Effects of transcranial direct current stimulation on visuospatial attention in air traffic controllers.

Visuospatial attention is a cognitive skill essential to the performance of air traffic control activities. We evaluated the effect of an anodic session of transcranial low-intensity direct current stimulation (tDCS) right parietal associated with cognitive training of visuospatial attention of 21 air traffic controllers. Within-subject designs were used, with all volunteers undergoing two tDCS sessions; an experimental (2 mA anodic) and control (sham) performed concomitantly with the cognitive training (2-Back). Visuospatial performance was measured using the Attention Network Test for Interactions and Vigilance pre- and post-intervention. The results indicate that after an active parietal tDCS session, the ATCOs showed faster responses, but not more accurate, for visuospatial attention in its aspects of orientation and reorientation. This result was significant when comparing baseline and post-tests in the active tDCS group. Comparing the post-tests between the tDCS active and sham groups, it is possible to infer a trend of improvement in the results based on faster and more accurate responses, which suggests a possible refinement of the ATCO's attentional orientation. However, this population may eventually have reached a plateau in the performance of this skill. From the analysis of the results we arrive at the following hypotheses: (I) the increase in cortical excitability mediated by anodic tDCS frequently recorded may not be accompanied by improvements in behavioural measures; (II) the interaction between anodic tDCS with another event of increased excitability-execution of a cognitive task, may have hindered the occurrence of neuroplasticity; (III) the air traffic control activity may be associated with a high level of attention, which may have contributed to a ceiling effect for the development of this skill; (IV) online assessments may be more relevant to identify acute effects; (V) repeated sessions may be more efficient to find cumulative effects; (VI) the analysis of interactions between attentional networks can contribute to the study of visuospatial attention; (VII) tDCS protocols aimed at ATCO need to consider the specifics of this audience, such as circadian rhythm and sleep and fatigue conditions.