Objective
Neurological conditions, such as multiple sclerosis and stroke, may impair memory and language. A technique called retrieval practice (RP) may improve memory and language outcomes in such clinical populations. The RP effect refers to the finding that retrieving information from memory leads to better long-term retention than restudying the same information. Although the benefits of RP have been repeatedly observed in healthy populations, less is known about its potential applications in cognitive rehabilitation in clinical populations. Here we review the RP literature in populations with acquired memory and language impairments.
Method
Systematic searches for studies published before January 2020 were conducted on Elsevier, PsycARTICLES, PsycINFO, Pubmed, Web of Science, and Wiley Online Library, with the terms “retrieval practice”/“testing effect” and “cognitive rehabilitation”. In addition, backward and forward snowballing were used to allow the identification of important publications missed by the initial search. Studies were included if they were peer-reviewed, empirical work in which memory or language outcome measures were compared between an RP condition and a re-exposure-control condition in patients with acquired memory or language impairments.
Results
Sixteen articles fulfilled the inclusion criteria. Studies from memory-impaired samples were relatively homogeneous with respect to experimental protocols and materials and favored RP over control conditions. The results were mostly positive despite short retention intervals and predominantly single-session designs. Similarly, studies from language-impaired samples focused on naming impairments in patients with aphasia and also favored RP over name repetition.
Conclusion
The results indicate that RP is a viable technique for cognitive rehabilitation.
Transcranial direct current stimulation (tDCS) has been showing promising effects for the treatment of obsessive–compulsive disorder (OCD), but there is still no conclusion on its efficacy for this disorder. We performed a systematic review and meta-analysis of trials using tDCS for OCD and a computer modeling analysis to evaluate the electric field (EF) strengths of different electrode assemblies in brain regions of interest (ROIs) (PROSPERO-42021262465). PubMed/MEDLINE, Embase, Cochrane Library and Web of Science databases were searched from inception to 25 September 2022. Randomized controlled trials (RCTs) and open-label studies were included. The primary aim was the effect size (Hedges’ g) of continuous outcomes and potential moderators of response. For EF modeling, SimNIBS software was used. Four RCTs and four open-label trials were included (n = 241). Results revealed a large effect of tDCS in the endpoint, but no significant effect between active and sham protocols. No predictor of response was found. EF analysis revealed that montages using the main electrode over the (pre)supplementary motor area with an extracephalic reference electrode might lead to stronger EFs in the predefined ROIs. Our results revealed that tDCS might be a promising intervention to treat OCD; however, larger studies are warranted.
Aim
Evidence indicates most people were resilient to the impact of the COVID-19 pandemic on mental health. However, evidence also suggests the pandemic effect on mental health may be heterogeneous. Therefore, we aimed to identify groups of trajectories of common mental disorders’ (CMD) symptoms assessed before (2017–19) and during the COVID-19 pandemic (2020–2021), and to investigate predictors of trajectories.
Methods
We assessed 2,705 participants of the ELSA-Brasil COVID-19 Mental Health Cohort study who reported Clinical Interview Scheduled-Revised (CIS-R) data in 2017–19 and Depression Anxiety Stress Scale-21 (DASS-21) data in May–July 2020, July–September 2020, October–December 2020, and April–June 2021. We used an equi-percentile approach to link the CIS-R total score in 2017–19 with the DASS-21 total score. Group-based trajectory modeling was used to identify CMD trajectories and adjusted multinomial logistic regression was used to investigate predictors of trajectories.
Results
Six groups of CMD symptoms trajectories were identified: low symptoms (17.6%), low-decreasing symptoms (13.7%), low-increasing symptoms (23.9%), moderate-decreasing symptoms (16.8%), low-increasing symptoms (23.3%), severe-decreasing symptoms (4.7%). The severe-decreasing trajectory was characterized by age < 60 years, female sex, low family income, sedentary behavior, previous mental disorders, and the experience of adverse events in life.
Limitations
Pre-pandemic characteristics were associated with lack of response to assessments. Our occupational cohort sample is not representative.
Conclusion
More than half of the sample presented low levels of CMD symptoms. Predictors of trajectories could be used to detect individuals at-risk for presenting CMD symptoms in the context of global adverse events.
Supplementary Information
The online version contains supplementary material available at 10.1007/s00127-022-02365-0.
S.S. prepared the manuscript and were involved in treating the patient. M.S. is a clinical engineer and was involved in patient treatment. T.N. is a psychiatrist and was involved in patient treatment. All authors read and approved the final version of the manuscript. Informed consent for publication was obtained from the patient. 2. Kokras N, Politis AM, Zervas IM, et al. Cardiac rhythm management devices and electroconvulsive therapy: a critical review apropos of a depressed patient with a pacemaker.
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