Transcranial direct current stimulation and cognitive changes in Parkinson's disease, a systematic review with meta-analysis and meta-regression.

Parkinson's disease is the second most common neurodegenerative disease, but therapeutic options such as neuromodulation continue to show variable effects, making clinical management of the disease difficult. This systematic review with meta-analysis and meta-regression aimed to analyze the isolated effect of cortical modulation with transcranial direct current stimulation (tDCS) compared to sham stimulation on cognitive changes in people with Parkinson's disease. The databases used were: Web of Science, Scopus, PsycINFO, PubMed, and Cochrane. The results showed that tDCS can influence the improvement of cognition in PD (Inverse Variance:0.24 [95% Confidence Interval: 0.09 to -0.40], p < 0.00). The meta-analysis showed that active tDCS can influence cognitive function by improving aspects related to memory (Inverse Variance:0.34 [95% Confidence Interval: 0.07 to 0.61], p < 0.01) and reducing reaction time in cognitive tasks (Inverse Variance:0.42 [95% Confidence Interval: 0.07 to 0.76], p < 0.02). Innovative meta-regression analyses showed that variables such as age (Q = 2.54, df = 1, p < 0.11), education level (Q = 2.62, df = 1, p < 0.10), disease duration (Q = 0.01, df = 1, p < 0.92), and Unified PD Rating Scale stage (Q = 0.01, df = 1, p < 0.92) did not influence the results. Thus, tDCS may be a therapeutic option for cognitive changes in people with PD, and we suggest further studies to identify protocols that can be replicated.

Comparison of color discrimination in chronic heavy smokers and healthy subjects.

Background: Cigarette smoke is probably the most significant source of exposure to toxic chemicals for humans, involving health-damaging components, such as nicotine, hydrogen cyanide and formaldehyde. The aim of the present study was to assess the influence of chronic heavy smoking on color discrimination (CD). Methods: All subjects were free of any neuropsychiatric disorder, identifiable ocular disease and had normal acuity. No abnormalities were detected in the fundoscopic examination and in the optical coherence tomography exam. We assessed color vision for healthy heavy smokers ( n = 15; age range, 20-45 years), deprived smokers ( n = 15, age range 20-45 years) and healthy non-smokers ( n = 15; age range, 20-45 years), using the psychophysical forced-choice method. All groups were matched for gender and education level. In this paradigm, the volunteers had to choose the pseudoisochromatic stimulus containing a test frequency at four directions (e.g., up, down, right and left) in the subtest of Cambridge Colour Test (CCT): Trivector. Results: Performance on CCT differed between groups, and the observed pattern was that smokers had lower discrimination compared to non-smokers. In addition, deprived smokers presented lower discrimination to smokers and non-smokers. Contrary to expectation, the largest differences were observed for medium and long wavelengths. Conclusions: These results suggests that cigarette smoke and chronic exposure to nicotine, or withdrawal from nicotine, affects CD. This highlights the importance of understanding the diffuse effects of nicotine either attentional bias on color vision.

Visual contrast sensitivity in patients with impairment of functional independence after stroke.

BACKGROUND: Stroke has been considered a serious public health problem in many countries, accounting for complex disorders involving perception, such as visual, cognitive and functional deficits. The impact of stroke on the visual perception of individuals with impairments in functional independence was investigated. METHODS: We measured changes in functional independence and visual function in 40 patients with stroke (M = 52.3, SD = 0.65) and 10 controls (M = 52.5, SD = 0.66). The patients were divided into four subgroups following the Barthel Index (Group A: 20-35, serious dependence; Group B: 40-55, moderate dependence; Group C: 60-95, mild dependence; and Group D: 100 points, independence). Visual function was evaluated using the Contrast Sensitivity Function (CSF). The contrast threshold was measured using a temporal, two-alternative, forced-choice psychophysical method. RESULTS: The results show significant differences in CSF between healthy volunteers and patients with stroke (F (1.56) = 151.2, p < 0.001) for all frequencies (F (2.56) = 125.96, p < 0.001). The results also show that patients with low functional independence had lower contrast sensitivity than those with greater functional independence (F (3.56) = 344.82, p < 0.001). CONCLUSIONS: An association exists between CSF and a worsening in the functional potential for performing daily living activities. Our results suggest that the CSF can be used as a diagnostic tool to analyze visual function associated with deficits in functional independence after stroke. These findings should be considered across the continuum of care for these patients.

Early malnutrition diffusely affects children contrast sensitivity to sine-wave gratings of different spatial frequencies.

Cognitive, behavioral and neurophysiological deficits, associated with malnutrition, are described in the literature. The aim of this study was to evaluate the visual contrast sensitivity in children with early malnutrition, classified according to the anthropometric parameters of Waterlow. Visual contrast sensitivity of 16 boys from 7-10 years old was measured using the staircase psychophysical method, using vertical sine-wave gratings of 0.25, 1.0, 2.0 and 8.0 cycles per degree (cpd) of visual angle. Malnourished children were approximately 3.3, 10.9 and 6.6 times less sensitive to the frequencies of 0.25, 1.0 and 2.0 cpd, respectively, although they were approximately 1.1 times more sensitive to the frequency of 8.0 cpd. It is likely that early malnutrition adversely affected the magnocellular pathway on the one hand, since early malnourished children needed more contrast to detect low and low-to-medium frequencies; on the other hand, early malnutrition did not affect the parvocellular pathway, since there was an increase of sensitivity to the highest frequency.

Narrow-band 1, 2, 3, 4, 8, 16, 24, 32, 48, 64, and 96 cycles/360 degrees angular frequency filters.

We measured human frequency response functions for eleven angular frequency filters using a forced-choice procedure in a supra-threshold summation paradigm. Each of the eleven functions of 17 experimental conditions was measured 4-9 times among 12 observers. Results show that, for the arbitrarily selected filter phases, maximum summation effect occurred at test frequency for all filters. These results lead to the conclusion that there are narrow-band angular frequency filters operating in human visual system mostly through summation surrounded by inhibition at the specific test frequency ranges. Our previous suggestion (Simas and Santos, 2002), arguing that summation for the higher angular frequency filters should occur if background angular frequency contrast were set to a maximum of 5 times the test frequency threshold, was supported.