Health Scope. 2023 February; 12(1):e132613. Published online 2023 March 30. https://doi.org/10.5812/jhealthscope-132613. Research Article Emotionally Loaded Visual Stimuli to Alter Brain Arousal: A Flicker Fusion Study Zahra Ghanbari 1 , Alireza Choobineh 2 , Seyed Abolfazl Zakerian 1 , Faramarz Gharagozlou 3 and Mohammad Nami 4, 5, 6, * 1 Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2 Research Center for Health Sciences, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran 3 Department of Occupational Health and Safety Engineering, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran 4 Neuroscience Center, Institute of Scientific Research and High-Technology Services (INDICASAT AIP), City of Knowledge, Panama City, Panama 5 Brain Mapping Foundation and Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA 6 BrainHub Academy, Dubai, UAE * Corresponding author: Neuroscience Center, Institute of Scientific Research and High-Technology Services (INDICASAT AIP), City of Knowledge, Panama City, Panama. Email: torabinami@sums.ac.ir Received 2022 November 20; Accepted 2022 December 23. Abstract Background: Human brain performance and arousal are still challenging and critical, especially in environments such as power plants. Since different emotions are common in daily work life and have inevitable effects on cognitive performance, it is important to evaluate whether emotional interventions can alter brain arousal. Poor cognitive performance in control room operators (CROs) can lead to mental fatigue and affect their cognitive emotion regulation. To address this issue, flicker fusion frequency (FFF) was employed as a simple and reproducible surrogate index for mental fatigue. Objectives: This study aimed to investigate whether emotionally loaded visual stimuli can alter brain arousal (brain fatigue) or is associated with cognitive emotion regulation (CER) ability. Methods: Flicker fusion frequency was assessed by RT-961, and the International Affective Picture System (IAPS) was adopted as the picture database of stimuli. Additionally, the Cognitive Emotion Regulation Questionnaire (CERQ) was used to determine the participants’ cognitive emotion CER ability. Twenty volunteer CROs from Fars Combined Cycle Power Plant participated in this study. After completing the CERQ , they were assessed at 2 different time points (ie, before and after presenting emotional stimuli). Flicker fusion frequency was assessed 20 times at each round, and the average frequency was recorded. Emotionally loaded images were considered as stimuli. The stimuli sets were classified based on their arousal levels and valences, yet they were presented in random order. Subjects were exposed to each image for 5 seconds (30 minutes in total). Results: The participants’ mean age was 39.55 ± 7.02 years. The first and second FFFs were 42.15 ± 3.90 and 41.96 ± 3.98 in the appro- priate group and 42.82 ± 3.59 and 42.26 ± 4.07 in the inappropriate group. Based on the statistical tests, there were no significant relationships between the measurements (P > 0.05). Conclusions: Control room operators may positively maintain their brain arousal during specific emotional stimuli when the in- tervention lasts less than 30 minutes. Considering the prolonged working hours in such industries (roughly over 8 hours a day) and the importance of cognitive aptitude in preventing work-related errors, we propose this line of research to gain momentum. Keywords: Flicker Fusion, Emotional Stimuli, Cognitive Performance, Cognitive Emotion Regulation 1. Background It is obvious that the human brain is the command cen- ter of the human nervous system, receiving signals from the body’s sensory organs and directing information to the feedback system. However, many aspects of cognitive performance and emotion (ie, inner feelings such as fear, anger, shame, etc) (1), which affect brain arousal and cog- nition, are still unclear. Emotion is also connected to cog- nitive processes (2). It is generally accepted that emotions influence the capability of a person to perform a given task (3). In physical activities, for example, emotion plays a major role in the quality of the athlete’s performance (3). Physiologically and psychologically, emotions influ- ence the health status of humans (4). Moreover, emotions are strong determinants of behavior, thinking, and experi- ence and can be regulated in different ways (5). The mem- ory of both positive and negative emotional stimuli, for instance, appears to be more effective than neutrals (6). In addition, attention seems to be captured by emotional Copyright © 2023, Author(s). 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