- Email: [email protected]
P40-F The relationship between age and SICI parameters obtained with threshold tracking TMS
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Abstracts / Clinical Neurophysiology 130 (2019) e21–e116
P37-F Predictors of cognitive impairment in patients with mine blast injury—OleksanSolonovych * (The State Institution ‘‘romodanov Neurosurgery Institute, National Academy Of Medical Science Of Ukraine”, Kiev, Ukraine) ⇑
Corresponding author.
Background: Mine blast injury is accompanied by traumatic brain injury (TBI) in 60–100% of cases. TBI is associated with cognitive impairment (CI). However, predictors of CI in this patients (pts) are studied insufficiently. Material and methods: 115 men aged 18 to 45 years with mild TBI caused by using of mine-blasting weapons. Cognitive functions were evaluated by using MoCA test, HADS scale. Cognitive dysfunction was defined as MoCa 6 25 scores. Besides routine examination, neurophysiological methods such as quantitative electroencephalography (qEEG) and cognitive evoked potentials P300 (CEP P300), were performed. Results. In binary logistic regression predictors CI were complaints on headache and fatigability (OR 2.52, 95% CI 2.6–59.7, p = 0.02), increased tendon reflexes (OR, 2.6, 95% CI 1.24–2.32, p = 0.017), higher HADS anxiety level (OR-1.8, 95% CI 1.59–2.2, p = 0.04), changes of alpha rhythm frequency (OR-1.02, 95% CI 1.01– 1.04, p = 0.004), decrease of alpha rhythm amplitudes (OR - 1.07, 95% CI 1.03–1.11, p < 0.001), dysfunction of nonspecific median structures (OR 1.02, 95% CI 1.0–1.04, p = 0.033), decrease of P3 peak amplitude (OR 2.6, 95% CI 1.14–5.9, p = 0.003) and increase of CEP P300 latency (OR 1.07, 95% CI 1.03–1.12, p = 0.002). In multinomial logistic regression the independent predictors of CI were decrease of alpha rhythm amplitudes, decrease of P3 peak amplitude and increase of CEP P300 latency. Conclusions: changes in qEEG and CEP P300 parameters are reliable independent predictors of CI in pts with TBI affected by mine blast trauma. doi:10.1016/j.clinph.2019.04.489
P38-F Motor evoked potentials elicited by TMS in Hirayama disease – Systematic review of the literature—Jan Bembenek a,*, _ Bozena Kłysz b, Iwona Kurkowska-Jastrze˛bska b (a Department of Clinical Neurophysiology, Institute of Psychiatry and Neurology, Warsaw, Poland, b 2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland) ⇑
Corresponding author.
Background: Hirayama disease (HD) is a rare motor disorder mainly affecting young men. It is characterized by atrophy and unilateral weakness of forearm and hand muscles corresponding to a C7-T1 myotome distribution. The progression is usually selflimiting. The etiology of HD is not fully understood. Motor evoked potentials (MEPs) seems to be useful in pyramidal tracts damage evaluation. Material and methods: We searched PubMed for original papers evaluating the use of transcranial magnetic stimulation elicited MEPs in HD until 02.01.2019 using key words: ‘‘motor evoked potentials Hirayama” and ‘‘transcranial magnetic stimulation Hirayama”. Results: We found six articles using the above key words which met inclusion criteria. Number of participants was small (78 and 55 control group), diagnostic procedures and methodology varied. Abnormal central motor conduction time was found in 17.1% of patients in one study whereas it was normal in 2 other studies. Peripheral motor latency (PML) was evaluated in one study which
found abnormally increased PMLs in at least one tested muscle in 16/41 (39.0%) of HD patients. Abnormal MEP parameters were found in 3 studies in 14.3–100% patients. They were not evaluated in one study and in two were normal in standard and flexed neck position. In one study inconsistent results in MEP size after neck flexion in patients after treatment with neck collar were found. Conclusions: Although MEP parameters may be abnormal in some HD patients, these have not been thoroughly assessed yet. Further studies are indispensable to evaluate their usefulness in assessing pyramidal tracts in HD. doi:10.1016/j.clinph.2019.04.490
P39-F Evaluation of visual pathways with visual evoked potentials in vitamin B12 deficiency patients—Hacer Erdem Tilki *, Onur Yıldız, Sß eyda Bayil (Departmant of Neurology, Ondokuz Mayis University, Samsun, Turkey) ⇑
Corresponding author.
Background: Vitamin b12 is a water-soluble vitamin and a wide variety of neurologic symptoms and signs were encountered including ataxia, loss of sensation, muscle weakness, hyperactive reflexes, incontinence, also it may not cause any symptoms in many patients. Material and methods: In our study, we have included asymptomatic patients. The diagnosis of vitamin B12 deficiency was based on low serum vitamin B12 level (<150 pg/ml). Forty patients with vitamin b12 deficiency and control group were included in the study. Vitamin B12 levels were intended to determine the existence of a possible relationship between P100 latency and amplitude values. Results: Visual acuity was found normal in all the patients. The mean vitamin B12 level was 96 pg/ml in the patient group and 374 pg/ml in the control group. Eight patient (20%) with vitamin B12 deficiency was determined megaloblastic anemia. In vitamin B12 deficiency patients mean P100 latency was 104 ± 8 ms and mean amplitude was 8.1 ± 4 uV. Patients with vitamin B12 deficiency P100 latency compared to the control group was significantly prolonged (P < 0.01). P100 wave amplitude did not find a significant difference between the cases and controls. Similarly, the P100 latency values of patients with hyperhomocysteinemia and megaloblastic anemia was significantly prolonged (P < 0.01). The possible reason for delayed latencies in vitamin B12 deficiency could be demyelination in visual pathways. Conclusions: As a result, pattern shift visual evoked responses may identify the subtle changes in the visual pathways easily in vitamin b12 deficiency patients even when there is no evidence of clinical abnormality. doi:10.1016/j.clinph.2019.04.491
P40-F The relationship between age and SICI parameters obtained with threshold tracking TMS—Søren Ørskov *, Christina Shen-Zhuang Nielsen, Kirsten Pugdahl, Anders FuglsangFrederiksen, Hatice Tankisi (Aarhus University, Århus N, Denmark) ⇑
Corresponding author.
Background: Recently developed threshold tracking TMS (TT-TMS) paired pulse techniques have been shown to be of benefit in clinical diagnostic practice. Reduced Short Interval Cortical Inhibition (SICI) with increasing age has been shown in several studies using
Abstracts / Clinical Neurophysiology 130 (2019) e21–e116
conventional paired-pulse TMS techniques. However, TT-TMS SICI parameters did not correlate to age in healthy subjects in a previous study (Shibuya et al., 2016). We aimed in this study to present the preliminary results of our normal material on TT-SICI and the relationship between SICI measurements and age. Material and methods: Thirty-three healthy subjects (mean age: 51.06 ± 2.48, range: 23–77) were included. Paired-pulse TT-TMS was undertaken using a 90 mm figure-of-eight coil applied to the motor cortex, with currents generated by BiStim system controlled by Qtrac software. The motor evoked potential (MEP) response was recorded over the first dorsal interosseus (FDI). MEP amplitude was set to a target value of 0.2 mV, and the changes in the intensity of the test stimulus required to generate this target MEP were measured. The relationship between age and SICI measurements were analyzed using regression analysis. Results: Resting motor threshold (RMT) (MSO, %) (mean: 54.43 ± 2.41) and SICI (%) at 1 ms (12.01 ± 1.86), 2.5 ms (11.02 ± 1.65), 3 ms (8.20 ± 1.69) and 1–7 ms (5.93 ± 1.12) on TT-TMS were analysed. RMT increased with increasing age (r = 0.45, p = 0.08), while age had an inverse relationship with SICI on 1 ms (r = 0.49, p = 0.003), 2.5 ms (r = 0.45, p = 0.008), 3 ms (r = 0.41, p = 0.019) and 1–7 ms (r = 0.41, p = 0.017). Conclusions: SICI parameters closely relate to age for TT-TMS similar to previously reported conventional. Further studies are required with large groups of healthy subjects. doi:10.1016/j.clinph.2019.04.492
P41-F Reliability of BAEP, MEP and blink reflex (BR) combination in posterior circulation ischemic stroke—Šteˇpánka Brušáková a,*, Jirˇí Ceé c, Dušan Ospalík a, Daniel Adámek b (a Neurologické oddeˇlení, Krajská Zdravotní, a.s., Masarykova nemocnice v Ústí nad Labem, o.z., Ústí nad Labem, Czech Republic , b Radiologická klinika Fakulty zdravotnicky´ch studií UJEP v Ústí nad Labem a Krajské zdravotní, a. s., Masarykovy nemocnice v Ústí nad Labem, o. z., Ústí nad Labem, Czech Republic, c Neurochirurgická klinika Fakulty zdravotnicky´ch studií Univerzity J. E. Purkyneˇ v Ústí nad Labem a Krajské zdravotní, a. s., Masarykovy nemocnice v Ústí nad Labem, o. z., Ústí nad Labem, Czech Republic) ⇑
Corresponding author.
Background: CTAG examination as a ‘‘gold standard” in acute phase of stroke in vertebrobasilar region is often inconclusive. The aim of our study is to evaluate the sensitivity and specificity of neurophysiological methods - BAEP, MEP ad blink reflex (BR) - and comparison with imaging methods (DWI) results. Methods: Group of 20 patients with clinical suspicion of acute ischemic stroke in vertebrobasilar region were evaluated from April to December 2018. The average time between onset of stroke and neurophysiological examination was 4,35 day. The patients with history of previous stroke and with the CT signs of acute supratentorial stroke were excluded. A combination of three electrophysiological methods (Blink reflex, MEP and BAEP) were used. Time of electrophysiological examination didn’t exceed 30 min. In all patients was also DWI performed. Electrophysiological abnormity patterns were correlated with the clinical presentation and with the DWI findings. Results: MEP abnormality (unilateral significant central motor latency prolongation) was observed in 6/20 patients. BAEP central abnormality (prolongation of wave III-V latency) was detected in only 4/20 patients. Blink reflex abnormality was found in 14/20 patients: In 1 case early response latency prolongation, other abnormalities were related to late responses. 6 observed we typical
e79
pattern of R2 and R2c prolongation/missing while stimulating on the site of damage. We assume abnormal electrophysiological test can help to indicate patients with a normal CTAG to DWI. There is a need for a larger group of patients to generalize the results. doi:10.1016/j.clinph.2019.04.493
P42-F New mobile application for adaptive threshold hunting in transcranial magnetic stimulation—Petro Julkunen a,b,* a ( Depertment of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland, b Department of Applied Physics, University of Eastern Finland, Kuopio, Finland) ⇑
Corresponding author.
Background: Use of transcranial magnetic stimulation (TMS) in clinical neurophysiology has expanded as navigated TMS and repetitive TMS therapies have gained popularity. Clinical applications and scientific studies often apply adaptive threshold hunting (ATH) to determine motor threshold (MT). MT expresses corticospinal excitability, and it is used as a baseline stimulation intensity (SI) for modulatory, therapeutic and mapping procedures. Currently available tools for ATH are system-integrated tools and standalone software. System-integrated tools are rare, and the available stand-alone software require a dedicated computer adding to laboratory space-requirements. Material and methods: I programmed an Android-based ‘‘bestPEST” mobile application for ATH to allow for a simple recording of MTs with sharing capabilities and logging. The application applies parameter estimation by sequential testing and was named after Pentlands BestPEST-routine (Pentland , 1980). The application is free through Google Play. For comparison I applied Motor Threshold Assessment Tool 2.0 (Awiszus and Borckardt, 2012) as a reference method. I used data gathered from 15 healthy volunteers to simulate realistic motor evoked potentials (MEPs) utilizing random generator which considered the experimentally measured individual mean MEP amplitude and variation at different SIs (Kallioniemi et al., 2018). Results: The MTs of the different methods agreed well (ICC P 0.989, p < 0.001). There was no significant difference between the MTs determined with the different methods (p P 0.194). Conclusions: The bestPEST application produced similar MTs with the reference method, and will help investigators to determine MTs and to log results. References Awiszus F, Borckardt JJ. [accessed 19.10.2012]. Kallioniemi E, et al. 2018. BrainStimul. Pentland A. PerceptPsychophys 1980. doi:10.1016/j.clinph.2019.04.494
P43-F The influence of transcranial magnetic stimulation on the recognition and processing of visual information—Rafal Rola a,*, Lidia Naurecka b, Bartosz Sierakowski b, Wiktoria Kasprzycka b, Grzegorz Chabik a (a Military Institute of Aviation Medicine, Warsaw, Poland, b Military Institute of Technology, Poland) ⇑
Corresponding author.
Processes of focused attention allow to focus the stream of attention on a specific visual stimulus from the environmental context.
Abstracts / Clinical Neurophysiology 130 (2019) e21–e116
P37-F Predictors of cognitive impairment in patients with mine blast injury—OleksanSolonovych * (The State Institution ‘‘romodanov Neurosurgery Institute, National Academy Of Medical Science Of Ukraine”, Kiev, Ukraine) ⇑
Corresponding author.
Background: Mine blast injury is accompanied by traumatic brain injury (TBI) in 60–100% of cases. TBI is associated with cognitive impairment (CI). However, predictors of CI in this patients (pts) are studied insufficiently. Material and methods: 115 men aged 18 to 45 years with mild TBI caused by using of mine-blasting weapons. Cognitive functions were evaluated by using MoCA test, HADS scale. Cognitive dysfunction was defined as MoCa 6 25 scores. Besides routine examination, neurophysiological methods such as quantitative electroencephalography (qEEG) and cognitive evoked potentials P300 (CEP P300), were performed. Results. In binary logistic regression predictors CI were complaints on headache and fatigability (OR 2.52, 95% CI 2.6–59.7, p = 0.02), increased tendon reflexes (OR, 2.6, 95% CI 1.24–2.32, p = 0.017), higher HADS anxiety level (OR-1.8, 95% CI 1.59–2.2, p = 0.04), changes of alpha rhythm frequency (OR-1.02, 95% CI 1.01– 1.04, p = 0.004), decrease of alpha rhythm amplitudes (OR - 1.07, 95% CI 1.03–1.11, p < 0.001), dysfunction of nonspecific median structures (OR 1.02, 95% CI 1.0–1.04, p = 0.033), decrease of P3 peak amplitude (OR 2.6, 95% CI 1.14–5.9, p = 0.003) and increase of CEP P300 latency (OR 1.07, 95% CI 1.03–1.12, p = 0.002). In multinomial logistic regression the independent predictors of CI were decrease of alpha rhythm amplitudes, decrease of P3 peak amplitude and increase of CEP P300 latency. Conclusions: changes in qEEG and CEP P300 parameters are reliable independent predictors of CI in pts with TBI affected by mine blast trauma. doi:10.1016/j.clinph.2019.04.489
P38-F Motor evoked potentials elicited by TMS in Hirayama disease – Systematic review of the literature—Jan Bembenek a,*, _ Bozena Kłysz b, Iwona Kurkowska-Jastrze˛bska b (a Department of Clinical Neurophysiology, Institute of Psychiatry and Neurology, Warsaw, Poland, b 2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland) ⇑
Corresponding author.
Background: Hirayama disease (HD) is a rare motor disorder mainly affecting young men. It is characterized by atrophy and unilateral weakness of forearm and hand muscles corresponding to a C7-T1 myotome distribution. The progression is usually selflimiting. The etiology of HD is not fully understood. Motor evoked potentials (MEPs) seems to be useful in pyramidal tracts damage evaluation. Material and methods: We searched PubMed for original papers evaluating the use of transcranial magnetic stimulation elicited MEPs in HD until 02.01.2019 using key words: ‘‘motor evoked potentials Hirayama” and ‘‘transcranial magnetic stimulation Hirayama”. Results: We found six articles using the above key words which met inclusion criteria. Number of participants was small (78 and 55 control group), diagnostic procedures and methodology varied. Abnormal central motor conduction time was found in 17.1% of patients in one study whereas it was normal in 2 other studies. Peripheral motor latency (PML) was evaluated in one study which
found abnormally increased PMLs in at least one tested muscle in 16/41 (39.0%) of HD patients. Abnormal MEP parameters were found in 3 studies in 14.3–100% patients. They were not evaluated in one study and in two were normal in standard and flexed neck position. In one study inconsistent results in MEP size after neck flexion in patients after treatment with neck collar were found. Conclusions: Although MEP parameters may be abnormal in some HD patients, these have not been thoroughly assessed yet. Further studies are indispensable to evaluate their usefulness in assessing pyramidal tracts in HD. doi:10.1016/j.clinph.2019.04.490
P39-F Evaluation of visual pathways with visual evoked potentials in vitamin B12 deficiency patients—Hacer Erdem Tilki *, Onur Yıldız, Sß eyda Bayil (Departmant of Neurology, Ondokuz Mayis University, Samsun, Turkey) ⇑
Corresponding author.
Background: Vitamin b12 is a water-soluble vitamin and a wide variety of neurologic symptoms and signs were encountered including ataxia, loss of sensation, muscle weakness, hyperactive reflexes, incontinence, also it may not cause any symptoms in many patients. Material and methods: In our study, we have included asymptomatic patients. The diagnosis of vitamin B12 deficiency was based on low serum vitamin B12 level (<150 pg/ml). Forty patients with vitamin b12 deficiency and control group were included in the study. Vitamin B12 levels were intended to determine the existence of a possible relationship between P100 latency and amplitude values. Results: Visual acuity was found normal in all the patients. The mean vitamin B12 level was 96 pg/ml in the patient group and 374 pg/ml in the control group. Eight patient (20%) with vitamin B12 deficiency was determined megaloblastic anemia. In vitamin B12 deficiency patients mean P100 latency was 104 ± 8 ms and mean amplitude was 8.1 ± 4 uV. Patients with vitamin B12 deficiency P100 latency compared to the control group was significantly prolonged (P < 0.01). P100 wave amplitude did not find a significant difference between the cases and controls. Similarly, the P100 latency values of patients with hyperhomocysteinemia and megaloblastic anemia was significantly prolonged (P < 0.01). The possible reason for delayed latencies in vitamin B12 deficiency could be demyelination in visual pathways. Conclusions: As a result, pattern shift visual evoked responses may identify the subtle changes in the visual pathways easily in vitamin b12 deficiency patients even when there is no evidence of clinical abnormality. doi:10.1016/j.clinph.2019.04.491
P40-F The relationship between age and SICI parameters obtained with threshold tracking TMS—Søren Ørskov *, Christina Shen-Zhuang Nielsen, Kirsten Pugdahl, Anders FuglsangFrederiksen, Hatice Tankisi (Aarhus University, Århus N, Denmark) ⇑
Corresponding author.
Background: Recently developed threshold tracking TMS (TT-TMS) paired pulse techniques have been shown to be of benefit in clinical diagnostic practice. Reduced Short Interval Cortical Inhibition (SICI) with increasing age has been shown in several studies using
Abstracts / Clinical Neurophysiology 130 (2019) e21–e116
conventional paired-pulse TMS techniques. However, TT-TMS SICI parameters did not correlate to age in healthy subjects in a previous study (Shibuya et al., 2016). We aimed in this study to present the preliminary results of our normal material on TT-SICI and the relationship between SICI measurements and age. Material and methods: Thirty-three healthy subjects (mean age: 51.06 ± 2.48, range: 23–77) were included. Paired-pulse TT-TMS was undertaken using a 90 mm figure-of-eight coil applied to the motor cortex, with currents generated by BiStim system controlled by Qtrac software. The motor evoked potential (MEP) response was recorded over the first dorsal interosseus (FDI). MEP amplitude was set to a target value of 0.2 mV, and the changes in the intensity of the test stimulus required to generate this target MEP were measured. The relationship between age and SICI measurements were analyzed using regression analysis. Results: Resting motor threshold (RMT) (MSO, %) (mean: 54.43 ± 2.41) and SICI (%) at 1 ms (12.01 ± 1.86), 2.5 ms (11.02 ± 1.65), 3 ms (8.20 ± 1.69) and 1–7 ms (5.93 ± 1.12) on TT-TMS were analysed. RMT increased with increasing age (r = 0.45, p = 0.08), while age had an inverse relationship with SICI on 1 ms (r = 0.49, p = 0.003), 2.5 ms (r = 0.45, p = 0.008), 3 ms (r = 0.41, p = 0.019) and 1–7 ms (r = 0.41, p = 0.017). Conclusions: SICI parameters closely relate to age for TT-TMS similar to previously reported conventional. Further studies are required with large groups of healthy subjects. doi:10.1016/j.clinph.2019.04.492
P41-F Reliability of BAEP, MEP and blink reflex (BR) combination in posterior circulation ischemic stroke—Šteˇpánka Brušáková a,*, Jirˇí Ceé c, Dušan Ospalík a, Daniel Adámek b (a Neurologické oddeˇlení, Krajská Zdravotní, a.s., Masarykova nemocnice v Ústí nad Labem, o.z., Ústí nad Labem, Czech Republic , b Radiologická klinika Fakulty zdravotnicky´ch studií UJEP v Ústí nad Labem a Krajské zdravotní, a. s., Masarykovy nemocnice v Ústí nad Labem, o. z., Ústí nad Labem, Czech Republic, c Neurochirurgická klinika Fakulty zdravotnicky´ch studií Univerzity J. E. Purkyneˇ v Ústí nad Labem a Krajské zdravotní, a. s., Masarykovy nemocnice v Ústí nad Labem, o. z., Ústí nad Labem, Czech Republic) ⇑
Corresponding author.
Background: CTAG examination as a ‘‘gold standard” in acute phase of stroke in vertebrobasilar region is often inconclusive. The aim of our study is to evaluate the sensitivity and specificity of neurophysiological methods - BAEP, MEP ad blink reflex (BR) - and comparison with imaging methods (DWI) results. Methods: Group of 20 patients with clinical suspicion of acute ischemic stroke in vertebrobasilar region were evaluated from April to December 2018. The average time between onset of stroke and neurophysiological examination was 4,35 day. The patients with history of previous stroke and with the CT signs of acute supratentorial stroke were excluded. A combination of three electrophysiological methods (Blink reflex, MEP and BAEP) were used. Time of electrophysiological examination didn’t exceed 30 min. In all patients was also DWI performed. Electrophysiological abnormity patterns were correlated with the clinical presentation and with the DWI findings. Results: MEP abnormality (unilateral significant central motor latency prolongation) was observed in 6/20 patients. BAEP central abnormality (prolongation of wave III-V latency) was detected in only 4/20 patients. Blink reflex abnormality was found in 14/20 patients: In 1 case early response latency prolongation, other abnormalities were related to late responses. 6 observed we typical
e79
pattern of R2 and R2c prolongation/missing while stimulating on the site of damage. We assume abnormal electrophysiological test can help to indicate patients with a normal CTAG to DWI. There is a need for a larger group of patients to generalize the results. doi:10.1016/j.clinph.2019.04.493
P42-F New mobile application for adaptive threshold hunting in transcranial magnetic stimulation—Petro Julkunen a,b,* a ( Depertment of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland, b Department of Applied Physics, University of Eastern Finland, Kuopio, Finland) ⇑
Corresponding author.
Background: Use of transcranial magnetic stimulation (TMS) in clinical neurophysiology has expanded as navigated TMS and repetitive TMS therapies have gained popularity. Clinical applications and scientific studies often apply adaptive threshold hunting (ATH) to determine motor threshold (MT). MT expresses corticospinal excitability, and it is used as a baseline stimulation intensity (SI) for modulatory, therapeutic and mapping procedures. Currently available tools for ATH are system-integrated tools and standalone software. System-integrated tools are rare, and the available stand-alone software require a dedicated computer adding to laboratory space-requirements. Material and methods: I programmed an Android-based ‘‘bestPEST” mobile application for ATH to allow for a simple recording of MTs with sharing capabilities and logging. The application applies parameter estimation by sequential testing and was named after Pentlands BestPEST-routine (Pentland , 1980). The application is free through Google Play. For comparison I applied Motor Threshold Assessment Tool 2.0 (Awiszus and Borckardt, 2012) as a reference method. I used data gathered from 15 healthy volunteers to simulate realistic motor evoked potentials (MEPs) utilizing random generator which considered the experimentally measured individual mean MEP amplitude and variation at different SIs (Kallioniemi et al., 2018). Results: The MTs of the different methods agreed well (ICC P 0.989, p < 0.001). There was no significant difference between the MTs determined with the different methods (p P 0.194). Conclusions: The bestPEST application produced similar MTs with the reference method, and will help investigators to determine MTs and to log results. References Awiszus F, Borckardt JJ.
P43-F The influence of transcranial magnetic stimulation on the recognition and processing of visual information—Rafal Rola a,*, Lidia Naurecka b, Bartosz Sierakowski b, Wiktoria Kasprzycka b, Grzegorz Chabik a (a Military Institute of Aviation Medicine, Warsaw, Poland, b Military Institute of Technology, Poland) ⇑
Corresponding author.
Processes of focused attention allow to focus the stream of attention on a specific visual stimulus from the environmental context.