This review presents the current knowledge of the usage of critical flicker fusion frequency (CFF) in human and animal model studies. CFF has a wide application in different fields, especially as an indicator of cortical arousal and visual processing. In medicine, CFF may be helpful for diagnostic purposes, for example in epilepsy or minimal hepatic encephalopathy. Given the environmental studies and a limited number of other methods, it is applicable in diving and hyperbaric medicine. Current research also shows the relationship between CFF and other electrophysiological methods, such as electroencephalography. The human eye can detect flicker at 50–90 Hz but reports are showing the possibility to distinguish between steady and modulated light up to 500 Hz. Future research with the use of CFF is needed to better understand its utility and application.

Scuba diving as a recreational activity is becoming increasingly popular. However, the safety of this activity, especially in the out-of-comfort zone, has been discussed worldwide. The latest publications bring conclusions regarding negative effects on cognitive functions. We compare the acute and chronic effects of diving on cognitive functioning depending on the type of dive performed, including recreational, technical and saturation diving. However, the results of research show that acute and chronic effects on cognitive functions can be negative. While acute effects are reversible after the ascent, chronic effects include white matter lesions in magnetic resonance imaging scans. We believe that more investigations should be performed to determine the chronic effects that could be observed after a few months of observations in a group of regular, intense divers. In addition, publications referring to technical divers are very limited, which is disquieting, as this particular group of divers seems to be neglected in research concerning the effects of diving on cognitive functions.

The aim of this review is to summarise current knowledge about flickering light and the underlying processes that occur during its processing in the brain. Despite the growing interest in the topic of flickering light, its clinical applications are still not well understood. Studies using EEG indicate an appearing synchronisation of brain wave frequencies with the frequency of flickering light, and hopefully, it could be used in memory therapy, among other applications. Some researchers have focused on using the flicker test as an indicator of arousal, which may be useful in clinical studies if the background for such a relationship is described. Since flicker testing has a risk of inducing epileptic seizures, however, every effort must be made to avoid high-risk combinations, which include, for example, red-blue light flashing at 15 Hz. Future research should focus on the usage of neuroimaging methods to describe the specific neuropsychological and neurophysiological processes occurring in the brain during the processing of flickering light so that its clinical utility can be preliminarily determined and randomised clinical trials can be initiated to test existing reports.

An individual’s ability to process flickering light is expressed by critical flicker fusion frequency (CFFF), tested with the flicker test. CFFF is used to assess visual processing, arousal, and cognitive functioning, among other things, although it is unclear how it reflects these processes. Due to possible differences between CFFF values obtained in trials with increasing and decreasing frequency, it also remains questionable to use only averaged CFFF values in research. The main objective of the present study was to assess how CFFF is related to cognitive functions (attention, short-term and working memory, and executive functions), and psychomotor speed. The research objectives also included assessing the stability of CFFF and its variability with age and comparing CFFF between men and women. Thirty-six participants (17 women and 19 men) completed computerized cognitive tests (Simon and flanker tasks, the Corsi block-tapping task, and the digit span task) three times, along with the flicker test. We found that CFFF scores were stable across sessions but differed between fusion and flicker thresholds, with age significantly correlating only with the fusion frequency. Given that, we suggest that future studies analyze not only the averaged CFFF, but also examine flicker and fusion thresholds separately to better understand their distinct contributions. Our results also revealed generally weak correlations between CFFF and neuropsychological test scores, with significant associations found only in women, suggesting that CFFF may not be a reliable indicator of cognitive functioning.

We first want to thank the authors of the excellent review for their contributions to summarizing the confounders associated with critical flicker fusion frequency (CFFF)

Critical flicker fusion frequency (CFFF) has been proposed as a rapid marker of central nervous system arousal state, but its relationship to cognitive performance under hyperbaric stress remains unclear. Forty healthy adults (20 women; age 19–46 years) underwent three hyperbaric exposures at 4 ATA (equivalent to 30 m seawater depth) while breathing air, heliox, and trimix in randomized order. CFFF and cognitive performance (Simon task, Digit Span, Corsi Block-Tapping) were assessed before compression, at 4 ATA, and after decompression. Both CFFF and reaction times increased modestly at 4 ATA across all breathing gases (3–5% elevation, p < 0.05). Following decompression, however, these measures showed divergent recovery patterns: CFFF normalized completely after heliox and trimix, but remained partially elevated after air breathing. In contrast, reaction times improved substantially after decompression (10–15% faster than baseline) regardless of breathing gas, reflecting practice effects. Weak correlations emerged between specific CFFF components and executive cognitive measures, while memory performance remained stable throughout all conditions. CFFF and cognitive performance exhibit some parallel increases under hyperbaric stress but most likely capture largely independent aspects of neural function. Breathing gas composition selectively influences CFFF recovery dynamics, with nitrogen producing prolonged neural effects relevant for assessing post-dive cognitive readiness.