Short-term beneficial effects of human dental pulp stem cells and their secretome in a rat model of mild ischemic stroke.

Although cell therapy has been applied in regenerative medicine for decades, recent years have seen greatly increased attention being given to the use of stem cell-based derivatives such as cell-free secretome. Dental pulp stem cells (DPSCs) are widely available, easily accessible, and have high neuroprotective and angiogenic properties. In addition, DPSC-derived secretome contains a rich mixture of trophic factors. The current investigation evaluated the short-term therapeutic effects of human DPSCs and their secretome in a rat model of mild ischemic stroke. Mild ischemic stroke was induced by 30 min middle cerebral artery occlusion, and hDPSCs or their secretome was administered intra-arterially and intranasally. Neurological function, infarct size, spatial working memory, and relative expression of seven target genes in two categories of neurotrophic and angiogenic factors were assessed three days after stroke. In the short-term, all treatments reduced the severity of neurological and histological deficits caused by ischemic stroke. Moreover, transient middle cerebral artery occlusion led to the striatal and cortical over-expression of BDNF, NT-3, and angiogenin, while NGF and VEGF expression was reduced. Almost all interventions were able to modulate the expression of target genes after stroke. The obtained data revealed that single intra-arterial administration of hDPSCs or their secretome, single intranasal transplantation of hDPSCs, or repeated intranasal administration of hDPSC-derived secretome was able to ameliorate the devastating effects of a mild stroke, at least in the short-term.

Comparative Analysis of the Chemotherapy-Related Cognitive Impairments in Patients with Breast Cancer: A Community-Based Research.

This study aimed to evaluate the effects of two common chemotherapy regimens on breast cancer (BC) survivors' cognition. The participants comprised 35 patients with BC who underwent two chemotherapy regimens, AC-T and TAC, and 24 matched healthy volunteers. The participants were assessed regarding cognitive function through Addenbrooke's Cognitive Examination and Cambridge Brain Science tests. The results represent the AC-T regimen to be more toxic than the TAC in domains of language, concentration, and visuospatial working memory (P-value = 0.036, 0.008, and 0.031, respectively) and should be prescribed with caution in patients with BC suffering from baseline cognitive impairments.

Neural correlates in functional brain mapping among breast cancer survivors receiving different chemotherapy regimens: a qEEG/HEG-based investigation.

BACKGROUND: Post-chemotherapy cognitive impairment commonly known as 'chemobrain' or 'chemofog' is a well-established clinical disorder affecting various cognitive domains including attention, visuospatial working memory, executive function, etc. Although several studies have confirmed the chemobrain in recent years, scant experiments have evaluated the potential neurotoxicity of different chemotherapy regimens and agents. In this study, we aimed to evaluate the extent of attention deficits, one of the commonly affected cognitive domains, among breast cancer patients treated with different chemotherapy regimens through neuroimaging techniques. METHODS: Breast cancer patients treated with two commonly prescribed chemotherapy regimens, Adriamycin, Cyclophosphamide and Taxol and Taxotere, Adriamycin and Cyclophosphamide, and healthy volunteers were recruited. Near-infrared hemoencephalography and quantitative electroencephalography assessments were recorded for each participant at rest and during task performance to compare the functional cortical changes associated with each chemotherapy regimen. RESULTS: Although no differences were observed in hemoencephalography results across groups, the quantitative electroencephalography analysis revealed increased power of high alpha/low beta in left fronto-centro-parietal regions involved in dorsal and ventral attention networks in the Adriamycin, Cyclophosphamide and Taxol-treated group compared with the Taxotere, Adriamycin and Cyclophosphamide and control group. The Adriamycin, Cyclophosphamide and Taxol-treated cases had the highest current source density values in dorsal attention network and ventral attention network and ventral attention network-related centers in 10 and 15 Hz associated with the lowest Z-scored Fast Fourier Transform coherence in the mentioned regions. CONCLUSIONS: The negatively affected neurocognitive profile in breast cancer patients treated with the Adriamycin, Cyclophosphamide and Taxol regimen proposes presumably neurotoxic sequelae of this chemotherapy regimen as compared with the Taxotere, Adriamycin and Cyclophosphamide regimen.

Local delivery of fingolimod through PLGA nanoparticles and PuraMatrix-embedded neural precursor cells promote motor function recovery and tissue repair in spinal cord injury.

Spinal cord injury (SCI) is a devastating clinical problem that can lead to permanent motor dysfunction. Fingolimod (FTY720) is a sphingosine structural analogue, and recently, its therapeutic benefits in SCI have been reported. The present study aimed to evaluate the therapeutic efficacy of fingolimod-incorporated poly lactic-co-glycolic acid (PLGA) nanoparticles (nanofingolimod) delivered locally together with neural stem/progenitor cells (NS/PCs) transplantation in a mouse model of contusive acute SCI. Fingolimod was encapsulated in PLGA nanoparticles by the emulsion-evaporation method. Mouse NS/PCs were harvested and cultured from embryonic Day 14 (E14) ganglionic eminences. Induction of SCI was followed by the intrathecal delivery of nanofingolimod with and without intralesional transplantation of PuraMatrix-encapsulated NS/PCs. Functional recovery, injury size and the fate of the transplanted cells were evaluated after 28 days. The nanofingolimod particles represented spherical morphology. The entrapment efficiency determined by UV-visible spectroscopy was approximately 90%, and the drug content of fingolimod loaded nanoparticles was 13%. About 68% of encapsulated fingolimod was slowly released within 10 days. Local delivery of nanofingolimod in combination with NS/PCs transplantation led to a stronger improvement in neurological functions and minimized tissue damage. Furthermore, co-administration of nanofingolimod and NS/PCs not only increased the survival of transplanted cells but also promoted their fate towards more oligodendrocytic phenotype. Our data suggest that local release of nanofingolimod in combination with three-dimensional (3D) transplantation of NS/PCs in the acute phase of SCI could be a promising approach to restore the damaged tissues and improve neurological functions.

The effects of virtual reality training on clinical indices and brain mapping of women with patellofemoral pain: a randomized clinical trial.

BACKGROUND: Virtual reality training (VRT) is a new method for the rehabilitation of musculoskeletal impairments. However, the clinical and central effects of VRT have not been investigated in patients with patellofemoral pain (PFP). To comprehensively assess the effects of VRT on clinical indices and brain function, we used a randomized clinical trial based on clinical and brain mapping assessment. METHODS: Twenty-six women with PFP for more than 6 months were randomly allocated to 2 groups: intervention and control. The intervention consisted of lifestyle education + 8 weeks VRT, in 24 sessions each lasting 40 min of training, whereas the control group just received lifestyle education. The balance was the primary outcome and was measured by the modified star excursion balance test. Secondary outcomes included pain, function, quality of life, and brain function which were assessed by visual analogue scale, step down test and Kujala questionnaire, SF-36, and EEG, respectively. Pre-intervention, post-intervention and follow-up (1 month after the end of the intervention) measurements were taken for all outcome measures except EEG, which was evaluated only at pre-intervention and post-intervention). Analyses of variance was used to compare the clinical outcomes between the two groups. The independent t-test also was used for between group EEG analyses. RESULTS: Balance score (P < 0.001), function (P < 0.001), and quality of life (P = 0.001) improved significantly at post-intervention and 1 month follow-up in the VRT group compared with the control group. VRT group showed a significantly decreased pain score (P = 0.004). Alpha (P < 0.05) and theta (P = 0.01) power activity also increased in the brain of the VRT group. CONCLUSION: This study demonstrated that long term VRT was capable of improving both clinical impairments and brain function in patients with PFP. Therefore, therapists and clinicians can use this method as a more holistic approach in the rehabilitation of PFP. TRIAL REGISTRATION: IRCT, IRCT20090831002391N40 . Registered 23 / 10 / 2019.

Ophthalmic manifestations of COVID-19; a less-appreciated yet significant challenge.

AIM: The current world has changed in all shapes since the emergence of the novel coronavirus (nCoV-2) also known as COVID-19. Among the extra-pulmonary manifestations of nCoV-2, ophthalmic symptoms have less been systematically studied. The so far existing body of evidence indicates that nCoV-2 has the potential to affect both anterior and posterior chambers of the eye. Albeit, the exact mechanisms which underlie ophthalmic manifestations of nCoV-2 are yet to be elucidated. METHODS: The present brief review is an attempt to put together and highlight the significant yet limited number of studies which have spotlighted ophthalmic issues in nCoV-2 patients using a systematic literature search strategy. RESULTS: All case series or reports (including both published and preprint articles) which described ocular manifestations of patients with COVID-19 and/or documented testing of SARS-COV-2 in ocular secretions via various sampling or detection methods were sought to be included. CONCLUSION: The ophthalmic presentations in SARS-COV-2 are often found to be salient. Raising awareness in this respect may help defining evidencebased protective measures in today's practice of ophthalmology and allied disciplines.

Transcranial Direct Current Stimulation to Assist Experienced Pistol Shooters in Gaining Even-Better Performance Scores.

Recently, brain stimulation has been considered as a promising method for the empowerment of athletes' performance. This study recruited 16 pistol shooters who were randomly assigned to two arms, including the control receiving no intervention and the experimental group receiving either sham or real transcranial direct current stimulation (tDCS), i.e., anodal stimulation and cathodal suppression over the cerebellar and dorsolateral prefrontal cortex (DLPFC) regions, respectively. Our outcome measures were the score and latency to shooting, as well as number of errors and task time in the dynamic tremor and mirror-tracing tasks. Our findings suggested that tDCS vs. sham improves the average shooting score in pistol shooters by 2.3% ± 0.65 (mean ± SEM, p = 0.018). Furthermore, the bullet hole distance from the Air Pistol Target center was found to be significantly shorter in the experimental (tDCS) group (p = 0.02). In the control group, no significant difference was noted between the shooting scores of shooters over the consecutive two sessions. In terms of latency to shooting, no significant difference was noted within groups between both sessions. However, for the dynamic tremor task outcome, there were significantly less errors after real tDCS than after sham stimulation. In addition, the results of the mirror-tracing task in the tDCS group showed significant differences between the sham and real-tDCS sessions favoring the real-tDCS session (p = 0.001). Therefore, concurrent suppression of dlPFC and stimulation of cerebellum through tDCS may increase shooting scores in experienced pistol shooters.

Electrophysiological modulation and cognitive-verbal enhancement by multi-session Broca's stimulation: a quantitative EEG transcranial direct current stimulation based investigation.

To evaluate transcranial direct current stimulation-induced changes in resting state quantitative EEG and cognitive-verbal performance of second language learners, 16 healthy individuals were randomly recruited to sham and real transcranial direct current stimulation groups receiving eight sessions of second language instruction accompanied by a 2 mA transcranial direct current stimulation over Broca's area with the cathode placed over the left arm. Quantitative EEG was recorded during the resting state after the stimulation session and second language instruction. Reduced theta activity at Fp1, F7, F3, and T5 caused by the stimulus current was reported. Multisession stimulation resulted in a significant increase in current density for beta power (25 Hz) in the language network. Cognitive-verbal pre-post stimulation performances suggest that anodal vs. sham transcranial direct current stimulation significantly improved the subjects test score on digit span, a cognitive-verbal ability. It is concluded that transcranial direct current stimulation of Broca's area increase cognitive-verbal performance by modulating brain electrical activity in language-related regions.

Coprolalia in aphasic patients with stroke: a longitudinal observation from the BLAS2T database.

The BLAS2T (bilingual aphasia in stroke-study team) initiative has been a multi-center attempt to investigate longitudinal changes in language function in a cohort of stroke subjects. This report discusses linguistic performance in four cases from the BLAS2T database who demonstrated coprolalia as an irresistible urge to say obscene words.  Coprolalia was found to partly resolve in a 30-day follow-up in three cases. Recognition of coprolalia and language recovery patterns in bilingual aphasic patients with stroke would potentially lead to their even better individualized care and neurolinguistic/cognitive rehabilitation.

Sleep microstructure dynamics and neurocognitive performance in obstructive sleep apnea syndrome patients.

The present study examined the relationship between the increment in cyclic alternating patterns (CAPs) in sleep electroencephalography and neurocognitive decline in obstructive Sleep Apnea Syndrome (OSAS) patients through source localization of the phase-A of CAPs. All-night polysomnographic recordings of 10 OSAS patients and 4 control subjects along with their cognitive profile using the Addenbrooke's Cognitive Examination (ACE) test were acquired. The neuropsychological assessment involved five key domains including attention and orientation, verbal fluency, memory, language and visuo-spatial skills. The standardized low-resolution brain electromagnetic tomography (sLORETA) tool was used to source-localize the phase-A of CAPs in sleep EEG aiming to investigate the correlation between CAP phase-A and cognitive functions. Our findings suggested a significant increase in CAP rates among OSAS subjects versus control subjects. Moreover, sLORETA revealed that CAP phase-A is mostly activated in frontoparietal cortices. As CAP rate increases, the activity of phase-A in such areas is dramatically enhanced leading to arousal instability, lower sleep efficiency and a possibly impaired cortical capacity to consolidate cognitive inputs in frontal and parietal areas during sleep. As such, cognitive domains including verbal fluency, memory and visuo-spatial skills which predominantly relate to frontoparietal areas tend to be affected. Based on our findings, CAP activity may possibly be considered as a predictor of cognitive decline among OSAS patients.

QEEG-based neural correlates of decision making in a well-trained eight year-old chess player.

The neurocognitive substrates of decision making (DM) in the context of chess has appealed to researchers' interest for decades. Expert and beginner chess players are hypothesized to employ different brain functional networks when involved in episodes of critical DM upon chess. Cognitive capacities including, but not restricted to pattern recognition, visuospatial search, reasoning, planning and DM are perhaps the key determinants of rewarding and judgmental decisions in chess. Meanwhile, the precise neural correlates of DM in this context has largely remained elusive. The quantitative electroencephalography (QEEG) is an investigation tool possessing a proper temporal resolution in the study of neural correlates of cognitive tasks at cortical level. Here, we used a 22-channel EEG setup and digital polygraphy in a well-trained 8 year-old boy while engaged in playing chess against the computer. Quantitative analyses were done to map and source-localize the EEG signals. Our analyses indicated a lower power spectral density (PSD) for higher frequency bands in the right hemisphere upon DM-related epochs. Moreover, the information flow upon DM blocks in this particular case was more of posterior towards anterior brain regions.

The effect of CA1 α2 adrenergic receptors on memory retention deficit induced by total sleep deprivation and the reversal of circadian rhythm in a rat model.

The α2 adrenergic receptors which abundantly express in the CA1 region of the hippocampus play an important role in the regulation of sleep and memory retention processes. Based on the available evidence, the aim of our study was to investigate consequences of the activation and deactivation of CA1 α2 adrenergic receptors (by clonidine and yohimbine, respectively) on the impairment of memory retention induced by total sleep deprivation (TSD) and the reversal of circadian rhythm (RCR) in a rat model. To this end, the water box apparatus and passive avoidance task were in turn used to induce sleep deprivation and assess memory retention. Our findings suggested that TSD (for 24 and 36, but not 12h) and RCR (12h/day for 3 consecutive days) impair memory function. The post-training intra-CA1 administration of yohimbine (α2 adrenergic receptor antagonist) on its own, at the dose of 0.1µg/rat, decreased the step-through latency and locomotor activity in the TSD- sham treated but not undisturbed sleep rats. Unlike yohimbine, clonidine (α2 adrenergic receptor agonist), in all applied doses (0.001, 0.01 and 0.1µg/rat), failed to induce such an effect. While the subthreshold dose of yohimbine (0.001µg/rat) abrogated the impairment of memory retention induced by the 24-h TSD, it could potentiate the impairment of memory retention induced by 36-h TSD, suggesting the modulatory effect of yohimbine. Moreover, the subthreshold dose of clonidine (0.1µg/rat) restored the memory retention deficit in TSD rats (24 and 36h). On the other hand, the subthreshold dose of clonidine (0.1µg/rat), but not yohimbine (0.001µg/rat) restored the memory retention deficit in RCR rats. Such interventions however did not alter the locomotor activity. The above observations proposed that CA1 α2 adrenergic receptors play a potential role in memory retention deficits induced by TSD and RCR.

Neural communication through theta-gamma cross-frequency coupling in a bistable motion perception task.

Functional significance of the neural oscillations has been debated since long. In particular, oscillations have been suggested to play a major role in formation of communication channels between brain regions. It has been previously suggested that gamma coherence increases during communication between hemispheres when subjects perceive a horizontal motion in Stroboscopic Alternative Motion (SAM) stimulus. In addition, disruption of this coherence may change the horizontal perception of SAM. In this study, we investigated the changes of Cross-Frequency Coupling (CFC) in EEG signals from parietal and occipital cortices during horizontal and vertical perception of SAM. Our results suggested that while the strength of CFC in parietal electrodes showed no significant change, CFC in P3-P4 electrode-pair demonstrated a significant correlation during horizontal perception of SAM. Therefore, the CFC between theta- and gamma-band oscillations seems to be correlated with changes in functional interactions between brain regions. Accordingly, we propose that in addition to gamma coherence, CFC is perhaps another neurophysiological mechanism involved in neural communication.

Withstanding the obstructive sleep apnea syndrome at the expense of arousal instability, altered cerebral autoregulation and neurocognitive decline.

The present review attempts to put together the available evidence and potential research paradigms at the interface of obstructive sleep apnea syndrome (OSAS), sleep micro- and macrostructure, cerebral vasoreactivity and cognitive neuroscience. Besides the significant health-related consequences of OSAS including hypertension, increased risk of cardio- and cerebrovascular events, notable neurocognitive lapses and excessive daytime somnolence are considered as potential burdens. The intermittent nocturnal hypoxia and hypercapnia which occur in OSAS are known to affect cerebral circulation and result in brain hypoperfusion. Arousal instability is then resulted from altered cyclic alternating patterns (CAPs) reflected in sleep EEG. In chronic state, some pathological loss of gray matter may be resulted from obstructive sleep apnea. This is proposed to be related to an upregulated proinflammatory state which may potentially result in apoptotic cell loss in the brain. On this basis, a pragmatic framework of the possible neural mechanisms which underpin obstructive sleep apnea-related neurocognitive decline has been discussed in this review. In addition, the impact of OSAS on cerebral autoregulation and sleep microstructure has been articulated.

A computer-based selective visual attention test for first-grade school children: design, development and psychometric properties.

BACKGROUND: Visual attention is known as a critical base for learning. The purpose of the present study was to design, develop and evaluate the test-retest and internal consistency reliability as well as face, content and convergent validity of the computer- based selective visual attention test (SeVAT) for healthy first-grade school children. METHODS: In the first phase of this study, the computer-based SeVAT was developed in two versions of original and parallel. Ten experts in occupational therapy helped to measure the content validity using the CVR and CVI methods. Face validity was measured through opinions collected from 10 first-grade children. The convergent validity of the test was examined using the Spearman correlation between the SeVAT and Stroop test. In addition, test-retest reliability was determined by measuring the intra-class correlation (ICC) between the original and parallel versions of the SeVAT in a single session. The internal consistency was calculated by Cronbach's alpha coefficients. Sixty first grade children (30 girls/30boys) participated in this study. RESULTS: The developed test was found to have good content and face validity. The SeVAT showed an excellent test-retest reliability (ICC= 0.778, p<0.001) and internal consistency (Cronbach's Alpha of original and parallel tests were 0.857 and 0.831, respectively). SeVAT and Stroop test demonstrated a positive correlation upon the convergent validity testing. CONCLUSION: Our results suggested an acceptable reliability and validity for the computer-based SeVAT in the assessment of selective attention in children. Further research may warrant the differential validity of such a test in other age groups and neuro-cognitively disordered populations.

Involvement of the CA1 GABAA receptors in MK-801-induced anxiolytic-like effects: an isobologram analysis.

There seems to be a close relationship between hippocampal N-methyl-D-aspartic acid (NMDA) and GABAA receptors with respect to the modulation of behavior that occurs in the CA1 region of the hippocampus. This study investigated the possible involvement of the CA1 GABAA receptors in anxiolytic-like effects induced by (+)-MK-801 (a noncompetitive antagonist of the NMDA subtype of the glutamate receptor). Male Wistar rats were subjected to the elevated plus-maze apparatus and open arm time (%OAT), and open arm entries (%OAE) for anxiety-related behaviors, and closed arm entries that correspond to the locomotor activity were assessed. An intra-CA1 injection of (+)-MK-801 (2 µg/rat) and muscimol (0.5 µg/rat; a GABAA receptor agonist) increased %OAT and %OAE by themselves while not altering the closed arm entries, indicating an anxiolytic-like effect of these drugs. Injection of bicuculline (0.1, 0.25, and 0.5 µg/rat; a GABAA receptor antagonist) did not alter any of the anxiety-related parameters. An intra-CA1 injection of a subthreshold dose of muscimol (0.1 µg/rat) or bicuculline (0.5 µg/rat), 5 min before injection of subthreshold and effective doses of (+)-MK-801 (0.5, 1 and 2 µg/rat), increased and decreased the anxiolytic-like effect of (+)-MK-801, respectively. The isobologram analysis of these findings suggested a synergistic anxiety-like effect of intra-CA1 (+)-MK-801 and muscimol. In conclusion, the CA1 GABAA receptors appear to be involved in anxiolytic-like behaviors induced by (+)-MK-801.

Quantitative EEG for the Monitoring of Walking Recovery in Chronic Stroke Patients Receiving Action Observation Training.

The current study aimed to evaluate the effects of action observation on the walking ability and oscillatory brain activity of chronic stroke patients. Fourteen chronic stroke patients were allocated randomly to the action observation (AO) or sham observation (SO) groups. Both groups received 12 sessions of intervention. Each session composed of 12 min of observational training, which depicted exercises for the experimental group but nature pictures for the sham group and 40 min of occupational therapy, which was the same for the both groups. Walking ability was assessed by a motion analysis system and brain activity was monitored using quantitative electroencephalography (QEEG) before and after the intervention. Brain asymmetry at alpha frequency, the percentage of stance phase, and step length showed significant changes in the AO group. Only the change in global alpha power was significantly correlated with the change in velocity after the intervention in AO group. Despite more improvements in walking and brain activity of patients in the AO group, our study failed to show significant correlations between the brain activity changes and functional improvements after the intervention, which might be mainly due to the small sample size in our study. Trial registration: IRCT20181014041333N1.

Validating the effectiveness of a self-report tool to predict unsafe behavior of industrial workers: a QEEG analysis.

Objectives. Unsafe behavior (UB) is defined as the likelihood of intentionally or unintentionally deviating from pre-defined plans. This study aims to investigate the validation of a self-report tool for measuring workers' cognitive-based UB using quantitative electroencephalography (QEEG). Methods. The cognitive-based unsafe behavior questionnaire (CUBQ) was completed by 632 front-line workers in a manufacturing industry to identify differences in the backgrounds of the subjects regarding UBs. Two groups were then selected as extreme groups and QEEG was conducted based on the international 10-20 electrode placement. Results. The mean values of absolute power (AP), alpha/beta ratio (ABR) and alpha/gamma ratio (AGR) from brain oscillations in different regions of the cortex were significantly different between the studied groups (p < 0.05). Additionally, these values were found to be significantly correlated with slips, lapses and mistakes, as measured by certain scales of the CUBQ (p < 0.05). Conclusions. The findings of this study indicated differences in brain oscillation activities among industrial workers with different UB backgrounds. These results confirm the effectiveness of CUBQ as a proactive tool for safety practitioners to predict industrial workers' UBs.

Source Localization and Spectrum Analyzing of EEG in Stuttering State upon Dysfluent Utterances.

Purpose: The present study which addressed adults who stutter (AWS) attempted to investigate power spectral dynamics in the stuttering state by answering the questions using quantitative electroencephalography (qEEG). Method: A 64-channel electroencephalography (EEG) setup was used for data acquisition at 20 AWS. Since the speech, especially stuttering, causes significant noise in the EEG, 2 conditions of speech preparation (SP) and imagined speech (IS) were considered. EEG signals were decomposed into 6 bands. The corresponding sources were localized using the standard low-resolution electromagnetic tomography (sLORETA) tool in both fluent and dysfluent states. Results: Significant differences were noted after analyzing the time-locked EEG signals in fluent and dysfluent utterances. Consistent with previous studies, poor alpha and beta suppression in SP and IS conditions were localized in the left frontotemporal areas in a dysfluent state. This was partly true for the right frontal regions. In the theta range, disfluency was concurrence with increased activation in the left and right motor areas. Increased delta power in the left and right motor areas as well as increased beta2 power over left parietal regions was notable EEG features upon fluent speech. Conclusion: Based on the present findings and those of earlier studies, explaining the neural circuitries involved in stuttering probably requires an examination of the entire frequency spectrum involved in speech.

Effect of temperature reduction of the prefrontal area on accuracy of visual sustained attention.

Objectives. Detection of sensitive signs in many work environments with automated systems (aviation industry, flight safety tower, maritime industry, monitoring in the military industry, etc.) is essential and requires constant visual attention. Therefore, the aim of this study was to investigate the effect of forehead cooling on the accuracy of stable visual attention. Methods. This interventional study was performed on 34 male students. The sampling method was a randomized block design. Subjects were assessed by demographic questionnaire, Snellen chart, Spielberger state-trait anxiety inventory (STAI) and physiological and cognitive measurements. Results. Prefrontal cortex (PFC) cooling caused significant changes in sublingual temperature during four measurements in the intervention group. There were no significant changes in heart rate, diastolic blood pressure and saturation of peripheral oxygen (%SpO2) between the two groups. The critical flicker frequency (CFF) as an indicator of cognitive fatigue showed that cognitive improvement after PFC cooling occurred following a reduction in cognitive fatigue. Conclusions. Considering the importance of choosing non-invasive methods to improve the operator's cognitive skills while performing cognitive tasks in the field of neuroergonomics, it can be concluded that PFC cooling is an effective and safe way to improve some cognitive skills such as visual attention.