusion test (CFF). Form discrimination was assessed with form coherence test (FC) and form-from-motion test (FFM). VMI-6 was used to evaluate visual motor integration. The MC, FC, and FFM were displayed in a foveal position, while CFF was assessed in central and peripheral positions. Generalized linear models evidenced differences between mTBI and controls in CFF test and in VMI tasks. In details, in CFF test the mTBI patients had lower performances in peripheral temporal resolution processing as compared to controls and in VMI-6 test they had lower motor and visual motor integration abilities. No difference was found between mTBI patients and controls in MC, FC, and FFM tasks showing similar performance in mTBI and controls in motion, form and form from motion perception. These results demonstrated that mTBI is associate with fine motor and visual motor integration deficits and confirmed anomalous temporal resolution in peripheral vision. Although we failed to find a more generalized visual perception impairment in motion and form perception, caution is needed in interpreting this result because of the small sample size.

A comparative study of effect of sodium valproate & flunarizine on psychomotor performance in patients of common migraine: A randomized, parallel, open label, prospective observational study

Introduction: Psychomotor performance results from the coordination of sensory and motor system through the integrative and organizational process of brain and central nervous system. Psychotropic drugs may adversely affect work performance which depends on psychomotor activities. Both valproate and flunarizine are widely used drugs in prophylaxis of migraine and they are known to have effect on psychomotor performance. Hence this study was carried out to evaluate the effect of valproate & flunarizine on psychomotor performance in patients of migraine with the help of battery of subjective & objective psychomotor tests over a period of 8 weeks. Materials and Methods: Patients were allocated to one of the two groups on first day of examination. Baseline psychomotor tests were measured using battery of tests including critical flicker fusion test (CFFT), hand steadiness test (HST), arithmetic ability test & reaction time monitoring. At the end of 4 weeks & 8 weeks, again tests using same methods employed previously were performed. Efficacy was calculated by using Migraine dairy template (0, 4, 8 weeks) & CGI Scale (end). A total of 44 patients were recruited with 22 patients in each arm. Results: Flunarizine (n=20) & valproate (n=20) significantly increased CFFT, AAT scores at the end of 8 weeks compared to baseline and significantly reduced HST, RT, Frequency, Duration and severity at the end of 8 weeks compared to baseline. When flunarizine was compared to valproate no statistical significance was found in scores of CFFT, AAT, HST, RT, Frequency, duration, severity, global improvement and efficacy index. Conclusion: Flunarizine & Valproate were found to be equally efficacious to improve psychomotor performance. Keywords: Sodium valproate, Flunarizine, Psychomotor, Migraine, Prophylaxis, Performance.

A Randomized Open-label Study to Evaluate the Effects of Escitalopram and Mirtazapine on Psychomotor Functions and Memory in Patients with Depression

Objective: To compare the effects of escitalopram and mirtazapine on psychomotor functions and memory and also to correlate the antidepressant efficacy of these drugs with psychomotor functions. Materials and Methods: This study was carried out at a tertiary care teaching hospital on 104 newly diagnosed literate patients with endogenous depression as per the inclusion and exclusion criteria. Patients were prescribed either escitalopram (20 mg OD) or mirtazapine (15 mg OD) or amitriptyline (75 mg BD). Psychomotor functions were assessed by digit-letter substitution, six-letter cancellation, choice reaction time, hand steadiness, and flicker fusion tests, and memory was assessed by PGI memory scale at the baseline and at the end of the 1st week, 1st month, and 4th month. Efficacy of drugs was measured by the Hamilton Depression Rating Scale (HDRS) at the baseline and each follow-up. The antidepressant efficacy of these drugs with various psychomotor function tests was correlated using Pearson's correlation test. P 0.05). A strong correlation was observed between psychomotor functions and HDRS score in patients treated with escitalopram (positive correlation), mirtazapine (positive correlation), and amitriptyline (negative correlation). Conclusion: Escitalopram and mirtazapine improve psychomotor function in patients with endogenous depression while amitriptyline deteriorates it. Thus, escitalopram and mirtazapine may be preferred to amitriptyline in clinical practice.

Effect of agomelatine on psychomotor function tests in healthy human volunteers

Background: Agomelatine is a melatonergic agonist that acts specifically on MT1/MT2 melatonergic receptors and 5-HT2C antagonism. The present study was taken up to evaluate the effect of Agomelatine 25mg on psychomotor function in healthy human volunteers.Methods: The effect of Agomelatine was studied in 12 healthy volunteers of either gender. The study was a randomised, cross over, placebo controlled study, done after obtaining permission from NIMS Institutional Ethics Committee and informed consent taken from all the subjects, after briefly explaining the study procedure and training them adequately. Psychomotor function was assessed using Choice reaction time (CRT), Critical Flicker fusion test (CFFT), Digit letter substitution test (DLST), Six letter cancellation test (SLCT), Card sorting test (CST) and Visual analog scale (VAS). Psychomotor function tests were performed, 90 minutes after administering Agomelatine 25 mg or placebo. Washout period of seven days was allowed between the cross over. Statistical analysis was done by comparing groups using unpaired t test.Results: There was significant decrease in the mean percentage of time (p<0.01) in CRT in Agomelatine group (20.09±9.47%) when compared to placebo (10.48±3.68%). Improved mean percentage of performance was seen in CFFT with Agomelatine (6.2±2.1%) compared to placebo (9.11±2.99%). No significant difference was noted in the performance of DLST, SLCT and CST. Drug was subjectively rated as sedative on VAS.Conclusions: There is no significant effect of Agomelatine on psychomotor performance. CNS processing of information also improved. Agomelatine can thus be safely administered to depressed patients.

Comparison of Effect of Antidepressants on Psychomotor Functions.

Objective:The comparison of the effect of antidepressants on psychomotor functions in patients with endogenous depression.Materials and Methods:This prospective interventional study was carried out at a tertiary care teaching hospital on 95 literate patients with newly diagnosed endogenous depression matching inclusion and exclusion criteria. Patients were prescribed either desvenlafaxine (50 mg) or fluoxetine (40 mg) or sertraline (50 mg). Psychomotor functions were assessed by digit letter substitution, six letter cancellation, choice reaction time, hand steadiness and flicker fusion test at the baseline 1st month and 3rd month. Efficacy of drugs was also measured by Hamilton rating scale for depression. Data were analyzed by using ANOVA and P < 0.05 was considered as statistically significant.Results:A total of 95 patients were enrolled. Fluoxetine, desvenlafaxine, and sertraline were prescribed in 32, 32, and 31 patients, respectively. At the end of 3 months, a significant improvement in psychomotor functions was observed in patients treated with sertraline (P < 0.05), while desvenlafaxine-treated patients did not show any significant change in any of the tests. Surprisingly, fluoxetine-treated patients showed deterioration in all psychomotor tests (P < 0.05). Hamilton rating score improved at the end of 3 months treatment as compared to baseline. Most commonly observed adverse reactions in all three drug groups were nausea (n = 20), dizziness (n = 3), headache (n = 20), and diarrhea (n = 3).Conclusion:Sertraline significantly improves psychomotor function as compared to desvenlafaxine while fluoxetine impairs.

Model-based meta-analysis of the effects of non-selective and α1-selective GABAA receptor agonists in healthy volunteers.

To quantify pharmacokinetic (PK) and pharmacodynamic (PD) relationships of various classes of GABAA agonists in healthy volunteers, in order to investigate the sensitivity of the biomarker responses due to differing GABAA-subtype selectivity and to explore the correlation between biomarker responses and side effects of these drugs. A comprehensive search was conducted for published placebo-controlled clinical studies of non- and α1-selective GABAA drugs in healthy volunteers. PK/PD models were developed for concentrations and biomarker outcomes (saccadic eye movement (SEM), visual analogue scale (VAS), digit symbol substitution task (DSST), and critical flicker fusion test (CFFT)) extracted from included studies. Predicted responses and equivalent doses for biomarkers (based on predicted response) were used to compare drug effects. And the relationship between biomarkers and safety was explored by linear regression. A total of 2237 data from 163 articles were included. Based on PK and placebo effect modeling, linear biomarker-concentration relationships well fit the data. The α1-selective compounds had similar equivalent doses for VAS, DSST, and CFFT (4.7-6.7mg), which were about three to seven times lower than that for SEM (14.4-35.5mg), while such difference was less evident for non-selective drugs. DSST had the highest correlations with incidences of somnolence and dizziness. The integral PK/PD models of GABAA agonists were established in healthy volunteers. SEM was identified as the most sensitive biomarker in differentiating GABAA receptor α1 subtype selective compounds. The exploratory analysis implied that different relationships existed between the drug effects on biomarkers and the adverse event profiles in healthy volunteers.

Residual effects of zolpidem, triazolam, rilmazafone and placebo in healthy elderly subjects: a randomized double-blind study

With current hypnotic agents, next-day residual effects are a common problem. The purpose of the present study was to evaluate the residual effects of the commercially available hypnotics – zolpidem, triazolam, and rilmazafone – on the physical and cognitive functions of healthy elderly people in the early morning and the day following drug administration.In this study, the next-day residual effects of zolpidem, triazolam, and rilmazafone, following bedtime dosing in elderly subjects, were evaluated. Women (n = 11) and men (n = 2) aged 60–70 years received a single dose (at 23:00) of one of these, zolpidem 5 mg, triazolam 0.125 mg, rilmazafone 1 mg and placebo in a randomized, double-blind, crossover design. Measures of objective parameters and psychomotor performances (Timed up and Go test, Functional Reach Test, body sway test, critical flicker fusion test, simple discrimination reaction test, short-term memory test) and subjective ratings were obtained at 04:00, 07:00, and the next time of the day.All hypnotics were generally well tolerated; there were no serious adverse side effects and no subjects discontinued the evaluations. Compared to placebo, zolpidem and rilmazafone had good results on the Functional Reach Test. Although subjective assessments tended to be poor in the early morning, rilmazafone significantly improved the body sway test in the other hypnotics.A single dose of zolpidem 5 mg and triazolam 0.125 mg did not have any next-day residual effects on healthy elderly subjects. Residual effects appeared to be related to the compound's half-life and the dose used. Rilmazafone 1 mg exhibited steadiness in static and dynamic balance and seemed to be more favorable for the elderly with early morning awakening.

Comparative study of effects of gabapentin, vigabatrin and sodium valproate on psychomotor performance in healthy volunteers

Context: The cognitive and psychomotor functions may become impaired in epileptic patients due to underlying etiology, effect of seizures and side-effects of antiepileptic drugs. It is desirable for the drug to have a minimal effect on cognitive abilities. Few studies have evaluated the psychomotor effects of newer antiepileptic agents and hence do not have the proper evidence base for their psychomotor adverse effects. Aims: The aim of this study is to evaluate the effects of gabapentin (GBP), vigabatrin (VGB), valproate (VAL) on psychomotor functions. Settings and Design: Randomized, prospective, double-blind, placebo (PLB) controlled crossover study. Subjects and Methods: A total of 24 healthy volunteers were included to administer single oral doses of GBP 300 mg, VGB 500 mg, sodium valproate 200 mg and PLB following a Latin square design. The objective parameters - six-digit cancellation test, digit symbol substitution test, critical flicker fusion test, arithmetic ability test, digit span test, hand steadiness test and subjective parameters like visual analog scale (VAS) were tested at 0, 1, 2 and 3 h. Statistical Analysis Used: Repeated measures ANOVA was used to compare the difference in mean score. Fisher's exact test was used for statistical analysis of adverse effects. Results: Sodium valproate impaired all subjective and objective psychomotor functions while GBP, VGB did not show any impairment when compared with PLB. GBP when compared with VGB, no difference was observed in any test, but when both the drugs were compared with sodium valproate, statistically significant difference at the end of third hourwas observed. Conclusions: VGB and GBP have few adverse cognitive and psychomotor effects as compared with sodium valproate, therefore are safe as add on therapy or monotherapy.

Tu1407 Extracorporeal Magnetic Stimulation for Sacral Nerve is as Effective as Biofeedback Therapy in Patients With Rectal Hyposensitivity

Background: Asimadoline, a peripherally-restricted highly selective kappa-opioid receptor (KOR) agonist, has been shown to be efficacious in relieving pain or discomfort, urgency, stool frequency and other symptoms in diarrhea-predominant-IBS (D-IBS) patients with at least moderate pain (Mangel et al 2008). The mechanism of action for this therapeutic effect is thought to involve activation of up-regulated KORs on visceral afferent terminals in the gut wall. KOR activation in the central nervous system (CNS) can lead to aquaresis, dysphoria, and sedation. Penetration of asimadoline into the CNS is poor due to its amphiphilic structure and because it is a substrate for P-glycoprotein (P-gp), thus, there is no evidence for CNS effects of asimadoline in the IBS dose range (1-2 mg/day). Aim: The potential for drug interaction-induced CNS effects with ketoconazole, an inhibitor of P-gp and cytochrome P450 3A4 (CYP3A4), which plays a role in the metabolism of asimadoline, was assessed in this study. Methods: This was a single center, double-blind, placebo-controlled, randomized, two-period, crossover drug interaction study. Twelve healthy male subjects (Caucasian, 1840 years) received ketoconazole 200 mg bid for 3 days followed by a combination of ketoconazole 200 mg and asimadoline 1.5 mg bid (3 fold higher than the 0.5 mg bid clinical dose for IBS) from Days 4 to 9 and a single morning dose on Day 10 in one period and the same treatments but with ketoconazole placebo in a second period, with a 14 day washout between treatments. Pharmacodynamic tests aimed at detecting activity of asimadoline in the CNS included plasma antidiuretic hormone concentrations, the Critical Flicker Fusion test, the Profile of Mood State and the Bond & Lader visual analogue scale of mood and alertness, performed on Days 1, 4, 7 and 10. Primary pharmacokinetic variables were plasma asimadoline Cmax and AUC0-τ after a single dose on Day 4 and after multiple doses on Day 10. Results: The Cmax of asimadoline was approximately doubled with ketoconazole compared to placebo co-administration (from 46.2 to 98.9 ng/mL on Day 4 and from 50.7 to 112.1 ng/mL on Day 10). Mean AUCτ values were 3-fold higher during ketoconazole compared to placebo treatment. Although co-administration of ketoconazole led to a 2to 3-fold increase in asimadoline Cmax and AUC, no effects were observed on any of the CNS pharmacodynamic endpoints. Conclusions: There were no CNS pharmacodynamic effects even at plasma asimadoline levels 8-fold higher than those achieved at the IBS dose. These data provide further evidence for the peripheral restriction of asimadoline and suggest that dose adjustment when co-administered with ketoconazole or other CYP3A4 / P-gp inhibitors is not required.

Tu1406 Impact of Concurrent use of PPIs or Anti-Depressants on Efficacy of Rifaximin for IBS Without Constipation

Background: Asimadoline, a peripherally-restricted highly selective kappa-opioid receptor (KOR) agonist, has been shown to be efficacious in relieving pain or discomfort, urgency, stool frequency and other symptoms in diarrhea-predominant-IBS (D-IBS) patients with at least moderate pain (Mangel et al 2008). The mechanism of action for this therapeutic effect is thought to involve activation of up-regulated KORs on visceral afferent terminals in the gut wall. KOR activation in the central nervous system (CNS) can lead to aquaresis, dysphoria, and sedation. Penetration of asimadoline into the CNS is poor due to its amphiphilic structure and because it is a substrate for P-glycoprotein (P-gp), thus, there is no evidence for CNS effects of asimadoline in the IBS dose range (1-2 mg/day). Aim: The potential for drug interaction-induced CNS effects with ketoconazole, an inhibitor of P-gp and cytochrome P450 3A4 (CYP3A4), which plays a role in the metabolism of asimadoline, was assessed in this study. Methods: This was a single center, double-blind, placebo-controlled, randomized, two-period, crossover drug interaction study. Twelve healthy male subjects (Caucasian, 1840 years) received ketoconazole 200 mg bid for 3 days followed by a combination of ketoconazole 200 mg and asimadoline 1.5 mg bid (3 fold higher than the 0.5 mg bid clinical dose for IBS) from Days 4 to 9 and a single morning dose on Day 10 in one period and the same treatments but with ketoconazole placebo in a second period, with a 14 day washout between treatments. Pharmacodynamic tests aimed at detecting activity of asimadoline in the CNS included plasma antidiuretic hormone concentrations, the Critical Flicker Fusion test, the Profile of Mood State and the Bond & Lader visual analogue scale of mood and alertness, performed on Days 1, 4, 7 and 10. Primary pharmacokinetic variables were plasma asimadoline Cmax and AUC0-τ after a single dose on Day 4 and after multiple doses on Day 10. Results: The Cmax of asimadoline was approximately doubled with ketoconazole compared to placebo co-administration (from 46.2 to 98.9 ng/mL on Day 4 and from 50.7 to 112.1 ng/mL on Day 10). Mean AUCτ values were 3-fold higher during ketoconazole compared to placebo treatment. Although co-administration of ketoconazole led to a 2to 3-fold increase in asimadoline Cmax and AUC, no effects were observed on any of the CNS pharmacodynamic endpoints. Conclusions: There were no CNS pharmacodynamic effects even at plasma asimadoline levels 8-fold higher than those achieved at the IBS dose. These data provide further evidence for the peripheral restriction of asimadoline and suggest that dose adjustment when co-administered with ketoconazole or other CYP3A4 / P-gp inhibitors is not required.

Cognitive Function During Vagus Nerve Stimulation for Treatment-Refractory Epilepsy: A Pilot Study Using the Critical Flicker Fusion Test

This pilot study assessed neuro-cognitive functioning in 7 adults treated with Vagus Nerve Stimulation (VNS) for refractory epilepsy over a 12-month period. All patients were assessed using the Critical Flicker Fusion (CFF) test, a sensitive measure of the ability of the central nervous system to discriminate items of sensory information, along with a standardized battery of neuropsychological and behavioral measures. Reduction in seizure frequency and psychiatric ratings was accompanied by a selective but significant (p < .05) improvement in CFF performance. These findings suggest that the CFF test could be a useful indicator of improvement in neurocognitive functioning during VNS.

Research on Beijing Bus Driver Psychology Fatigue Evaluation

As the capital and political centre of China, Beijing's motor vehicle ownership, road congestion and flow intensity are all increasing. The traffic accident explosion has become a growing number of serious social problems, and the driver's driving safety requirements are higher. In this background, the research on Beijing bus driver's mental fatigue becomes a critical issue in reducing road accidents, decreasing passengers' injuries, and ensuring safe operation. Psychology Fatigue Measurement System was established in the experiment. Critical flicker fusion test, perceptual speed test, distribution of attention value test, reaction time test were used to test drivers of three types of buses, and then Wilcoxon non-parametric test was used to calculate significance of data changes with SPSS. This thesis reveals the Beijing bus drivers' fatigue evaluation index changing trends under different driving models and running time. As a conclusion, changes of each index obtained obey normal distribution, and changes in indicators are independent. The changes of the fatigue test index are discovered caused by different buses and different time.

Absence of Psychostimulant Effects of a Supratherapeutic Dose of Tianeptine

The primary objective of the present study was to assess the potential psychostimulant effect of a single oral supratherapeutic dose of tianeptine (75 mg in 1 shot) in young healthy volunteers compared with methylphenidate (40 mg) and placebo. Eighteen healthy young male and female volunteers with no history of psychostimulant abuse completed this balanced, crossover, placebo-controlled study. Subjective and behavioral effects were assessed before treatment and 1, 2, 3, 4, and 8 hours after drug intake. Subjective effects of the drugs were recorded using self-questionnaire Addiction Research Center Inventory (ARCI 49). In addition, the Profile of Mood Scale, Visual Analog Scale, and attention/vigilance tests (choice reaction time and critical flicker fusion test) were used to evaluate mood state, subjective feeling, and sustained attention, respectively. Analysis on changes from baseline, from 1 to 8 hours, showed statistically significant differences between treatment groups for 2 of the 5 ARCI subscales: amphetamine and morphine benzedrine scales. A trend to significance was observed for Lysergic Acid Diethylamide scale. Indeed, although tianeptine did not significantly change any ARCI scores, methylphenidate significantly increased amphetamine and morphine benzedrine scores of the ARCI compared with placebo. No significant treatment effect was observed on the Profile of Mood Scale and the visual analog scale. Analyses of attention and vigilance tests showed a psychostimulant effect for methylphenidate on choice reaction time (decrease of recognition time) and critical flicker fusion test (higher frequency). A single administration of a supratherapeutic dose of tianeptine does not induce psychostimulant effect in young healthy volunteers in contrast to methylphenidate at a therapeutic dose. These findings suggest an absence of psychostimulant liability of tianeptine in a therapeutic situation.

MF.06 Cognitive function during vagus nerve stimulation (VNS) for treatment-refractory epilepsy: a Pilot Study using the Critical Flicker Fusion (CFF) Test

AimsTo explore the neuro-cognitive effects of VNS in patients with treatment-refractory epilepsy using the Critical Flicker Fusion (CFF) Test, a neuropsychological measure of cognitive integrative capacity of the central nervous...

Effects of discontinuing benzodiazepine‐derivative hypnotics on postural sway and cognitive functions in the elderly

Benzodiazepines (BZDs) have been reported to cause negative impacts on body stability and cognitive functions, which in turn could result in lethal incidents, including falls, especially in the elderly. This fact notwithstanding, no systematic trial has evaluated the feasibility and benefits of discontinuing BZD-derivative hypnotics in this population, which was addressed in this study. In this 8-week open-label study, subjects aged ≥ 60 living in a nursing home who received BZD as a hypnotic were recruited. The BZD dose was tapered off over 3 weeks. The following assessments were performed 12 h post-dose at baseline and at endpoint: the Clinical Stabilometric Platform (CSP), the Critical Flicker Fusion Test (CFF), the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and the Leeds Sleep Evaluation Questionnaire (LSEQ). Thirty subjects were enrolled (mean ± SD age = 79.1 ± 8.9 years, mean ± SD flurazepam equivalent BZD dose = 19.5 ± 10.9 mg/day). Psychiatric diagnoses (DSM-IV) of subjects were as follows: schizophrenia (n = 12), primary insomnia (n = 9), dementia (n = 7), and bipolar disorder (n = 2). In 26 completers, significant changes were found in a total length and a range of trunk motion with eyes closed. Significant improvements were also observed in the CFF and RBANS immediate memory, language, and attention index scores. Subjective worsening in sleep was not reported in those completers, assessed with the LSEQ. Our results suggest that discontinuation of BZD hypnotics is feasible in a majority of elderly persons and leads to an improvement in the stability of body and a recovery in cognitive functions during the daytime.

Effects of Different Blood Alcohol Concentrations and Post-Alcohol Impairment on Driving Behavior and Task Performance

Objective: A study using simulator methodology was conducted to investigate the effects of (1) different blood alcohol concentrations (BAC) of 0, 0.05, 0.08, and 0.10 percent and (2) post-alcohol impairment (where BAC ∼ 0%) on driving behavior and subsidiary cognitive task performance. Methods: Two driving sessions were investigated, that is, drunk driving and post-alcohol driving, with each requiring approximately 20 min of driving. In addition to driving safely, participants were instructed to perform the critical flicker fusion (CFF) test and completed the NASA-TLX mental workload questionnaire. Eight licensed drivers (6 males, 2 females) participated in this 2 (road complexities) × 2 (simulated driving sessions) × 4 (levels of BAC) within-subjects experiment. Results: The study revealed that higher BAC levels were associated with lower performing driving behavior. The driver's mental workload reached the highest values in the post-alcohol session. In terms of tasks involving divided attention, the traffic sign distance estimation showed significant deterioration with increased BAC levels. Conclusions: The relationship between drunk-driving behavior and alcohol dosage was supported in this study. Noticeably, no significant difference was found between drunk driving and post-alcohol driving, indicating that even in the post-alcohol situation, the impairment still remained significant enough to jeopardize traffic safety as much as it does in the case of drunk driving. In real-life situations, adopting a rest-time strategy to avoid post-alcohol impairment effects may not be the most appropriate solution by drivers; rather, drivers should be given some tests to verify the probability of post-alcohol effects on driving.

Study of the Effect of Nortriptyline and Fluvoxamine on Psychomotor Functions in Healthy Volunteers

Background:Today, many antidepressants are available, but they often cause adverse effects, particularly psychomotor and cognitive. It leads to patient maladjustment and may impair psychomotor performance. Fluvoxamine is a newer antidepressant and hence the present study was planned to investigate its effect on psychomotor functions and compare with nortriptyline and record their adverse reactions.Materials and Methods:A total of 26 healthy volunteers were included in this double-blind, placebocontrolled, crossover study. Single oral doses of fluvoxamine 50 mg, nortriptyline 50 mg and placebo were administered following a Latin square design. The objective parameters-six digit cancellation test, digit symbol substitution test, critical flicker fusion test, arithmetic ability test, hand steadiness test and subjective parameters such as visual analogue scale 1, 2, 3 were tested at 0, 2 and 4 h. The side-effects were also investigated.Results:Nortriptyline impaired all subjective and objective psychomotor functions while fluvoxamine did not show any significant effect on objective tests. However, on subjective parameters, there was a significant effect. The side-effects observed were dryness of mouthwith the nortriptyline and nausea and headache with fluvoxamine.Conclusion:Fluvoxamine is a better antidepressant drug in comparison with nortriptyline as it causes a less impairment of psychomotor functions.