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Yan X, Abudouresuli A, Yuemaier A, Ge Y, Shang S, Yang J, Zhang L. Enhancing cosmetic suturing skill acquisition in surgical residents through spaced learning training: a randomized controlled trial. Ann Med 2024; 56:2363940. [PMID: 39212199 PMCID: PMC11370668 DOI: 10.1080/07853890.2024.2363940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 03/29/2024] [Accepted: 03/31/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Previous research has strongly supported the utility of spaced learning in enhancing memory, but its effectiveness in complex surgical procedures has largely been unexplored. The main objective of this study was to evaluate whether, in comparison to concentrated learning, spaced learning improves the short-term acquisition and long-term retention of cosmetic suturing skills as outcomes of surgical resident training courses. METHODS This randomized controlled trial was conducted from February 2023 to June 2023. Surgical residents were recruited from a teaching hospital in Guangzhou, China. The participants were randomly assigned at a 1:1 ratio to either the spaced training group (40 min of training followed by a 20-minute break) or the concentrated training group (3 h of continuous training), in which they received one-on-one training for cosmetic suturing skills. The short-term acquisition and long-term retention outcomes were evaluated by three independent raters using an objective scoring scale to assess the participants' cosmetic suturing skills before the training (pretraining test), within one hour after the training (posttraining test), and three months after the completion of the training (follow-up test). The score for each participant was calculated as the average of three independent scores. RESULTS The study included 23 surgical residents, 12 in the spaced training group and 11 in the concentrated training group. The pretraining test revealed no significant difference between the groups. However, in the post-training test, the spaced training group achieved a significantly higher total score than did the concentrated training group (74.06 ± 5.87 vs. 63.43 ± 10.73, p = 0.0070). Specifically, the suture technique scores were 28.46 ± 1.78 and 22.85 ± 3.75, respectively, which were significantly different (p = 0.0002). During the long-term follow-up test, the spaced training group consistently outperformed the concentrated training group by having significantly higher total (75.60 ± 4.78 vs. 60.68 ± 10.40, p = 0.0001), suture quality (32.26 ± 4.01 vs. 26.23 ± 4.16, p = 0.0019), suture technique (28.68 ± 2.63 vs. 22.18 ± 3.94, p = 0.0001), and suturing time scores (14.67 ± 1.15 vs. 12.27 ± 6.07, p = 0.0460). CONCLUSIONS Incorporating the principles of spaced learning into the instructional process of obtaining cosmetic suture skills for surgical residents not only significantly enhances short-term skill improvement but also contributes to the long-term retention of training outcomes.
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Affiliation(s)
- Xinjian Yan
- Department of Cardiac Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Adilijiang. Abudouresuli
- The Center of Cardiovascular Surgery, The First People’ Hospital of Kashi Prefecture, Kashi, China
| | - Abudukeremu. Yuemaier
- The Center of Cardiovascular Surgery, The First People’ Hospital of Kashi Prefecture, Kashi, China
| | - Yan Ge
- Department of Pathology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Shiyao Shang
- Department of Ultrasound, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Jue Yang
- Department of Cardiac Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Liulu Zhang
- Department of Breast Cancer, Cancer Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
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Tan B, Chen J, Liu Y, Lin Q, Wang Y, Shi S, Ye Y, Che X. Differential analgesic effects of high-frequency or accelerated intermittent theta burst stimulation of M1 on experimental tonic pain: Correlations with cortical activity changes assessed by TMS-EEG. Neurotherapeutics 2024:e00451. [PMID: 39304439 DOI: 10.1016/j.neurot.2024.e00451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 09/08/2024] [Accepted: 09/08/2024] [Indexed: 09/22/2024] Open
Abstract
Accelerated intermittent theta burst stimulation (AiTBS) has attracted much attention in the past few years as a new form of brain stimulation paradigm. However, it is unclear the relative efficacy of AiTBS on cortical excitability compared to conventional high-frequency rTMS. Using concurrent TMS and electroencephalogram (TMS-EEG), this study systematically compared the efficacy on cortical excitability and a typical clinical application (i.e. pain), between AiTBS with different intersession interval (ISIs) and 10-Hz rTMS. Participants received 10-Hz rTMS, AiTBS-15 (3 iTBS sessions with a 15-min ISI), AiTBS-50 (3 iTBS sessions with a 50-min ISI), or Sham stimulation over the primary motor cortex on four separate days. All four protocols included a total of 1800 pulses but with different session durations (10-Hz rTMS = 18, AiTBS-15 = 40, and AiTBS-50 = 110 min). AiTBS-50 and 10-Hz rTMS were more effective in pain reduction compared to AiTBS-15. Using single-pulse TMS-induced oscillation, our data revealed low gamma oscillation as a shared cortical excitability change across all three active rTMS protocols but demonstrated completely opposite directions. Changes in low gamma oscillation were further associated with changes in pain perception across the three active conditions. In contrast, a distinct pattern of TMS-evoked potentials (TEPs) was revealed, with 10-Hz rTMS decreasing inhibitory N100 amplitude and AiTBS-15 reducing excitatory P60 amplitude. These changes in TEPs were also covarying with low gamma power changes. Sham stimulation indicated no significant effect on either cortical excitability or pain perception. These results are relevant only for provoked experimental pain, without being predictive for chronic pain, and revealed a change in low gamma oscillation, particularly around the very particular frequency of 40 Hz, shared between AiTBS and high-frequency rTMS. Conversely, cortical excitability (balance between excitation and inhibition) assessed by TEP recording was modulated differently by AiTBS and high-frequency rTMS paradigms.
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Affiliation(s)
- Bolin Tan
- Centre for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Jielin Chen
- Centre for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Ying Liu
- Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Qiuye Lin
- Centre for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Ying Wang
- Centre for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Shuyan Shi
- Centre for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Yang Ye
- Centre for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China; Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Xianwei Che
- Centre for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.
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Sozer E, Fagin M, Meksin R, Hirst W. Durability of retrieval-induced forgetting: Effects of different practice schedules. Mem Cognit 2024:10.3758/s13421-024-01634-4. [PMID: 39256319 DOI: 10.3758/s13421-024-01634-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2024] [Indexed: 09/12/2024]
Abstract
If retrieval-induced forgetting (RIF) is to play a role in the formation of collective memories, it should be long lasting. Although several studies have found that RIF is short-lived, there is other evidence to suggest that repeated selective practice schedules with a temporal gap between each practice trial may increase the durability of RIF. We tested this possibility in three experiments, focusing on socially shared retrieval-induced forgetting (SSRIF). In two experiments, participants studied scientific or story materials, then listened to someone selectively recall the material repeatedly, either in rapid succession or over an extended time period, and finally recalled the original materials either immediately, after a 1-week delay, or after a 3-week delay. A third experiment examined selective practice in free-flowing conversations. In each instance, RIF was found with repeated selective practice with a temporal gap between trials. The results are discussed in terms of the role RIF might play in the formation of collective memory.
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Affiliation(s)
- Elif Sozer
- Department of Psychology, New School for Social Research, 80 Fifth Avenue, New York, NY, 10011, USA.
| | - Martin Fagin
- Department of Psychology, New School for Social Research, 80 Fifth Avenue, New York, NY, 10011, USA
| | - Robert Meksin
- Department of Psychology, New School for Social Research, 80 Fifth Avenue, New York, NY, 10011, USA
| | - William Hirst
- Department of Psychology, New School for Social Research, 80 Fifth Avenue, New York, NY, 10011, USA
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Burke DA, Taylor A, Jeong H, Lee S, Wu B, Floeder JR, K Namboodiri VM. Reward timescale controls the rate of behavioural and dopaminergic learning. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.03.31.535173. [PMID: 37034619 PMCID: PMC10081323 DOI: 10.1101/2023.03.31.535173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Learning the causes of rewards is necessary for survival. Thus, it is critical to understand the mechanisms of such a vital biological process. Cue-reward learning is controlled by mesolimbic dopamine and improves with spacing of cue-reward pairings. However, whether a mathematical rule governs such improvements in learning rate, and if so, whether a unifying mechanism captures this rule and dopamine dynamics during learning remain unknown. Here, we investigate the behavioral, algorithmic, and dopaminergic mechanisms governing cue-reward learning rate. Across a range of conditions in mice, we show a strong, mathematically proportional relationship between both behavioral and dopaminergic learning rates and the duration between rewards. Due to this relationship, removing up to 19 out of 20 cue-reward pairings over a fixed duration has no influence on overall learning. These findings are explained by a dopamine-based model of retrospective learning, thereby providing a unified account of the biological mechanisms of learning.
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Affiliation(s)
- Dennis A Burke
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Annie Taylor
- Neuroscience Graduate Program, University of California, San Francisco, CA, USA
| | - Huijeong Jeong
- Department of Neurology, University of California, San Francisco, CA, USA
| | - SeulAh Lee
- Department of Neurology, University of California, San Francisco, CA, USA
- University of California, Berkeley, CA, USA
| | - Brenda Wu
- Department of Neurology, University of California, San Francisco, CA, USA
- Neuroscience Graduate Program, University of California, San Francisco, CA, USA
| | - Joseph R Floeder
- Neuroscience Graduate Program, University of California, San Francisco, CA, USA
| | - Vijay Mohan K Namboodiri
- Department of Neurology, University of California, San Francisco, CA, USA
- Neuroscience Graduate Program, University of California, San Francisco, CA, USA
- Weill Institute for Neurosciences, Kavli Institute for Fundamental Neuroscience, Center for Integrative Neuroscience, University of California, San Francisco, CA, USA
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5
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Kamolvisit S, Limsrivilai J, Mekaroonkamol P, Chantarojanasiri T, Chalermsuksant N, Harinwan K, Rattananukrom C, Wong T, Pittayanon R, Sattayalertyanyong O, Sathirawich P, Kaosombatwattana U, Pulsombat A, Kamalaporn P, Sottisuporn J, Pausawasdi N, Rattanasiri S, Kitiyakara T. Validation and efficacy of the Varix Trainer model as a Training device for esophagogastroduodenoscopy. Endosc Int Open 2024; 12:E1043-E1055. [PMID: 39268154 PMCID: PMC11392590 DOI: 10.1055/a-2374-8476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 07/01/2024] [Indexed: 09/15/2024] Open
Abstract
Background and study aims The Varix Trainer model 1 (VTM1) was created for trainees to safely practice basic endoscope manipulation skills. The VTM1 was tested to see if it could distinguish levels of endoscope manipulation skills (construct validity) and whether training with it could improve these skills faster (content validity). Patients and methods We enrolled 23 novice endoscopists, 18 second-year trainees, and 13 expert endoscopists. They were asked to point with the endoscope tip to 20 numbers in the model as quickly as possible using torque, single-hand small/large wheel manipulation (SHSW), and retroflexion techniques. Their mean times (t20) were compared to determine if the model could distinguish different levels of expertise. Subsequently, 14 novices trained for eight short sessions, and the pre-training and post-training t20 were compared. Nine novice endoscopists received no training and were retested after 4 to 6 weeks (controls). Results Experts had faster t20 than second-year trainees, who were faster than novices, for all three techniques ( P < 0.001). After eight sessions, the mean t20 for novices improved from 112 to 66 seconds for torque, 144 to 72 seconds for SHSW, and 108 to 63 seconds for retroflexion, (all P < 0.001). Their t20 were equivalent to second-year trainees. Improvement in t20 was also seen with the control group, but total reduction was less than for the training group. Conclusions The VTM1 distinguished varying levels of expertise for all techniques, suggesting that it is a valid tool for assessing endoscope manipulation skill. A short curriculum improved novices' manipulation skills faster than traditional practice.
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Affiliation(s)
- Sarunporn Kamolvisit
- Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Julajak Limsrivilai
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Parit Mekaroonkamol
- Division of Gastroenterology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Tanyaporn Chantarojanasiri
- Division of Gastroenterology, Department of Internal Medicine, Rajavithi Hospital, Rangsit University, Bangkok, Thailand
| | - Nalerdon Chalermsuksant
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Kamin Harinwan
- Division of Gastroenterology and Hepatology, Department of Medicine, Pramongkutklao Hospital and College of Medicine, Royal Thai Army, Bangkok, Thailand
| | - Chitchai Rattananukrom
- Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand
| | - Thanawin Wong
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkla, Thailand
| | - Rapat Pittayanon
- Division of Gastroenterology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Onuma Sattayalertyanyong
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Phalat Sathirawich
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Uayporn Kaosombatwattana
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Akharawit Pulsombat
- Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Patarapong Kamalaporn
- Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Jaksin Sottisuporn
- NKC Institute of Gastroenterology and Hepatology, Songklanagarind Hospital, Faculty of Medicine, Prince Songkla University, Songkla, Thailand
| | - Nonthalee Pausawasdi
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sasivimol Rattanasiri
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Taya Kitiyakara
- Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Panda R, Deluisi JA, Lee TG, Davis S, Muñoz-Orozco I, Albin RL, Vesia M. Improving efficacy of repetitive transcranial magnetic stimulation for treatment of Parkinson disease gait disorders. Front Hum Neurosci 2024; 18:1445595. [PMID: 39253068 PMCID: PMC11381384 DOI: 10.3389/fnhum.2024.1445595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Accepted: 08/07/2024] [Indexed: 09/11/2024] Open
Abstract
Parkinson disease (PD) is a neurodegenerative disorder that causes motor and cognitive deficits, presenting complex challenges for therapeutic interventions. Repetitive transcranial magnetic stimulation (rTMS) is a type of neuromodulation that can produce plastic changes in neural activity. rTMS has been trialed as a therapy to treat motor and non-motor symptoms in persons with Parkinson disease (PwP), particularly treatment-refractory postural instability and gait difficulties such as Freezing of Gait (FoG), but clinical outcomes have been variable. We suggest improving rTMS neuromodulation therapy for balance and gait abnormalities in PwP by targeting brain regions in cognitive-motor control networks. rTMS studies in PwP often targeted motor targets such as the primary motor cortex (M1) or supplementary motor area (SMA), overlooking network interactions involved in posture-gait control disorders. We propose a shift in focus toward alternative stimulation targets in basal ganglia-cortex-cerebellum networks involved in posture-gait control, emphasizing the dorsolateral prefrontal cortex (dlPFC), cerebellum (CB), and posterior parietal cortex (PPC) as potential targets. rTMS might also be more effective if administered during behavioral tasks designed to activate posture-gait control networks during stimulation. Optimizing stimulation parameters such as dosage and frequency as used clinically for the treatment of depression may also be useful. A network-level perspective suggests new directions for exploring optimal rTMS targets and parameters to maximize neural plasticity to treat postural instabilities and gait difficulties in PwP.
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Affiliation(s)
- Rupsha Panda
- Department of Psychology, University of Michigan, Ann Arbor, MI, United States
| | - Joseph A Deluisi
- School of Kinesiology, University of Michigan, Ann Arbor, MI, United States
| | - Taraz G Lee
- Department of Psychology, University of Michigan, Ann Arbor, MI, United States
| | - Sheeba Davis
- School of Kinesiology, University of Michigan, Ann Arbor, MI, United States
| | | | - Roger L Albin
- Department of Neurology, University of Michigan, Ann Arbor, MI, United States
- Neurology Service & GRECC, VAAAHS, Ann Arbor, MI, United States
| | - Michael Vesia
- School of Kinesiology, University of Michigan, Ann Arbor, MI, United States
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Lonati C, Wellhausen M, Pennig S, Röhrßen T, Kircelli F, Arendt S, Tschulena U. The Use of a Novel Virtual Reality Training Tool for Peritoneal Dialysis: Qualitative Assessment Among Health Care Professionals. JMIR MEDICAL EDUCATION 2024; 10:e46220. [PMID: 39106093 PMCID: PMC11336508 DOI: 10.2196/46220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/05/2024] [Accepted: 03/11/2024] [Indexed: 08/07/2024]
Abstract
BACKGROUND Effective peritoneal dialysis (PD) training is essential for performing dialysis at home and reducing the risk of peritonitis and other PD-related infections. Virtual reality (VR) is an innovative learning tool that is able to combine theoretical information, interactivity, and behavioral instructions while offering a playful learning environment. To improve patient training for PD, Fresenius Medical Care launched the stay•safe MyTraining VR, a novel educational program based on the use of a VR headset and a handheld controller. OBJECTIVE This qualitative assessment aims to investigate opinions toward the new tool among the health care professionals (HCPs) who were responsible for implementing the VR application. METHODS We recruited nursing staff and nephrologists who have gained practical experience with the stay•safe MyTraining VR within pilot dialysis centers. Predetermined open-ended questions were administered during individual and group video interviews. RESULTS We interviewed 7 HCPs who have 2 to 20 years of experience in PD training. The number of patients trained with the stay•safe MyTraining VR ranged from 2 to 5 for each professional. The stay•safe MyTraining VR was well accepted and perceived as a valuable supplementary tool for PD training. From the respondents' perspective, the technology improved patients' learning experience by facilitating the internalization of both medical information and procedural skills. HCPs highlighted that the opportunity offered by VR to reiterate training activities in a positive and safe learning environment, according to each patient's needs, can facilitate error correction and implement a standardized training curriculum. However, VR had limited use in the final phase of the patient PD training program, where learners need to get familiar with the handling of the materials. Moreover, the traditional PD training was still considered essential to manage the emotional and motivational aspects and address any patient-specific application-oriented questions. In addition to its use within PD training, VR was perceived as a useful tool to support the decision-making process of patients and train other HCPs. Moreover, VR introduction was associated with increased efficiency and productivity of HCPs because it enabled them to perform other activities while the patient was practicing with the device. As for patients' acceptance of the new tool, interviewees reported positive feedback, including that of older adults. Limited use with patients experiencing dementia or severe visual impairment or lacking sensomotoric competence was mentioned. CONCLUSIONS The stay•safe MyTraining VR is suggested to improve training efficiency and efficacy and thus could have a positive impact in the PD training scenario. Our study offers a process proposal that can serve as a guide to the implementation of a VR-based PD training program within other dialysis centers. Dedicated research is needed to assess the operational benefits and the consequences on patient management.
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Affiliation(s)
- Caterina Lonati
- Center for Preclinical Research, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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8
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Antipova V, Siwetz M, Engelhardt M, Fellner FA, Manhal S, Niedermair JF, Ondruschka B, Pietras SM, Poilliot AJ, Pretterklieber ML, Wimmer-Röll M, Wree A, Hammer N. A comparison of 1- versus 3-month regional anatomy exposure on learning outcomes of undergraduate medical students. Clin Anat 2024. [PMID: 39101524 DOI: 10.1002/ca.24206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 07/02/2024] [Accepted: 07/16/2024] [Indexed: 08/06/2024]
Abstract
Regional anatomy teaching forms a cornerstone of undergraduate medical education. Owing to an increase in teaching and learning content throughout the medical curriculum in recent years, contact hours and overall course durations in anatomy are under review worldwide. This study aimed to assess whether shortening the course content duration impacts learning gain and the ability to identify anatomical structures correctly. Undergraduate medical students of the Johannes Kepler University Linz (JKU; n = 310) and at the Medical University of Graz (MUG; n = 156) participating in regional anatomy courses were included. Whole body regional anatomy courses, including hands-on dissection and accompanying lectures, were delivered over one or three months. Course content and examination mode were kept consistent, while the duration of knowledge delivery was one or three months, respectively. Objective structured practical examinations (OSPE) were then carried out on prosections for the neck, thorax, and abdomen. 3-month course exposure resulted in significantly higher OSPE scores for the neck (49 vs. 37%), thorax (65 vs. 54%), and abdomen (65 vs. 45%), respectively. Further evaluation of the utility of different embalming types yielded higher 3-month scores in the neck and thorax regions with Thiel-embalmed tissues and thorax and abdomen regions in ethanol-glycerin-embalmed tissues. Course exposure over a more extended period, like three months, appears to be highly beneficial.
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Affiliation(s)
- Veronica Antipova
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Martin Siwetz
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Maren Engelhardt
- Institute of Anatomy and Cell Biology, Johannes Kepler University, Linz, Austria
| | - Franz A Fellner
- Central Radiology Institute, Johannes Kepler University Hospital, Linz, Austria
- Division of Virtual Morphology, Institute of Anatomy and Cell Biology, Johannes Kepler University, Linz, Austria
| | - Simone Manhal
- Office of the Vice-Rector for Studies and Teaching, Medical University of Graz, Graz, Austria
| | - Julian F Niedermair
- Central Radiology Institute, Johannes Kepler University Hospital, Linz, Austria
- Division of Virtual Morphology, Institute of Anatomy and Cell Biology, Johannes Kepler University, Linz, Austria
| | - Benjamin Ondruschka
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sandra M Pietras
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | | | - Michael L Pretterklieber
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Monika Wimmer-Röll
- Institute of Anatomy and Cell Biology, Johannes Kepler University, Linz, Austria
| | - Andreas Wree
- Institute of Anatomy, Rostock University Medical Center, Rostock, Germany
| | - Niels Hammer
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
- Department of Orthopedic and Trauma Surgery, University of Leipzig, Leipzig, Germany
- Division of Biomechatronics, Fraunhofer Institute for Machine Tools and Forming Technology (IWU), Chemnitz and Dresden, Germany
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Dubinsky JM, Hamid AA. The neuroscience of active learning and direct instruction. Neurosci Biobehav Rev 2024; 163:105737. [PMID: 38796122 DOI: 10.1016/j.neubiorev.2024.105737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 05/13/2024] [Accepted: 05/20/2024] [Indexed: 05/28/2024]
Abstract
Throughout the educational system, students experiencing active learning pedagogy perform better and fail less than those taught through direct instruction. Can this be ascribed to differences in learning from a neuroscientific perspective? This review examines mechanistic, neuroscientific evidence that might explain differences in cognitive engagement contributing to learning outcomes between these instructional approaches. In classrooms, direct instruction comprehensively describes academic content, while active learning provides structured opportunities for learners to explore, apply, and manipulate content. Synaptic plasticity and its modulation by arousal or novelty are central to all learning and both approaches. As a form of social learning, direct instruction relies upon working memory. The reinforcement learning circuit, associated agency, curiosity, and peer-to-peer social interactions combine to enhance motivation, improve retention, and build higher-order-thinking skills in active learning environments. When working memory becomes overwhelmed, additionally engaging the reinforcement learning circuit improves retention, providing an explanation for the benefits of active learning. This analysis provides a mechanistic examination of how emerging neuroscience principles might inform pedagogical choices at all educational levels.
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Affiliation(s)
- Janet M Dubinsky
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, USA.
| | - Arif A Hamid
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, USA
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10
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Ang WHD, Shorey S, Zheng ZJ, Ng WHD, Chen ECW, Shah L, Chew HSJ, Lau Y. Evaluating the online Resilience Skills Enhancement programme among undergraduate students: A double-blind parallel randomized controlled trial. Stress Health 2024; 40:e3367. [PMID: 38180743 DOI: 10.1002/smi.3367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/12/2023] [Accepted: 12/10/2023] [Indexed: 01/06/2024]
Abstract
Resilience training has beneficial effects on the ability of undergraduate students to withstand adversity and stress. However, there are inconsistencies in the content and delivery approaches for resilience training. Given the increasing shifts towards computer-assisted instruction, there is a need to develop and evaluate innovative approaches for resilience training. This study aimed to examine the efficacy of two versions of the Resilience Skills Enhancement (RISE) programme. A randomized controlled trial was used to evaluate the effects of blended learning (BL) and a self-guided RISE programme on the resilience, social support, and learning outcomes of undergraduate students. One hundred and fourteen students were recruited and randomly allocated to receive either BL or the self-guided RISE programme. The within-group analyses indicated significant improvements in resilience scores for the BL (F = 37.74, p < 0.001) and self-guided groups (F = 10.16, p < 0.001) with moderate (d = 0.62, 95% CI: 0.25, 1.00) to large effect sizes (d = 1.11, 95% CI: 0.71, 1.50) respectively. There were also significant differences across the three time points for social support scores for the BL (F = 4.50, p < 0.05) and self-guided groups (F = 4.59, p < 0.05). Students in the BL group had considerable improvements in self-efficacy of learning and performance (F = 5.42, p < 0.01) and meta-cognitive self-regulation scores (F = 5.91, p < 0.01). In the between-group analyses, both BL and self-guided RISE were comparable for resilience, social support, and learning scores (p > 0.05). The study provided preliminary evidence that both modes, BL and self-guided RISE programme lead to positive effects on the resilience, social support, and learning scores of students.
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Affiliation(s)
- Wei How Darryl Ang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Zhongjia James Zheng
- Toa Payoh Polyclinic, National Healthcare Group Polyclinics, Singapore, Singapore
| | - Wai Hung Daniel Ng
- Department of Nursing, National Cancer Centre Singapore, Singapore Health Services, Singapore, Singapore
| | - Emmanuel Chih-Wei Chen
- Department of Nursing, Tan Tock Seng Hospital, National Healthcare Group, Singapore, Singapore
| | - Lubna Shah
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Han Shi Jocelyn Chew
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ying Lau
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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11
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Gall CM, Le AA, Lynch G. Contributions of site- and sex-specific LTPs to everyday memory. Philos Trans R Soc Lond B Biol Sci 2024; 379:20230223. [PMID: 38853551 PMCID: PMC11343211 DOI: 10.1098/rstb.2023.0223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/27/2024] [Accepted: 03/06/2024] [Indexed: 06/11/2024] Open
Abstract
Commentaries about long-term potentiation (LTP) generally proceed with an implicit assumption that largely the same physiological effect is sampled across different experiments. However, this is clearly not the case. We illustrate the point by comparing LTP in the CA3 projections to CA1 with the different forms of potentiation in the dentate gyrus. These studies lead to the hypothesis that specialized properties of CA1-LTP are adaptations for encoding unsupervised learning and episodic memory, whereas the dentate gyrus variants subserve learning that requires multiple trials and separation of overlapping bodies of information. Recent work has added sex as a second and somewhat surprising dimension along which LTP is also differentiated. Triggering events for CA1-LTP differ between the sexes and the adult induction threshold is significantly higher in females; these findings help explain why males have an advantage in spatial learning. Remarkably, the converse is true before puberty: Females have the lower LTP threshold and are better at spatial memory problems. A mechanism has been identified for the loss-of-function in females but not for the gain-of-function in males. We propose that the many and disparate demands of natural environments, with different processing requirements across ages and between sexes, led to the emergence of multiple LTPs. This article is part of a discussion meeting issue 'Long-term potentiation: 50 years on'.
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Affiliation(s)
- Christine M. Gall
- Department of Anatomy and Neurobiology, University of California at Irvine, Irvine, CA92697, USA
- Department of Neurobiology and Behavior, University of California at Irvine, Irvine, CA92697, USA
| | - Aliza A. Le
- Department of Anatomy and Neurobiology, University of California at Irvine, Irvine, CA92697, USA
| | - Gary Lynch
- Department of Anatomy and Neurobiology, University of California at Irvine, Irvine, CA92697, USA
- Department of Psychiatry and Human Behavior, University of California at Irvine, Irvine, CA92868, USA
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12
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Harris KM, Kuwajima M, Flores JC, Zito K. Synapse-specific structural plasticity that protects and refines local circuits during LTP and LTD. Philos Trans R Soc Lond B Biol Sci 2024; 379:20230224. [PMID: 38853547 DOI: 10.1098/rstb.2023.0224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/05/2024] [Indexed: 06/11/2024] Open
Abstract
Synapses form trillions of connections in the brain. Long-term potentiation (LTP) and long-term depression (LTD) are cellular mechanisms vital for learning that modify the strength and structure of synapses. Three-dimensional reconstruction from serial section electron microscopy reveals three distinct pre- to post-synaptic arrangements: strong active zones (AZs) with tightly docked vesicles, weak AZs with loose or non-docked vesicles, and nascent zones (NZs) with a postsynaptic density but no presynaptic vesicles. Importantly, LTP can be temporarily saturated preventing further increases in synaptic strength. At the onset of LTP, vesicles are recruited to NZs, converting them to AZs. During recovery of LTP from saturation (1-4 h), new NZs form, especially on spines where AZs are most enlarged by LTP. Sentinel spines contain smooth endoplasmic reticulum (SER), have the largest synapses and form clusters with smaller spines lacking SER after LTP recovers. We propose a model whereby NZ plasticity provides synapse-specific AZ expansion during LTP and loss of weak AZs that drive synapse shrinkage during LTD. Spine clusters become functionally engaged during LTP or disassembled during LTD. Saturation of LTP or LTD probably acts to protect recently formed memories from ongoing plasticity and may account for the advantage of spaced over massed learning. This article is part of a discussion meeting issue 'Long-term potentiation: 50 years on'.
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Affiliation(s)
- Kristen M Harris
- Department of Neuroscience and Center for Learning and Memory, The University of Texas at Austin , Austin, TX 78712, USA
| | - Masaaki Kuwajima
- Department of Neuroscience and Center for Learning and Memory, The University of Texas at Austin , Austin, TX 78712, USA
| | - Juan C Flores
- Center for Neuroscience, University of California , Davis, CA 95618, USA
| | - Karen Zito
- Center for Neuroscience, University of California , Davis, CA 95618, USA
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13
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Tanaka C, Taniuchi T. Rats show up to 72 h of significant retention for spatial memory in the radial maze. Learn Behav 2024:10.3758/s13420-024-00633-4. [PMID: 39048834 DOI: 10.3758/s13420-024-00633-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2024] [Indexed: 07/27/2024]
Abstract
This study explored long-term retention of spatial memory in rats using an eight-arm radial maze. Crystal and Babb (Learning and motivation, 39(4), 278-284, 2008) previously demonstrated that rats could retain spatial memory for up to 25 h in the radial maze. Notably, they found performance improved with 48-h intertrial intervals compared with 24-h intervals. Our study investigated the effects of extending intertrial intervals on long-term retention of spatial memory by reducing the potential for proactive interference. Each trial comprised a learning phase, during which subjects were required to sequentially visit four randomly selected arms, followed by a free-choice test that included all eight arms, conducted after increasing the retention and intertrial intervals. The retention intervals were systematically increased from 1 h to 24, 48, and, ultimately, 72 h, with corresponding intertrial intervals expanding from 24 to 48, 120, and 144 h. Performance significantly surpassed chance levels across all conditions, demonstrating that rats are capable of retaining spatial memory for up to 72 h.
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Affiliation(s)
- Chiaki Tanaka
- Graduate School of Socio-Environmental Studies, Kanazawa University, Kakuma, Kanazawa, Ishikawa, 920-1192, Japan
| | - Tohru Taniuchi
- Graduate School of Socio-Environmental Studies, Kanazawa University, Kakuma, Kanazawa, Ishikawa, 920-1192, Japan.
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14
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Huang C, Luo J, Woo SJ, Roitman LA, Li J, Pieribone VA, Kannan M, Vasan G, Schnitzer MJ. Dopamine-mediated interactions between short- and long-term memory dynamics. Nature 2024:10.1038/s41586-024-07819-w. [PMID: 39038490 DOI: 10.1038/s41586-024-07819-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 07/11/2024] [Indexed: 07/24/2024]
Abstract
In dynamic environments, animals make behavioural decisions on the basis of the innate valences of sensory cues and information learnt about these cues across multiple timescales1-3. However, it remains unclear how the innate valence of a sensory stimulus affects the acquisition of learnt valence information and subsequent memory dynamics. Here we show that in the Drosophila brain, interconnected short- and long-term memory units of the mushroom body jointly regulate memory through dopamine signals that encode innate and learnt sensory valences. By performing time-lapse in vivo voltage-imaging studies of neural spiking in more than 500 flies undergoing olfactory associative conditioning, we found that protocerebral posterior lateral 1 dopamine neurons (PPL1-DANs)4 heterogeneously and bidirectionally encode innate and learnt valences of punishment, reward and odour cues. During learning, these valence signals regulate memory storage and extinction in mushroom body output neurons (MBONs)5. During initial conditioning bouts, PPL1-γ1pedc and PPL1-γ2α'1 neurons control short-term memory formation, which weakens inhibitory feedback from MBON-γ1pedc>α/β to PPL1-α'2α2 and PPL1-α3. During further conditioning, this diminished feedback allows these two PPL1-DANs to encode the net innate plus learnt valence of the conditioned odour cue, which gates long-term memory formation. A computational model constrained by the fly connectome6,7 and our spiking data explains how dopamine signals mediate the circuit interactions between short- and long-term memory traces, yielding predictions that our experiments confirmed. Overall, the mushroom body achieves flexible learning through the integration of innate and learnt valences in parallel learning units sharing feedback interconnections. This hybrid physiological-anatomical mechanism may be a general means by which dopamine regulates memory dynamics in other species and brain structures, including the vertebrate basal ganglia.
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Affiliation(s)
- Cheng Huang
- James Clark Center, Stanford University, Stanford, CA, USA.
- Department of Biology, Stanford University, Stanford, CA, USA.
- Dept. of Neuroscience, Washington University School of Medicine, St. Louis, MO, USA.
| | - Junjie Luo
- James Clark Center, Stanford University, Stanford, CA, USA
- Howard Hughes Medical Institute, Stanford University, Stanford, CA, USA
| | - Seung Je Woo
- James Clark Center, Stanford University, Stanford, CA, USA
| | | | - Jizhou Li
- Howard Hughes Medical Institute, Stanford University, Stanford, CA, USA
- CNC Program, Stanford University, Stanford, CA, USA
- Department of Electronic Engineering, The Chinese University of Hong Kong, Hong Kong, China
| | - Vincent A Pieribone
- The John B. Pierce Laboratory, New Haven, CT, USA
- Department of Cellular & Molecular Physiology, Yale University, New Haven, CT, USA
| | - Madhuvanthi Kannan
- The John B. Pierce Laboratory, New Haven, CT, USA.
- Department of Cellular & Molecular Physiology, Yale University, New Haven, CT, USA.
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, USA.
| | - Ganesh Vasan
- The John B. Pierce Laboratory, New Haven, CT, USA.
- Department of Cellular & Molecular Physiology, Yale University, New Haven, CT, USA.
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, USA.
| | - Mark J Schnitzer
- James Clark Center, Stanford University, Stanford, CA, USA.
- Department of Biology, Stanford University, Stanford, CA, USA.
- Howard Hughes Medical Institute, Stanford University, Stanford, CA, USA.
- CNC Program, Stanford University, Stanford, CA, USA.
- Department of Applied Physics, Stanford University, Stanford, CA, USA.
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15
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Zhang Y, Peng Z, Tang N, Zhang Y, Liu N, Lv R, Meng Y, Cai M, Wang H. Efficacy of MRI-guided rTMS for post-traumatic stress disorder by modulating amygdala activity: study protocol for a randomised controlled trial. BMJ Open 2024; 14:e081751. [PMID: 38960463 PMCID: PMC11227799 DOI: 10.1136/bmjopen-2023-081751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 06/17/2024] [Indexed: 07/05/2024] Open
Abstract
INTRODUCTION Post-traumatic stress disorder (PTSD) is a prevalent and severe psychiatric disorder. Repetitive transcranial magnetic stimulation (rTMS) targeting the dorsolateral prefrontal cortex provides limited relief for symptoms of PTSD. This study will be conducted to validate the efficacy of MRI-guided rTMS in targeting the sites most closely associated with the amygdala for patients with PTSD. We hypothesise that the intervention will improve clinical symptoms by decreasing amygdala activity in patients. METHODS AND ANALYSIS A randomised, double-blind, sham-controlled trial will be conducted. Forty-eight eligible patients with PTSD will be randomly assigned to receive either active or sham MRI-guided rTMS for 10 consecutive days after the initial MRI scans. MRI scans will be recollected at the end of the intervention. Clinical assessments will be performed at baseline, treatment day 5, treatment day 10, and 2 weeks, 4 weeks, 8 weeks after completion of the intervention to monitor changes in clinical symptoms. The primary assessment outcome is the change in PTSD symptoms between baseline and treatment day 10, as measured by the PTSD Checklist for DSM-5. Repeated measures analysis of variance will be performed using statistical software SPSS V.26.0. The significance level will be set at 0.05. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Ethics Committee of Xijing Hospital in Xi'an, China (KY20222176-X-1), and the trial has been registered on ClinicalTrials.gov. The findings of this trial will be disseminated at academic conferences or published in peer-reviewed scientific journals. TRIAL REGISTRATION NUMBER NCT05544110.
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Affiliation(s)
- Yaochi Zhang
- Department of Psychiatry, Xijing Hospital of Air Force Military Medical University, Xian, Shaanxi, China
| | - Zhengwu Peng
- Department of Psychiatry, Xijing Hospital of Air Force Military Medical University, Xian, Shaanxi, China
| | - Nailong Tang
- Department of Psychiatry, Xijing Hospital of Air Force Military Medical University, Xian, Shaanxi, China
| | - Yuyu Zhang
- Department of Psychiatry, Xijing Hospital of Air Force Military Medical University, Xian, Shaanxi, China
| | - Nian Liu
- Department of Psychiatry, Xijing Hospital of Air Force Military Medical University, Xian, Shaanxi, China
| | - Runxin Lv
- Department of Psychiatry, Xijing Hospital of Air Force Military Medical University, Xian, Shaanxi, China
| | - Yumeng Meng
- Department of Psychiatry, Xijing Hospital of Air Force Military Medical University, Xian, Shaanxi, China
| | - Min Cai
- Department of Psychiatry, Xijing Hospital of Air Force Military Medical University, Xian, Shaanxi, China
| | - Huaning Wang
- Department of Psychiatry, Xijing Hospital of Air Force Military Medical University, Xian, Shaanxi, China
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16
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Cross L, Banham D, Melendez-Torres GJ, Ford T, van Sluijs E, Liabo K. Developing inclusive public involvement and engagement activities with secondary school students and educational professionals: a protocol. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:68. [PMID: 38951878 PMCID: PMC11218269 DOI: 10.1186/s40900-024-00581-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 05/01/2024] [Indexed: 07/03/2024]
Abstract
BACKGROUND Public involvement and engagement (PI&E) is increasingly recognised as an important component of research. It can offer valuable insights from those with experiential knowledge to improve research quality, relevance, and reach. Similarly, schools are ever more common sites for health research and, more recently, PI&E. However, 'gold-standard' practice is yet to be established, and activities/approaches remain underreported. As a result, knowledge can remain localised or lost. Diversity and inclusion also remains a challenge. METHODS This protocol has been informed by UK national guidance, evidence-based frameworks and available implementation literature. It describes both rationale and approach to conducting PI&E activities within a secondary school context. Activities are designed to be engaging, safe and accessible to young people with diverse experiences, with scope to be iteratively developed in line with public collaborator preference. DISCUSSION Young people should be architects of their involvement and engagement. Ongoing appraisal and transparency of approaches to PI&E in school settings is crucial. Expected challenges of implementing this protocol include facilitating a safe space for the discussion of sensitive topics, absence and attrition, recruiting students with a diverse range of experiences, and potential knowledge and capacity barriers of both facilitator and contributors. Activities to mitigate these risks are suggested and explored.
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Affiliation(s)
- Lauren Cross
- University of Cambridge (MRC Epidemiology Unit), Cambridge, UK.
| | | | | | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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17
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Sreejan A, Saxena P, Gadgil CJ. Network motifs exhibiting a differential response to spaced and massed inputs. Learn Mem 2024; 31:a054012. [PMID: 39074905 PMCID: PMC11369633 DOI: 10.1101/lm.054012.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 06/18/2024] [Indexed: 07/31/2024]
Abstract
One characteristic of long-term memory is the existence of an inverted U-shaped response to increasing intervals between training sessions, and consequently, an optimal spacing that maximizes memory formation. Current models of this spacing effect focus on specific molecular components and their interactions. Here, we computationally study the underlying network architecture, in particular, the potential of motif dynamics in qualitatively capturing the spacing effect in a manner that is independent of the animal model, biomolecular components, and the timescales involved. We define a common training and test protocol, and computationally identify network topologies that can qualitatively replicate the experimentally observed characteristics of the spacing effect. For 41 motifs derived from fundamental network architectures such as autoregulation, feedback, and feedforward motifs, we tested their capacity to manifest the spacing effect in terms of an inverted U-shaped response curve, using different combinations of stimulation protocols, response metrics, and kinetic parameters. Our findings indicate that positive feedback motifs where the stimulus enhances conversion reaction in the loop replicate the spacing effect across all response metrics, while feedforward motifs exhibit a metric-specific spacing effect. For some parameter combinations, linear cascades of activation and conversion reactions were found sufficient to qualitatively exhibit spacing effect characteristics.
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Affiliation(s)
- Ashley Sreejan
- Chemical Engineering and Process Development Division, CSIR-National Chemical Laboratory, Pune 411008, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Priyanka Saxena
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
- CSIR-Institute of Genomics and Integrative Biology, New Delhi 110025, India
| | - Chetan J Gadgil
- Chemical Engineering and Process Development Division, CSIR-National Chemical Laboratory, Pune 411008, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
- CSIR-Institute of Genomics and Integrative Biology, New Delhi 110025, India
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18
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Zhou J, Hou J, Li S, Zhang J. The effect of duration between sessions on microperimetric biofeedback training in patients with maculopathies. Sci Rep 2024; 14:12524. [PMID: 38822030 PMCID: PMC11143284 DOI: 10.1038/s41598-024-63327-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 05/28/2024] [Indexed: 06/02/2024] Open
Abstract
Aim of this study was to explore the optimal training interval and times of microperimetric biofeedback training (MBFT) in maculopathies. Twenty-nine patients with maculopathies were divided into two groups: daily training (Group A) or alternate daily training (Group B). Both groups underwent 15 MBFT sessions. We compared the BCVA, reading speed, and fixation stability at baseline, after 5, 10, 15 sessions. After 15 sessions of MBFT, all visual parameters in both groups improved. There was a significant increase in BCVA after 5 sessions in both groups (P=0.016, and P<0.001 respectively), but Group A showed further improvement after 10 sessions (P<0.001). Regarding reading speed, Group A showed significant improvement from baseline after 15 sessions(P=0.020), Group B improved significantly after 5 sessions (P=0.047) and continued to improve after 10 sessions (P=0.030). Additionally, P1 and LgBCEA of Group A significantly improved after 10 sessions (P=0.001, and P=0.001 respectively), while Group B significantly improved after 5 sessions (P=0.002, and P<0.001 respectively). There was no significant difference in visual outcomes between the two groups (P>0.05) except LgBCEA (P=0.046) after 15 sessions. We concluded that the both MBFT frequencies are effective at improving vision and quality of life in patients with maculopathies. The alternate daily training group showed less time-dependent of improvement in all parameters and a greater benefit in fixation stability. Ten sessions are the optimal number of treatment sessions for alternate daily training.
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Affiliation(s)
- Jie Zhou
- Aier School of Ophthalmology, Central South University, Changsha, 410000, Hunan, China
- Guangzhou Aier Eye Hospital, Jinan University, Guangzhou, 510040, Guangdong, China
| | - Jintong Hou
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA
| | - Shengnan Li
- Aier School of Ophthalmology, Central South University, Changsha, 410000, Hunan, China
- Sichuan Eye Hospital, Aier Eye Hospital Group, Chengdu, 610047, Sichuan, China
| | - Jinglin Zhang
- Aier School of Ophthalmology, Central South University, Changsha, 410000, Hunan, China.
- Guangzhou Aier Eye Hospital, Jinan University, Guangzhou, 510040, Guangdong, China.
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19
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Flores JC, Zito K. A synapse-specific refractory period for plasticity at individual dendritic spines. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.05.24.595787. [PMID: 38826343 PMCID: PMC11142223 DOI: 10.1101/2024.05.24.595787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
How newly formed memories are preserved while brain plasticity is ongoing has been a source of debate. One idea is that synapses which experienced recent plasticity become resistant to further plasticity, a type of metaplasticity often referred to as saturation. Here, we probe the local dendritic mechanisms that limit plasticity at recently potentiated synapses. We show that recently potentiated individual synapses exhibit a synapse-specific refractory period for further potentiation. We further found that the refractory period is associated with reduced postsynaptic CaMKII signaling; however, stronger synaptic activation only partially restored the ability for further plasticity. Importantly, the refractory period is released after one hour, a timing that coincides with the enrichment of several postsynaptic proteins to pre-plasticity levels. Notably, increasing the level of the postsynaptic scaffolding protein, PSD95, but not of PSD93, overcomes the refractory period. Our results support a model in which potentiation at a single synapse is sufficient to initiate a synapse-specific refractory period that persists until key postsynaptic proteins regain their steady-state synaptic levels.
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Affiliation(s)
- Juan C. Flores
- Center for Neuroscience, University of California, Davis, CA 95618
| | - Karen Zito
- Center for Neuroscience, University of California, Davis, CA 95618
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20
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Zou F, Kuhl BA, DuBrow S, Hutchinson JB. Benefits of spaced learning are predicted by re-encoding of past experience in ventromedial prefrontal cortex. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.05.14.594263. [PMID: 38798652 PMCID: PMC11118271 DOI: 10.1101/2024.05.14.594263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
More than a century of research shows that spaced learning improves long-term memory. Yet, there remains debate concerning why. A major limitation to resolving theoretical debates is the lack of evidence for how neural representations change as a function of spacing. Here, leveraging a massive-scale 7T human fMRI dataset, we tracked neural representations and behavioral expressions of memory as participants viewed thousands of natural scene images that repeated at lags ranging from seconds to many months. We show that spaced learning increases the similarity of human ventromedial prefrontal cortex representations across stimulus encounters and, critically, these increases parallel and predict the behavioral benefits of spacing. Additionally, we show that these spacing benefits critically depend on remembering and, in turn, 're-encoding' past experience. Collectively, our findings provide fundamental insight into how spaced learning influences neural representations and why spacing is beneficial.
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Affiliation(s)
- Futing Zou
- Department of Psychology, University of Oregon, Eugene, OR, USA
| | - Brice A. Kuhl
- Department of Psychology, University of Oregon, Eugene, OR, USA
- Institute of Neuroscience, University of Oregon, Eugene, OR, USA
| | - Sarah DuBrow
- Department of Psychology, University of Oregon, Eugene, OR, USA
- Institute of Neuroscience, University of Oregon, Eugene, OR, USA
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21
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Zimmermann E, Tomczyk S. Fostering Digital Life Skills Through Social Media With Adolescents in 6 German States: Protocol for an Accessibility Study According to the RE-AIM Framework. JMIR Res Protoc 2024; 13:e51085. [PMID: 38631035 PMCID: PMC11063895 DOI: 10.2196/51085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 01/23/2024] [Accepted: 02/22/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Social media is essential in the lives of adolescents, with 97% of US teenagers engaging daily. While it facilitates communication, learning, and identity development, it also poses risks like harmful content exposure and psychological distress, particularly for adolescents in their critical developmental stage. Teaching digital life skills innovatively counters these risks, adapting traditional competencies such as decision-making, problem-solving, creative and critical thinking, communication, interpersonal skills, self-awareness, empathy, and emotional and stress management to digital challenges. OBJECTIVE This study evaluates the accessibility of the "leduin" program, a novel intervention designed to impart digital life skills through Instagram. The program aims to leverage social media's educational potential, focusing on effective strategies to engage adolescents. Emphasizing accessibility is crucial, as it determines the program's overall impact. METHODS The leduin program, developed through intervention mapping, applies behavior change techniques via social media for 9th and 10th graders. It is a 14-week spaced learning curriculum with daily sessions <5 minutes. Emphasizing the "reach" aspect of the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) model, the recruitment targets diverse educational settings across 6 German states, aiming for inclusivity. Recruitment will involve schools, youth centers, and therapeutic facilities. The study seeks at least 128 participants, a calculated minimum to detect medium-sized effects in the quasi-experimental design and explore varying engagement levels and program responses. Data collection includes preintervention, postintervention, and 6-month follow-up surveys, using multilevel regression, latent growth models, and qualitative analysis to extensively assess reach and gain first insights on effectiveness, acceptance, implementation, and maintenance. The study aims to reveal key factors influencing program participation and interaction; a detailed analysis of engagement patterns will reveal the effectiveness of the recruitment strategies and barriers to participation. Additionally, initial indications of the program's impact on life skills, social media-related skills, health status, risk behaviors, and academic performance will be analyzed. RESULTS Recruitment was planned from May 2023 until the beginning of the leduin program in October 2023. As of March 2024, we have recruited 283 participants. CONCLUSIONS The leduin program stands as an innovative and essential initiative in adolescent health promotion, harnessing the power of social media to teach important digital life skills. This study highlights the critical role of accessibility in the success of social media interventions. Effective adolescent engagement strategies are imperative, as they dictate the overall impact of such interventions. The insights gained from this study will be instrumental in shaping future programs, laying groundwork for a subsequent, more comprehensive cluster-randomized controlled trial. The study's design acknowledges the limitations of the current quasi-experimental approach, including the anticipated sample size and the absence of a control group, and aims to provide a foundational understanding for future research in this field. TRIAL REGISTRATION Deutsches Register Klinischer Studien DRKS00032308; https://drks.de/search/de/trial/DRKS00032308. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/51085.
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Affiliation(s)
- Elizabeth Zimmermann
- Institute for Health Psychology, Department of Psychology, University of Greifswald, Greifswald, Germany
| | - Samuel Tomczyk
- Institute for Health Psychology, Department of Psychology, University of Greifswald, Greifswald, Germany
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22
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Karandish M, Karimian Z, Parastar M. Dental students in an orthodontic course flipped classroom: A semi-experimental study on knowledge, practice, attitude, and satisfaction. Clin Exp Dent Res 2024; 10:e868. [PMID: 38433300 PMCID: PMC10909801 DOI: 10.1002/cre2.868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/31/2024] [Accepted: 02/17/2024] [Indexed: 03/05/2024] Open
Abstract
OBJECTIVE The purpose of this study was to determine the students' attitudes before and after the flipped classroom, and the effectiveness of this method to promote the students' lateral cephalograms tracing abilities, students' satisfaction and their final exam scores. MATERIALS AND METHODS This is a single-group quasi-experimental research conducted on dental students of Shiraz University of Medical Sciences (SUMS), Iran in 2019. The intervention was carried out in a blended learning approach with the flipped classroom model. Thirty-five fourth-year dental students participated in a flipped classroom held during a semester for the lateral cephalograms tracing course. The students were provided with the educational materials before the class time through multimedia learning tools and the class time was devoted to discussions. The students were asked to fill out four questionnaires (pretest/posttest attitudes, pretest/posttest self-assessments of theoretical knowledge and practical skills in cephalograms, posttest of satisfaction from quality of the course, and posttest of students' views about effectiveness of blended learning tools) and final exam scores of students. RESULTS Students' attitudes toward e-Learning were improved after the flipped classroom and the quality of this method was acceptable to the students (p < .001). Their self-assessment of theoretical knowledge and practical skills were promoted (p < .001). While all blended learning tools averaged more than the cut-off-point, short lecture (5.11 ± 0.98) and live feedback (4.98 ± 1.07) were considered to be the most efficient interactive tools. CONCLUSION It seems that the flipped classroom has a positive effect on increasing students' knowledge, attitude, and satisfaction. In general, this method of learning seems to be favored by dental students. CLINICAL SIGNIFICANCE The findings showed that blended learning had a positive effect on increasing knowledge, performance, and satisfaction among dental students. Therefore, blended learning as a reliable method might be used in training dental students.
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Affiliation(s)
- Maryam Karandish
- Department of Orthodontics, School of DentistryShiraz University of Medical SciencesShirazIran
| | - Zahra Karimian
- Department of e‐Learning in Medical Sciences, Virtual School and Center of Excellence in e‐LearningShiraz University of Medical SciencesShirazIran
| | - Mina Parastar
- Student Research Center, Dental SchoolShiraz University of Medical SciencesShirazIran
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23
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Cole E, O'Sullivan SJ, Tik M, Williams NR. Accelerated Theta Burst Stimulation: Safety, Efficacy, and Future Advancements. Biol Psychiatry 2024; 95:523-535. [PMID: 38383091 PMCID: PMC10952126 DOI: 10.1016/j.biopsych.2023.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 12/05/2023] [Accepted: 12/08/2023] [Indexed: 02/23/2024]
Abstract
Theta burst stimulation (TBS) is a noninvasive brain stimulation technique that can be used to modulate neural networks underlying psychiatric and neurological disorders. TBS can be delivered intermittently or continuously. The conventional intermittent TBS protocol is approved by the U.S. Food and Drug Administration to treat otherwise treatment-resistant depression, but the 6-week duration limits the applicability of this therapy. Accelerated TBS protocols present an opportunity to deliver higher pulse doses in shorter periods of time, thus resulting in faster and potentially more clinically effective treatment. However, the acceleration of TBS delivery raises questions regarding the relative safety, efficacy, and durability compared with conventional TBS protocols. In this review paper, we present the data from accelerated TBS trials to date that support the safety and effectiveness of accelerated protocols while acknowledging the need for more durability data. We discuss the stimulation parameters that seem to be important for the efficacy of accelerated TBS protocols and possible avenues for further optimization.
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Affiliation(s)
- Eleanor Cole
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California
| | - Sean J O'Sullivan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California; Department of Psychiatry and Behavioral Sciences, Dell School of Medicine, Austin, Texas
| | - Martin Tik
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California; Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Nolan R Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California.
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24
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Lin H, Liang J, Wang Q, Shao Y, Song P, Li S, Bai Y. Effects of accelerated intermittent theta-burst stimulation in modulating brain of Alzheimer's disease. Cereb Cortex 2024; 34:bhae106. [PMID: 38517175 DOI: 10.1093/cercor/bhae106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/27/2024] [Accepted: 02/16/2024] [Indexed: 03/23/2024] Open
Abstract
Intermittent theta-burst stimulation (iTBS) is emerging as a noninvasive therapeutic strategy for Alzheimer's disease (AD). Recent advances highlighted a new accelerated iTBS (aiTBS) protocol, consisting of multiple sessions per day and higher overall pulse doses, in brain modulation. To examine the possibility of applying the aiTBS in treating AD patients, we enrolled 45 patients in AD at early clinical stages, and they were randomly assigned to either receive real or sham aiTBS. Neuropsychological scores were evaluated before and after treatment. Moreover, we detected cortical excitability and oscillatory activity changes in AD, by the single-pulse TMS in combination with EEG (TMS-EEG). Real stimulation showed markedly better performances in the group average of Auditory Verbal Learning Test scores compared to baseline. TMS-EEG revealed that aiTBS has reinforced this memory-related cortical mechanism by increasing cortical excitability and beta oscillatory activity underlying TMS target. We also found an enhancement of local natural frequency after aiTBS treatment. The novel findings implicated that high-dose aiTBS targeting left DLPFC is rapid-acting, safe, and tolerable in AD patients. Furthermore, TMS-related increase of specific neural oscillation elucidates the mechanisms of the AD cognitive impairment ameliorated by aiTBS.
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Affiliation(s)
- Hua Lin
- Department of Neurology, Xuanwu Hospital, Capital Medical University, 45th, Changchun Street, Beijing 100053, China
| | - Junhua Liang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, 45th, Changchun Street, Beijing 100053, China
| | - Qianqian Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, 45th, Changchun Street, Beijing 100053, China
| | - Yuxuan Shao
- Department of Neurology, Xuanwu Hospital, Capital Medical University, 45th, Changchun Street, Beijing 100053, China
| | - Penghui Song
- Department of Neurology, Xuanwu Hospital, Capital Medical University, 45th, Changchun Street, Beijing 100053, China
| | - Siran Li
- Department of Neurology, Xuanwu Hospital, Capital Medical University, 45th, Changchun Street, Beijing 100053, China
| | - Yang Bai
- Affiliated Rehabilitation Hospital, Jiangxi Medical College, Nanchang University, 133th, south road of square Street, Nanchang 330006, Jiangxi, China
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Xu DM, Zhang ZJ, Guo HK, Chen GJ, Ma YL. ERRα regulates synaptic transmission through reactive oxygen species in hippocampal neurons. Heliyon 2024; 10:e23739. [PMID: 38192817 PMCID: PMC10772171 DOI: 10.1016/j.heliyon.2023.e23739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 11/23/2023] [Accepted: 12/12/2023] [Indexed: 01/10/2024] Open
Abstract
Reactive oxygen species (ROS) play multiple roles in synaptic transmission, and estrogen-related receptor α (ERRα) is involved in regulating ROS production. The purpose of our study was to explore the underlying effect of ERRα on ROS production, neurite formation and synaptic transmission. Our results revealed that knocking down ERRα expression affected the formation of neuronal neurites and dendritic spines, which are the basic structures of synaptic transmission and play important roles in learning, memory and neuronal plasticity; moreover, the amplitude and frequency of miniature excitatory postsynaptic currents (mEPSCs) and miniature inhibitory postsynaptic currents (mIPSCs) were decreased. These abnormalities were reversed by overexpression of human ERRα. Additionally, we also found that knocking down ERRα expression increased intracellular ROS levels in neurons. ROS inhibitor PBN rescued the changes in neurite formation and synaptic transmission induced by ERRα knockdown. These results indicate a new possible cellular mechanism by which ERRα affects intracellular ROS levels, which in turn regulate neurite and dendritic spine formation and synaptic transmission.
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Affiliation(s)
- De-Mei Xu
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Neurology, 1 Youyi Road, Chongqing 400016, China
| | - Zhi-Juan Zhang
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Neurology, 1 Youyi Road, Chongqing 400016, China
| | - Hao-Kun Guo
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Neurology, 1 Youyi Road, Chongqing 400016, China
| | - Guo-Jun Chen
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Neurology, 1 Youyi Road, Chongqing 400016, China
| | - Yuan-Lin Ma
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Neurology, 1 Youyi Road, Chongqing 400016, China
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Goodman MS, Vila-Rodriguez F, Barwick M, Burke MJ, Downar J, Hunter J, Kaster TS, Knyahnytska Y, Kurdyak P, Maunder R, Thorpe K, Trevizol AP, Voineskos D, Zhang W, Blumberger DM. A randomized sham-controlled trial of high-dosage accelerated intermittent theta burst rTMS in major depression: study protocol. BMC Psychiatry 2024; 24:28. [PMID: 38191370 PMCID: PMC10773082 DOI: 10.1186/s12888-023-05470-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/19/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Intermittent theta burst stimulation (iTBS), a novel form of repetitive transcranial magnetic stimulation (rTMS), can be administered in 1/10th of the time of standard rTMS (~ 3 min vs. 37.5 min) yet achieves similar outcomes in depression. The brief nature of the iTBS protocol allows for the administration of multiple iTBS sessions per day, thus reducing the overall course length to days rather than weeks. This study aims to compare the efficacy and tolerability of active versus sham iTBS using an accelerated regimen in patients with treatment-resistant depression (TRD). As a secondary objective, we aim to assess the safety, tolerability, and treatment response to open-label low-frequency right-sided (1 Hz) stimulation using an accelerated regimen in those who do not respond to the initial week of treatment. METHODS Over three years, approximately 230 outpatients at the Centre for Addiction and Mental Health and University of British Columbia Hospital, meeting diagnostic criteria for unipolar MDD, will be recruited and randomized to a triple blind sham-controlled trial. Patients will receive five consecutive days of active or sham iTBS, administered eight times daily at 1-hour intervals, with each session delivering 600 pulses of iTBS. Those who have not achieved response by the week four follow-up visit will be offered a second course of treatment, regardless of whether they initially received active or sham stimulation. DISCUSSION Broader implementation of conventional iTBS is limited by the logistical demands of the current standard course consisting of 4-6 weeks of daily treatment. If our proposed accelerated iTBS protocol enables patients to achieve remission more rapidly, this would offer major benefits in terms of cost and capacity as well as the time required to achieve clinical response. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04255784.
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Affiliation(s)
- Michelle S Goodman
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Fidel Vila-Rodriguez
- Non-Invasive Neurostimulation Therapies Laboratory, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Melanie Barwick
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- The Hospital for Sick Children, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Matthew J Burke
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Jonathan Downar
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Jonathan Hunter
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Mount Sinai Hospital, Toronto, ON, Canada
| | - Tyler S Kaster
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Yuliya Knyahnytska
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Paul Kurdyak
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
| | - Robert Maunder
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Mount Sinai Hospital, Toronto, ON, Canada
| | - Kevin Thorpe
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Applied Health Research Centre, St. Michael's Hospital, Toronto, ON, Canada
| | - Alisson P Trevizol
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Daphne Voineskos
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Wei Zhang
- Centre for Advancing Health Outcomes, St Paul's Hospital, Vancouver, BC, Canada
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Daniel M Blumberger
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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27
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Zhang XO, Zhang Y, Cho CE, Engelke DS, Smolen P, Byrne JH, Do-Monte FH. Enhancing Associative Learning in Rats With a Computationally Designed Training Protocol. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:165-181. [PMID: 38298784 PMCID: PMC10829654 DOI: 10.1016/j.bpsgos.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 06/30/2023] [Accepted: 07/20/2023] [Indexed: 02/02/2024] Open
Abstract
Background Learning requires the activation of protein kinases with distinct temporal dynamics. In Aplysia, nonassociative learning can be enhanced by a computationally designed learning protocol with intertrial intervals (ITIs) that maximize the interaction between fast-activated PKA (protein kinase A) and slow-activated ERK (extracellular signal-regulated kinase). Whether a similar strategy can enhance associative learning in mammals is unknown. Methods We simulated 1000 training protocols with varying ITIs to predict an optimal protocol based on empirical data for PKA and ERK dynamics in rat hippocampus. Adult male rats received the optimal protocol or control protocols in auditory fear conditioning and fear extinction experiments. Immunohistochemistry was performed to evaluate pCREB (phosphorylated cAMP response element binding)\protein levels in brain regions that have been implicated in fear acquisition. Results Rats exposed to the optimal conditioning protocol with irregular ITIs exhibited impaired extinction memory acquisition within the session using a standard footshock intensity, and stronger fear memory retrieval and spontaneous recovery with a weaker footshock intensity, compared with rats that received massed or spaced conditioning protocols with fixed ITIs. Rats exposed to the optimal extinction protocol displayed improved extinction of contextual fear memory and reduced spontaneous recovery compared with rats that received standard extinction protocols. Moreover, the optimal conditioning protocol increased pCREB levels in the dentate gyrus of the dorsal hippocampus, suggesting enhanced induction of long-term potentiation. Conclusions These findings demonstrate that a computational model-driven behavioral intervention can enhance associative learning in mammals and may provide insight into strategies to improve cognition in humans.
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Affiliation(s)
- Xu O. Zhang
- Department of Neurobiology and Anatomy, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Yili Zhang
- Department of Neurobiology and Anatomy, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Claire E. Cho
- Department of Neurobiology and Anatomy, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Douglas S. Engelke
- Department of Neurobiology and Anatomy, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Paul Smolen
- Department of Neurobiology and Anatomy, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas
| | - John H. Byrne
- Department of Neurobiology and Anatomy, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Fabricio H. Do-Monte
- Department of Neurobiology and Anatomy, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas
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Majeed GM, Islam J, Nandakumar G, Phoong K. Progress Testing in UK Medical Education: Evaluating Its Impact and Potential. Cureus 2024; 16:e52607. [PMID: 38249657 PMCID: PMC10800161 DOI: 10.7759/cureus.52607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2024] [Indexed: 01/23/2024] Open
Abstract
This comprehensive review critically examines the UK medical curriculum, with a particular focus on progress testing as an innovative assessment strategy. The curriculum, evolving from foundational sciences to practical applications, is encapsulated in the integrated curriculum model (ICM). This model adeptly combines theoretical knowledge with clinical practice, fostering cognitive, affective, and psychomotor skills among medical students. Central to this review is an exploration of progress testing. This method, grounded in constructivist learning theories, emphasises continuous assessment and professional development. Progress testing's regular, comprehensive examinations are instrumental in guiding students through the progressive stages of competence, as outlined in Miller's pyramid, from foundational knowledge to clinical proficiency. The review also addresses the broader impacts of progress testing on teaching approaches, student feedback, academic and pastoral support, and quality assurance. By aligning with the dynamic requirements of 21st-century medical training, progress testing not only nurtures well-rounded professionals but also ensures compliance with regulatory bodies like the General Medical Council. Its emphasis on continuous evaluation aligns with the practical realities of a medical career, driving curricular innovation and aligning with regulatory standards. The implementation of progress testing marks a significant advancement in medical education. Its continuous, holistic nature benefits both students and educators, nurturing a more engaged learning attitude and meeting evolving medical needs. The adoption of this assessment strategy is seen as pivotal in shaping competent medical professionals, ready to face the challenges of modern medical practice.
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Affiliation(s)
- Ghulam M Majeed
- Faculty of Health, Education, Medicine, and Social Care, Anglia Ruskin University, Cambridge, GBR
| | - Juned Islam
- Department of Psychiatry, Whittington Hospital, London, GBR
| | - Girinath Nandakumar
- Department of Trauma and Orthopaedics, East Lancashire Healthcare Trust, Blackburn, GBR
| | - KarYen Phoong
- Department of General Practice, East Lancashire Healthcare Trust, Blackburn, GBR
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29
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Nguyen TAS, Castro N, Vitevitch MS, Harding A, Teng R, Arciuli J, Leyton CE, Piguet O, Ballard KJ. Do age and language impairment affect speed of recognition for words with high and low closeness centrality within the phonological network? INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 25:915-928. [PMID: 36416187 DOI: 10.1080/17549507.2022.2141323] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE Speed and accuracy of lexical access change with healthy ageing and neurodegeneration. While a word's immediate phonological neighbourhood density (i.e. words differing by a single phoneme) influences access, connectivity to all words in the phonological network (i.e. closeness centrality) may influence processing. This study aimed to investigate the effect of closeness centrality on speed and accuracy of lexical processing pre- and post- a single word-training session in healthy younger and older adults, and adults with logopenic primary progressive aphasia (lvPPA), which affects phonological processing. METHOD Participants included 29 young and 17 older healthy controls, and 10 adults with lvPPA. Participants received one session of word-training on words with high or low closeness centrality, using a picture-word verification task. Changes in lexical decision reaction times (RT) and accuracy were measured. RESULT Baseline RT was unaffected by age and accuracy was at ceiling for controls. Post-training, only young adults' RT were significantly faster. Adults with lvPPA were slower and less accurate than controls at baseline, with no training effect. Closeness centrality did not influence performance. CONCLUSION Absence of training effect for older adults suggests higher threshold to induce priming, possibly associated with insufficient dosage or fatigue. Implications for word-finding interventions with older adults are discussed.
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Affiliation(s)
| | - Nichol Castro
- Department of Communicative Disorders and Sciences, University at Buffalo, Buffalo, NY, USA
| | | | - Annabel Harding
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Renata Teng
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Joanne Arciuli
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Cristian E Leyton
- School of Psychology and the Brain & Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Olivier Piguet
- School of Psychology and the Brain & Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Kirrie J Ballard
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- School of Psychology and the Brain & Mind Centre, The University of Sydney, Sydney, NSW, Australia
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De La Fontaine E, Hamel R, Lepage JF, Bernier PM. The influence of learning history on anterograde interference. Neurobiol Learn Mem 2023; 206:107866. [PMID: 37995802 DOI: 10.1016/j.nlm.2023.107866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 10/04/2023] [Accepted: 11/20/2023] [Indexed: 11/25/2023]
Abstract
Classically interpreted as a competition between opposite memories (A vs B), anterograde interference (AI) also emerges in the absence of competing memories (A vs A), suggesting that mechanisms other than those involved in memory competition contribute to AI. To investigate this, we tested the hypothesis that extending motor practice would enhance a first memory, but come at the cost of reduced learning capabilities when subsequently exposed to a second learning session of the same task. Based on converging biological evidence, AI was expected to depend upon the degree of extended practice of the initial exposure. During a first Session, four conditions were carried out where participants (n = 24) adapted to a gradually introduced -20° visual deviation while the extent of the initial exposure was manipulated by varying the duration or type of the performance asymptote. Specifically, the performance asymptote at -20° was either Short (40 trials), Moderate (160 trials), Long (320 trials), or absent due to continuously changing perturbations around the mean of -20° (Jagged; 160 trials). After a 2-min interval, participants re-adapted to the same (-20°) visual deviation, which was meant to probe the effect of extended practice in the first Session on the learning capabilities of a second identical memory (A vs A). The results first confirmed that the duration of exposure in the first Session enhanced immediate aftereffects in the Moderate, Long, and Jagged conditions as compared to the Short condition, suggesting that extended practice enhanced retention of the first memory. When comparing the second Session to the first one, results revealed a different pattern of re-adaptation depending on the duration of initial exposure: in the Short condition, there was evidence for facilitated re-adaptation and similar aftereffects. However, in the Moderate, Long and Jagged conditions, re-adaptation was similar and aftereffects were impaired, suggestive of AI. This suggests that extended practice initially enhances memory formation, but comes at the cost of reduced subsequent learning capabilities. One possibility is that AI occurs because extended practice induces the emergence of network-specific homeostatic constraints, which limit subsequent neuroplastic and learning capabilities in the same neural network.
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Affiliation(s)
- E De La Fontaine
- Département de kinanthropologie, Faculté des sciences de l'activité physique, Université de Sherbrooke
| | - R Hamel
- Département de kinanthropologie, Faculté des sciences de l'activité physique, Université de Sherbrooke; Département de pédiatrie, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke
| | - J F Lepage
- Département de pédiatrie, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke
| | - P M Bernier
- Département de kinanthropologie, Faculté des sciences de l'activité physique, Université de Sherbrooke.
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Maltagliati AJ, Paree JH, McIntosh KL, Moynahan KF, Vanderah TW. Development and evaluation of a pre-clerkship spiral curriculum: data from three medical school classes. MEDICAL EDUCATION ONLINE 2023; 28:2167258. [PMID: 36642963 PMCID: PMC9848358 DOI: 10.1080/10872981.2023.2167258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 12/06/2022] [Accepted: 01/07/2023] [Indexed: 06/17/2023]
Abstract
Pre-clerkship curricula of most Liaison Committee on Medical Education (LCME)-accredited medical schools are divided into blocks by organ system, leaving a significant amount of information susceptible to loss due to prolonged nonuse. We describe the implementation of a formal Spiral Curriculum that periodically revisits material from previous blocks. Learners were surveyed on receptivity to the curriculum across three graduating classes at a single medical school. Medical school graduate classes of 2020, 2021, and 2022 were surveyed at the end of their pre-clerkship years (2018-2020). The class of 2022 actually received the Spiraled Curriculum intervention, for which the authors created 500 board exam style multiple-choice questions, periodically administered via mandatory in-class sessions ranging from 10 to 20 questions reviewing content from previous blocks with designated expert faculty. Response rates were 36% (n = 46), 45% (n = 52), and 32% (n = 40) for classes of 2020, 2021, and 2022, respectively. On a Likert scale (1 = strongly disagree, 5 = neutral, 10 = strongly agree), the classes of 2020, 2021, and 2022 provided statistically significant differences in their belief that a Spiraled Curriculum would/did help them retain information as 8.2 (SD 1.7), 8.2 (SD 2.2), and 5.0 (SD 3.0) (n < 0.05). All classes endorsed neutral confidence in the existing pre-clerkship curriculum in themselves to prepare for United Stated Medical Licensing Examination (USMLE) Step 1, and in their retention of previous block material with no statistically significant differences between classes. USMLE Step 1 scores did not differ significantly between classes (n = 0.21). Those who did not receive the Spiral Curriculum were highly receptive to it in theory, while those who actually received the intervention gave a neutral rating. Per survey comments, implementation of a Spiraling Curriculum would ideally be administered as either team-based or self-directed activities, and a Spiraling Curriculum may be difficult to implement in accelerated (18 month) pre-clerkship formats.Practice points Question: What is the receptivity of medical students to a formal Spiral curriculum that uses time-spaced repetition sessions of board exam style questions to revisit previous block content of their pre-clerkship years?Findings: In this single-center, quasi-experimental study, the two control group medical school classes had very positive theoretical reception to a Spiral curriculum proposal (rated 8 out of 10) while the class who actually received the Spiral curriculum provided a statistically significant lower neutral rating (rated 5 out of 10), citing preference for a team-based or self-directed format.Meaning: Medical students are strongly in favor of structured time-spaced repetition with board exam style questions to revisit previous material but prefer a format that does not interfere with time to personalize their medical school experience.
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Affiliation(s)
| | - Joshua H. Paree
- The University of Arizona College of Medicine, 1501 N Campbell Ave, Tucson, AZ, USA
| | - Kadian L. McIntosh
- The University of Arizona College of Medicine, 1501 N Campbell Ave, Tucson, AZ, USA
| | - Kevin F. Moynahan
- The University of Arizona College of Medicine, 1501 N Campbell Ave, Tucson, AZ, USA
| | - Todd W. Vanderah
- The University of Arizona College of Medicine, 1501 N Campbell Ave, Tucson, AZ, USA
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Cuschieri S, Narnaware Y. Improving physiotherapy students' anatomy learning experience and short-term knowledge retention-An observational study in Malta. ANATOMICAL SCIENCES EDUCATION 2023; 16:1134-1143. [PMID: 37312260 DOI: 10.1002/ase.2307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/24/2023] [Accepted: 05/06/2023] [Indexed: 06/15/2023]
Abstract
Anatomy is physiotherapy's foundation. However, undergraduate classroom learning and knowledge acquisition-retention remain questionable. This study explored the possibility of improving this learning experience and evaluates the gross anatomy of abdomen and pelvis short-term knowledge retention among first-year physiotherapy students in Malta. The online Kahoot! game-based quiz platform was used through an instructor-designed best-of-four multiple-choice questions. Correctly answered questions and Kahoot! scores generated by the platform were utilized to measure knowledge retention. Kahoot! sessions 1 and 3 shared similar attendance and response rate and were compared together. The Mann-Whitney U test was used to compare Kahoot! scores and Chi test for trend to compare correctly answered questions. Students' perceived learning experiences before and after the introduction of the Kahoot quizzes were gathered through Likert scores and analyzed using McNamar's chi-square test. Overall, a significantly increased trend in correctly answered questions (χ2 : 23.38, p-value: <0.001) across the Kahoot! sessions were evident. Four questions out of 12 exhibited significant Kahoot! scores differences. Students reported better learning experiences following the initiation of Kahoot! (χ2 : 5.1, p-value: 0.02). Indeed, all students agreed that the use of the interactive quiz improved their anatomy short term knowledge retention. Introducing an online interactive quiz as part of the lecture program may be useful to improve the learning experience and anatomy knowledge retention among physiotherapy students.
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Affiliation(s)
- Sarah Cuschieri
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
- Department of Epidemiology and Biostatistics, Western University, London, Canada
| | - Yuwaraj Narnaware
- Department of Human Health and Science, Faculty of Nursing, MacEwan University, Alberta, Edmonton, Canada
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Moscovitch DA, Moscovitch M, Sheldon S. Neurocognitive Model of Schema-Congruent and -Incongruent Learning in Clinical Disorders: Application to Social Anxiety and Beyond. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2023; 18:1412-1435. [PMID: 36795637 PMCID: PMC10623626 DOI: 10.1177/17456916221141351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Negative schemas lie at the core of many common and debilitating mental disorders. Thus, intervention scientists and clinicians have long recognized the importance of designing effective interventions that target schema change. Here, we suggest that the optimal development and administration of such interventions can benefit from a framework outlining how schema change occurs in the brain. Guided by basic neuroscientific findings, we provide a memory-based neurocognitive framework for conceptualizing how schemas emerge and change over time and how they can be modified during psychological treatment of clinical disorders. We highlight the critical roles of the hippocampus, ventromedial prefrontal cortex, amygdala, and posterior neocortex in directing schema-congruent and -incongruent learning (SCIL) in the interactive neural network that comprises the autobiographical memory system. We then use this framework, which we call the SCIL model, to derive new insights about the optimal design features of clinical interventions that aim to strengthen or weaken schema-based knowledge through the core processes of episodic mental simulation and prediction error. Finally, we examine clinical applications of the SCIL model to schema-change interventions in psychotherapy and provide cognitive-behavior therapy for social anxiety disorder as an illustrative example.
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Affiliation(s)
- David A. Moscovitch
- Department of Psychology and Centre for Mental Health Research & Treatment, University of Waterloo
| | - Morris Moscovitch
- Rotman Research Institute and Department of Psychology, Baycrest Centre for Geriatric Care
- Department of Psychology, University of Toronto
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Xie L, Zhang X, Xie J, Xu Y, Li XJ, Lin L. Emerging Roles for DNA 6mA and RNA m6A Methylation in Mammalian Genome. Int J Mol Sci 2023; 24:13897. [PMID: 37762200 PMCID: PMC10531503 DOI: 10.3390/ijms241813897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 08/25/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Epigenetic methylation has been shown to play an important role in transcriptional regulation and disease pathogenesis. Recent advancements in detection techniques have identified DNA N6-methyldeoxyadenosine (6mA) and RNA N6-methyladenosine (m6A) as methylation modifications at the sixth position of adenine in DNA and RNA, respectively. While the distributions and functions of 6mA and m6A have been extensively studied in prokaryotes, their roles in the mammalian brain, where they are enriched, are still not fully understood. In this review, we provide a comprehensive summary of the current research progress on 6mA and m6A, as well as their associated writers, erasers, and readers at both DNA and RNA levels. Specifically, we focus on the potential roles of 6mA and m6A in the fundamental biological pathways of the mammalian genome and highlight the significant regulatory functions of 6mA in neurodegenerative diseases.
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Affiliation(s)
| | | | | | | | | | - Li Lin
- Guangdong Key Laboratory of Non-Human Primate Research, Laboratory of CNS Regeneration (Ministry of Education), Guangdong-Hongkong-Macau Institute of CNS Regeneration, Jinan University, Guangzhou 510632, China; (L.X.); (X.Z.); (J.X.); (Y.X.); (X.-J.L.)
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Li Z, Athwal D, Lee HL, Sah P, Opazo P, Chuang KH. Locating causal hubs of memory consolidation in spontaneous brain network in male mice. Nat Commun 2023; 14:5399. [PMID: 37669938 PMCID: PMC10480429 DOI: 10.1038/s41467-023-41024-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 08/17/2023] [Indexed: 09/07/2023] Open
Abstract
Memory consolidation after learning involves spontaneous, brain-wide network reorganization during rest and sleep, but how this is achieved is still poorly understood. Current theory suggests that the hippocampus is pivotal for this reshaping of connectivity. Using fMRI in male mice, we identify that a different set of spontaneous networks and their hubs are instrumental in consolidating memory during post-learning rest. We found that two types of spatial memory training invoke distinct functional connections, but that a network of the sensory cortex and subcortical areas is common for both tasks. Furthermore, learning increased brain-wide network integration, with the prefrontal, striatal and thalamic areas being influential for this network-level reconfiguration. Chemogenetic suppression of each hub identified after learning resulted in retrograde amnesia, confirming the behavioral significance. These results demonstrate the causal and functional roles of resting-state network hubs in memory consolidation and suggest that a distributed network beyond the hippocampus subserves this process.
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Affiliation(s)
- Zengmin Li
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Dilsher Athwal
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Hsu-Lei Lee
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Pankaj Sah
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Joint Center for Neuroscience and Neural Engineering, and Department of Biology, Southern University of Science and Technology, Shenzhen, Guangdong, PR China
| | - Patricio Opazo
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Clem Jones Centre for Ageing Dementia Research, The University of Queensland, Brisbane, QLD, Australia
- UK Dementia Research Institute, Centre for Discovery Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | - Kai-Hsiang Chuang
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia.
- Centre of Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia.
- Australian Research Council Training Centre for Innovation in Biomedical Imaging Technology, Brisbane, QLD, Australia.
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Sharifdini M, Evazalipour M, Hesari Z. Virtual spaced-learning method, during COVID-19 for Pharm D students. BMC MEDICAL EDUCATION 2023; 23:605. [PMID: 37620834 PMCID: PMC10463503 DOI: 10.1186/s12909-023-04595-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 08/16/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND The coronavirus (COVID-19) outbreak basically changed teaching methods across the world, and learning was almost replaced by virtual learning during the pandemic. Also, the spacing effect is one of the most well-established phenomena in the science of learning. Using temporal intervals for re-exposing learners to information over time (spaced learning) leads to more effective retention of knowledge compared to having information presented at a single time (massed learning). Hence, we designed a virtual spaced learning method to reap the benefits of virtual learning and spaced learning concomitantly. METHODS/APPROACH An interventional semi- experimental survey among 66 Pharm D students was designed and implemented. Students were divided into two groups (spaced vs mass learning) in the national integrated virtual education platform (NAVID) as the matrix for teaching as well as evaluation. Classes were conducted in the following sequence: 1- answering the pre-test, 2- watching and listening to the educational content (separately for each group), 3- answering the post-test (n = 1). The pre/post-test consisted of 10 four-choice questions based on the Kirkpatrick Model extracted from the educational content. RESULTS/OUTCOMES Findings revealed that the average score was not significantly different between the post-tests of the spaced learning and mass learning (7.26 ± 2.26 vs 6.5 ± 2.5) methods utilizing the independent t- test (p ≥ 0.05). CONCLUSIONS Since no statistically significant improvement was observed in the virtual spaced learning group compared to the control group, it seems that clarifying the significant influence of the spaced learning strategy in pharmacy education requires longer period of study, or study on less complex or skill-based topics for further evaluation.
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Affiliation(s)
- Meysam Sharifdini
- Department of Medical Parasitology and Mycology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mehdi Evazalipour
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Hesari
- Medical Education Research Center, Education Development Center, Guilan University of Medical Sciences, Rasht, Iran.
- Department of Pharmaceutics, School of Pharmacy, Guilan University of Medical Sciences, Rasht, Iran.
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Budriesi P, Tintorelli R, Correa J, Villar ME, Marchal P, Giurfa M, Viola H. A behavioral tagging account of kinase contribution to memory formation after spaced aversive training. iScience 2023; 26:107278. [PMID: 37520708 PMCID: PMC10372744 DOI: 10.1016/j.isci.2023.107278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 09/14/2022] [Accepted: 06/30/2023] [Indexed: 08/01/2023] Open
Abstract
Long-term memory (LTM) can be induced by repeated spaced training trials. Using the weak inhibitory avoidance (wIA) task, we showed that one wIA session does not lead to a 24-h LTM, whereas two identical wIA sessions spaced by 15 min to 6 h induce a 24-h LTM. This LTM promotion depends both on hippocampal protein synthesis and the activity of several kinases. In agreement with the behavioral tagging (BT) hypothesis, our results suggest that the two training sessions induce transient learning tags and lead, via a cooperative effect, to the synthesis of plasticity-related proteins (PRPs) that become available and captured by the tag from the second session. Although ERKs1/2 are needed for PRPs synthesis and CaMKs are required for tag setting, PKA participates in both processes. We conclude that the BT mechanism accounts for the molecular constraints underlying the classic effect of spaced learning on LTM formation.
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Affiliation(s)
- Pablo Budriesi
- Instituto de Biología Celular y Neurociencia “Prof. E. De Robertis” (IBCN), Facultad de Medicina, UBA-CONICET, Ciudad Autónoma de Buenos Aires, Argentina
| | - Ramiro Tintorelli
- Instituto de Biología Celular y Neurociencia “Prof. E. De Robertis” (IBCN), Facultad de Medicina, UBA-CONICET, Ciudad Autónoma de Buenos Aires, Argentina
| | - Julieta Correa
- Instituto de Biología Celular y Neurociencia “Prof. E. De Robertis” (IBCN), Facultad de Medicina, UBA-CONICET, Ciudad Autónoma de Buenos Aires, Argentina
| | - Maria Eugenia Villar
- Instituto de Biología Celular y Neurociencia “Prof. E. De Robertis” (IBCN), Facultad de Medicina, UBA-CONICET, Ciudad Autónoma de Buenos Aires, Argentina
- Departamento de Biología y Geología, Física y Química Inorgánica, Área de Biodiversidad y Conservación, Universidad Rey Juan Carlos, Madrid, Spain
| | - Paul Marchal
- Instituto de Biología Celular y Neurociencia “Prof. E. De Robertis” (IBCN), Facultad de Medicina, UBA-CONICET, Ciudad Autónoma de Buenos Aires, Argentina
- Poe Lab, Integrative Biology and Physiology department, University of California Los Angeles, Los Angeles, CA, USA
| | - Martin Giurfa
- Centre de Recherches sur la Cognition Animale, Centre de Biologie Intégrative (CBI), University of Toulouse, CNRS, UPS, 31062 Toulouse cedex 9, France
- Institut Universitaire de France (IUF), Paris, France
| | - Haydee Viola
- Instituto de Biología Celular y Neurociencia “Prof. E. De Robertis” (IBCN), Facultad de Medicina, UBA-CONICET, Ciudad Autónoma de Buenos Aires, Argentina
- Departamento de Fisiología, Biología Molecular y Celular “Dr. Héctor Maldonado” (FBMC), Facultad de Ciencias Exactas y Naturales, UBA, Ciudad Autónoma de Buenos Aires, Argentina
- Instituto Tecnológico de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
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Centofante E, Fralleoni L, Lupascu CA, Migliore M, Rinaldi A, Mele A. Specific patterns of neural activity in the hippocampus after massed or distributed spatial training. Sci Rep 2023; 13:13357. [PMID: 37587232 PMCID: PMC10432541 DOI: 10.1038/s41598-023-39882-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 08/01/2023] [Indexed: 08/18/2023] Open
Abstract
Training with long inter-session intervals, termed distributed training, has long been known to be superior to training with short intervals, termed massed training. In the present study we compared c-Fos expression after massed and distributed training protocols in the Morris water maze to outline possible differences in the learning-induced pattern of neural activation in the dorsal CA1 in the two training conditions. The results demonstrate that training and time lags between learning opportunities had an impact on the pattern of neuronal activity in the dorsal CA1. Mice trained with the distributed protocol showed sustained neuronal activity in the postero-distal component of the dorsal CA1. In parallel, in trained mice we found more active cells that tended to constitute spatially restricted clusters, whose degree increased with the increase in the time lags between learning trials. Moreover, activated cell assemblies demonstrated increased stability in their spatial organization after distributed as compared to massed training or control condition. Finally, using a machine learning algorithm we found that differences in the number of c-Fos positive cells and their location in the dorsal CA1 could be predictive of the training protocol used. These results suggest that the topographic organization and the spatial location of learning activated cell assemblies might be critical to promote the increased stability of the memory trace induced by distributed training.
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Affiliation(s)
- Eleonora Centofante
- Department of Biology and Biotechnology 'C. Darwin' - Centre for Research in Neurobiology 'D.Bovet', Sapienza University of Rome, P.Le A. Moro, 5, 00185, Rome, Italy
- Institute of Biophysics, National Research Council, Palermo, Italy
| | - Luca Fralleoni
- Department of Biology and Biotechnology 'C. Darwin' - Centre for Research in Neurobiology 'D.Bovet', Sapienza University of Rome, P.Le A. Moro, 5, 00185, Rome, Italy
| | - Carmen A Lupascu
- Institute of Biophysics, National Research Council, Palermo, Italy
| | - Michele Migliore
- Institute of Biophysics, National Research Council, Palermo, Italy
| | - Arianna Rinaldi
- Department of Biology and Biotechnology 'C. Darwin' - Centre for Research in Neurobiology 'D.Bovet', Sapienza University of Rome, P.Le A. Moro, 5, 00185, Rome, Italy
| | - Andrea Mele
- Department of Biology and Biotechnology 'C. Darwin' - Centre for Research in Neurobiology 'D.Bovet', Sapienza University of Rome, P.Le A. Moro, 5, 00185, Rome, Italy.
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Fattorini L, Rodio A, Filippi GM, Pettorossi VE. Effectiveness of Focal Muscle Vibration in the Recovery of Neuromotor Hypofunction: A Systematic Review. J Funct Morphol Kinesiol 2023; 8:103. [PMID: 37606398 PMCID: PMC10443241 DOI: 10.3390/jfmk8030103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 08/23/2023] Open
Abstract
Adequate physical recovery after trauma, injury, disease, a long period of hypomobility, or simply ageing is a difficult goal because rehabilitation protocols are long-lasting and often cannot ensure complete motor recovery. Therefore, the optimisation of rehabilitation procedures is an important target to be achieved. The possibility of restoring motor functions by acting on proprioceptive signals by unspecific repetitive muscle vibration, focally applied on single muscles (RFV), instead of only training muscle function, is a new perspective, as suggested by the effects on the motor performance evidenced by healthy persons. The focal muscle vibration consists of micro-stretching-shortening sequences applied to individual muscles. By repeating such stimulation, an immediate and persistent increase in motility can be attained. This review aims to show whether this proprioceptive stimulation is useful for optimising the rehabilitative process in the presence of poor motor function. Papers reporting RFV effects have evidenced that the motor deficits can be counteracted by focal vibration leading to an early and quick complete recovery. The RFV efficacy has been observed in various clinical conditions. The motor improvements were immediate and obtained without loading the joints. The review suggests that these protocols can be considered a powerful new advantage to enhance traditional rehabilitation and achieve a more complete motor recovery.
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Affiliation(s)
- Luigi Fattorini
- Department of Physiology and Pharmacology “V. Erspamer”, School of Medicine, Faculty of Medicine and Surgery, Sapienza Università di Roma, L.go A. Moro 5, 00185 Rome, Italy;
| | - Angelo Rodio
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, Loc. Folcara, 03043 Cassino, Italy
| | - Guido Maria Filippi
- Department of Neuroscience, School of Medicine, Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Vito Enrico Pettorossi
- Department of Medicine and Surgery, Human Physiology Section, Università degli Studi di Perugia, Piazzale Gambuli 1, 06129 Perugia, Italy;
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Wrightson JG, Cole J, Sohn MN, McGirr A. The effects of D-Cycloserine on corticospinal excitability after repeated spaced intermittent theta-burst transcranial magnetic stimulation: A randomized controlled trial in healthy individuals. Neuropsychopharmacology 2023; 48:1217-1224. [PMID: 37041205 PMCID: PMC10267195 DOI: 10.1038/s41386-023-01575-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 03/22/2023] [Accepted: 03/23/2023] [Indexed: 04/13/2023]
Abstract
Repeated spaced TMS protocols, also termed accelerated TMS protocols, are of increasing therapeutic interest. The long-term potentiation (LTP)-like effects of repeated spaced intermittent theta-burst transcranial magnetic stimulation (iTBS) are presumed to be N-Methyl-D-Aspartate receptor (NMDA-R) dependent; however, this has not been tested. We tested whether the LTP-like effects of repeated spaced iTBS are influenced by low-dose D-Cycloserine (100 mg), an NMDA-R partial-agonist. We conducted a randomized, double-blind, placebo-controlled crossover trial in 20 healthy adults from August 2021-Feb 2022. Participants received repeated spaced iTBS, consisting of two iTBS sessions 60 minutes apart, to the primary motor cortex. The peak-to-peak amplitude of the motor evoked potentials (MEP) at 120% resting motor threshold (RMT) was measured after each iTBS. The TMS stimulus-response (TMS-SR; 100-150% RMT) was measured at baseline, +30 min, and +60 min after each iTBS. We found evidence for a significant Drug*iTBS effect in MEP amplitude, revealing that D-Cycloserine enhanced MEP amplitudes relative to the placebo. When examining TMS-SR, pairing iTBS with D-Cycloserine increased the TMS-SR slope relative to placebo after both iTBS tetani, and this was due to an increase in the upper bound of the TMS-SR. This indicates that LTP-like and metaplastic effects of repeated-spaced iTBS involve NMDA-R, as revealed by two measures of corticospinal excitability, and that low-dose D-Cycloserine facilitates the physiological effects of repeated spaced iTBS. However, extension of these findings to clinical populations and therapeutic protocols targeting non-motor regions of cortex requires empirical validation.
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Affiliation(s)
- James G Wrightson
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Jaeden Cole
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Mathison Centre for Mental Health Research and Education, Calgary, AB, Canada
| | - Maya N Sohn
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Mathison Centre for Mental Health Research and Education, Calgary, AB, Canada
| | - Alexander McGirr
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
- Mathison Centre for Mental Health Research and Education, Calgary, AB, Canada.
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Ruggeri P, Miehlbradt J, Kabbara A, Hassan M. Dynamic rewiring of electrophysiological brain networks during learning. Netw Neurosci 2023; 7:578-603. [PMID: 37397886 PMCID: PMC10312289 DOI: 10.1162/netn_a_00289] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 11/02/2022] [Indexed: 09/22/2024] Open
Abstract
Human learning is an active and complex process. However, the brain mechanisms underlying human skill learning and the effect of learning on the communication between brain regions, at different frequency bands, are still largely unknown. Here, we tracked changes in large-scale electrophysiological networks over a 6-week training period during which participants practiced a series of motor sequences during 30 home training sessions. Our findings showed that brain networks become more flexible with learning in all the frequency bands from theta to gamma ranges. We found consistent increase of flexibility in the prefrontal and limbic areas in the theta and alpha band, and over somatomotor and visual areas in the alpha band. Specific to the beta rhythm, we revealed that higher flexibility of prefrontal regions during the early stage of learning strongly correlated with better performance measured during home training sessions. Our findings provide novel evidence that prolonged motor skill practice results in higher, frequency-specific, temporal variability in brain network structure.
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Affiliation(s)
- Paolo Ruggeri
- Brain Electrophysiology Attention Movement Laboratory, Institute of Psychology, University of Lausanne, Switzerland
| | - Jenifer Miehlbradt
- Brain Electrophysiology Attention Movement Laboratory, Institute of Psychology, University of Lausanne, Switzerland
| | - Aya Kabbara
- Lebanese Association for Scientific Research, Tripoli, Lebanon
- MINDig, F-35000 Rennes, France
| | - Mahmoud Hassan
- School of Engineering, University of Reykjavik, Reykjavik, Iceland
- MINDig, F-35000 Rennes, France
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Marques-Medeiros AC, Martins RC, Souza LND, Gomez RS, Silva MEDSE, Martins MAP, Abreu MHNGD. E-learning as a strategy in dentistry in the context of COVID-19: a path to follow? Braz Oral Res 2023; 37:e060. [PMID: 37341233 DOI: 10.1590/1807-3107bor-2023.vol37.0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 02/06/2023] [Indexed: 06/22/2023] Open
Abstract
The current study aims to assess the effectiveness of e-learning in compliance with the new biosafety recommendations in dentistry in the context of COVID-19 applied to the clinical staff of a dental school in Brazil. A quasi-experimental epidemiological study was carried out by means of a structured, pre-tested online questionnaire, applied before and after an educational intervention, using an e-learning format. After data collection, statistical tests were performed. A total of 549 members of the clinical staff participated in the study in the two collection phases, with a return rate of 26.9%. After the e-learning stage, a reduction was found in the reported use of disposable gloves, protective goggles, and surgical masks. The course had no impact on the staff's knowledge concerning the proper sequence for donning PPE and showed 100% effectiveness regarding proper PPE doffing sequence. Knowledge about avoiding procedures that generate aerosols in the clinical setting was improved. Despite the low rate of return, it can be concluded that online intervention alone was ineffective in significantly improving learning about the new clinical biosafety guidelines. Therefore, the use of hybrid teaching and repetitive training is highly recommended.
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Affiliation(s)
- Ana Carolina Marques-Medeiros
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Graduate Program in Dentistry, Belo Horizonte, MG, Brazil
| | - Renata Castro Martins
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Community and Preventive Dentistry, Belo Horizonte, MG, Brazil
| | - Leandro Napier de Souza
- Universidade Federal de Minas Gerais - UFMG,School of Dentistry, Department of Oral Surgery and Oral Pathology, Belo Horizonte, MG, Brazil
| | - Ricardo Santiago Gomez
- Universidade Federal de Minas Gerais - UFMG,School of Dentistry, Department of Oral Surgery and Oral Pathology, Belo Horizonte, MG, Brazil
| | - Maria Elisa de Souza E Silva
- Universidade Federal de Minas Gerais - UFMG,School of Dentistry, Department of Operative Dentistry, Belo Horizonte, MG, Brazil
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Morrison S, Newell KM. Strength training as a dynamical model of motor learning. J Sports Sci 2023:1-16. [PMID: 37270792 DOI: 10.1080/02640414.2023.2220177] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 05/22/2023] [Indexed: 06/06/2023]
Abstract
This paper outlines a framework for strength training as a dynamical model of perceptual-motor learning. We show, with emphasis on fixed-point attractor dynamics, that strength training can be mapped to the general dynamical principles of motor learning that arise from the constraints on action, including the distribution of practice/training. The time scales of the respective dynamics of performance change (increment and decrement) in discrete strength training and motor learning tasks reveal superposition of exponential functions in fixed-point dynamics, but distinctive attractor and parameter dynamics in oscillatory limit cycle and more continuous tasks, together with unique timescales to process influences (including practice, learning, strength, fitness, fatigue, warm-up decrement). Increments and decrements of strength can be viewed within a dynamical model of change in motor performance that reflects the integration of practice and training processes at multiple levels of learning and skill development.
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Affiliation(s)
- Steven Morrison
- School of Rehabilitation Sciences, Old Dominion University, Norfolk, VA, USA
| | - Karl M Newell
- Department of Kinesiology, University of Georgia, Athens, GA, USA
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Chen L, Klooster DCW, Tik M, Thomas EHX, Downar J, Fitzgerald PB, Williams NR, Baeken C. Accelerated Repetitive Transcranial Magnetic Stimulation to Treat Major Depression: The Past, Present, and Future. Harv Rev Psychiatry 2023; 31:142-161. [PMID: 37171474 PMCID: PMC10188211 DOI: 10.1097/hrp.0000000000000364] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is an effective and evidence-based therapy for treatment-resistant major depressive disorder. A conventional course of rTMS applies 20-30 daily sessions over 4-6 weeks. The schedule of rTMS delivery can be accelerated by applying multiple stimulation sessions per day, which reduces the duration of a treatment course with a predefined number of sessions. Accelerated rTMS reduces time demands, improves clinical efficiency, and potentially induces faster onset of antidepressant effects. However, considerable heterogeneity exists across study designs. Stimulation protocols vary in parameters such as the stimulation target, frequency, intensity, number of pulses applied per session or over a course of treatment, and duration of intersession intervals. In this article, clinician-researchers and neuroscientists who have extensive research experience in accelerated rTMS synthesize a consensus based on two decades of investigation and development, from early studies ("Past") to contemporaneous theta burst stimulation, a time-efficient form of rTMS gaining acceptance in clinical settings ("Present"). We propose descriptive nomenclature for accelerated rTMS, recommend avenues to optimize therapeutic and efficiency potential, and suggest using neuroimaging and electrophysiological biomarkers to individualize treatment protocols ("Future"). Overall, empirical studies show that accelerated rTMS protocols are well tolerated and not associated with serious adverse effects. Importantly, the antidepressant efficacy of accelerated rTMS appears comparable to conventional, once daily rTMS protocols. Whether accelerated rTMS induces antidepressant effects more quickly remains uncertain. On present evidence, treatment protocols incorporating high pulse dose and multiple treatments per day show promise and improved efficacy.
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Affiliation(s)
- Leo Chen
- From the Monash Alfred Psychiatry Research Centre, Department of Psychiatry, Central Clinical School, Monash University, Melbourne, Australia (Drs. Chen, Thomas); Ghent Experimental Psychiatry (GHEP) Lab, Department of Head and Skin (UZGent), Ghent University, Ghent, Belgium (Drs. Klooster, Baeken); Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Stanford University, Stanford, CA (Drs. Tik, Williams); Institute of Medical Science and Department of Psychiatry, University of Toronto, Canada (Dr. Downar); School of Medicine and Psychology, he Australian National University, Canberra, Australia (Dr. Fitzgerald)
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45
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Filippi GM, Rodio A, Fattorini L, Faralli M, Ricci G, Pettorossi VE. Plastic changes induced by muscle focal vibration: A possible mechanism for long-term motor improvements. Front Neurosci 2023; 17:1112232. [PMID: 36908788 PMCID: PMC9992721 DOI: 10.3389/fnins.2023.1112232] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/07/2023] [Indexed: 02/25/2023] Open
Abstract
Repetitive focal vibrations can induce positive and persistent after-effects. There is still no satisfactory interpretation of the underlying mechanisms. A rationale, which can provide consistency among different results, is highly desirable to guide both the use of the application and future research. To date, interpretive models are formulated to justify the results, depending on the specific protocol adopted. Indeed, protocol parameters, such as stimulus intensity and frequency, intervention time and administration period, are variable among different studies. However, in this article, we have identified features of the protocols that may allow us to suggest a possible common mechanism underlying the effectiveness of focal vibration under different physiologic and pathologic conditions. Since repetitive focal muscle vibration induces powerful and prolonged activation of muscle proprioceptors, we hypothesize that this intense activation generates adaptive synaptic changes along sensory and motor circuits. This may lead to long-term synaptic potentiation in the central network, inducing an enhancement of the learning capability. The plastic event could increase proprioceptive discriminative ability and accuracy of the spatial reference frame and, consequently, improve motor planning and execution for different motor functions and in the presence of different motor dysfunctions. The proposed mechanism may explain the surprising and sometimes particularly rapid improvements in motor execution in healthy and diseased individuals, regardless of specific physical training. This hypothetic mechanism may require experimental evidence and could lead to extend and adapt the application of the "learning without training" paradigms to other functional and recovery needs.
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Affiliation(s)
- Guido M. Filippi
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Angelo Rodio
- Department of Human Sciences, Society, and Health, University of Cassino and Southern Lazio, Frosinone, Italy
| | - Luigi Fattorini
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza Università di Roma, Rome, Italy
| | - Mario Faralli
- Department of Medicine and Surgery, Otorhinolaryngology Section, Università degli Studi di Perugia, Perugia, Italy
| | - Giampietro Ricci
- Department of Medicine and Surgery, Otorhinolaryngology Section, Università degli Studi di Perugia, Perugia, Italy
| | - Vito E. Pettorossi
- Department of Medicine and Surgery, Human Physiology Section, Università degli Studi di Perugia, Perugia, Italy
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Chuang IC, Chen IC, Su KH, Wu YR, Wu CY. The effects of high versus low frequency of combined physical and cognitive training on cognitive function in older adults with cognitive decline: a quasi-experimental study. BMC Geriatr 2023; 23:94. [PMID: 36788482 PMCID: PMC9926662 DOI: 10.1186/s12877-023-03802-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 02/06/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND The effects of combined training can be affected by training characteristics such as frequency, session length, and duration. No empirical studies to date have directly compared how combined physical and cognitive training offered at different training frequencies affects cognitive function for older adults with cognitive decline. This study investigated the impact of training frequency on cognitive outcomes after combined physical and cognitive training for older adults with cognitive decline. METHODS A quasi-experimental study was conducted in community facilities and day care centers. The study assigned 89 older adults with cognitive decline into high-frequency (HF) or low-frequency (LF) training groups. The participants received 90- to 105-min training sessions, one (LF) or three (HF) times a week, for 12 weeks. Outcome measures were the Montreal Cognitive Assessment, Word List subtest of the Wechsler Memory Scale, Digit Symbol Substitution Test (DSST), and Stroop Color Word Test. RESULTS The HF group demonstrated greater improvement in immediate memory measured by the WL-IM (F = 8.7, P = 0.004) and in executive function measured by the SCWT (F = 5.89, P = 0.017) than the LF group. Compared with the HF group, the LF group showed a great improvement in delayed memory measured by the WL-DM (F = 9.62, P = 0.003). The HF and LF groups both increased in processing speed and global cognitive function. CONCLUSIONS Our study indicated that the different training frequency of combined physical and cognitive training may result in benefits on different cognitive functions in older adults with cognitive decline. These findings may assist clinical practitioners in choosing appropriate training frequencies based on various intervention purposes for the elderly with cognitive decline. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT03619577 (08/08/2018).
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Affiliation(s)
- I-Ching Chuang
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, No. 259 Wen-Hwa 1St Road, Taoyuan, Taiwan.,Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - I-Chen Chen
- Department of Occupational Therapy, College of Nursing and Health Sciences, Da-Yeh University, Changhua, Taiwan
| | - Ken-Hsien Su
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, No. 259 Wen-Hwa 1St Road, Taoyuan, Taiwan
| | - Yih-Ru Wu
- Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ching-Yi Wu
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, No. 259 Wen-Hwa 1St Road, Taoyuan, Taiwan. .,Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan. .,Department of Physical Medicine and Rehabilitation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
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Caffrey M, Commins S. Preservation of long-term memory in older adults using a spaced learning paradigm. Eur J Ageing 2023; 20:2. [PMID: 36723694 PMCID: PMC9892402 DOI: 10.1007/s10433-023-00750-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2023] [Indexed: 02/02/2023] Open
Abstract
How much information we retain depends on type/schedule of training. It has been widely acknowledged that spaced learning is advantageous compared to massed learning for cognitively healthy young adults and should be considered an educational standard. Literature would suggest that the spacing effect is preserved with age, though it is unclear whether this effect translates to more ecologically valid concepts such as face-name associations, which are particularly susceptible to deterioration with age. Two experiments were conducted to investigate the effects of spacing across recent/remote retention intervals, and the effect of age on spacing in cognitively healthy older adults using the Face-Name Pairs task. Experiment 1 results suggest that the beneficial memory effects of spacing are particularly observed with long-term memory. Experiment 2 results suggest that older adults are impaired at learning compared to younger adults, that the spacing effect influences both older and younger adults at longer intervals, and that spaced-trained participants display similar forgetting patterns at longer intervals, irrespective of age. These results may have some implications regarding improving the conditions under which optimum retention occurs (namely, whether spacing is beneficial when learning ecologically valid concepts at longer intervals outside of laboratory settings), and may provide insight into the effect of age on our ability to learn and remember face-name associations.
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Affiliation(s)
- Michelle Caffrey
- Department of Psychology, Maynooth University, Co. Kildare, Ireland.
| | - Sean Commins
- Department of Psychology, Maynooth University, Co. Kildare, Ireland
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Enhancing learning and retention through the distribution of practice repetitions across multiple sessions. Mem Cognit 2023; 51:455-472. [PMID: 36190659 DOI: 10.3758/s13421-022-01361-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2022] [Indexed: 02/24/2023]
Abstract
The acquisition and retention of knowledge is affected by a multitude of factors including amount of practice, elapsed time since practice occurred, and the temporal distribution of practice. The third factor, temporal distribution of practice, is at the heart of research on the spacing effect. This research has consistently shown that separating practice repetitions by a delay slows acquisition but enhances retention. The current study addresses an empirical gap in the spacing effects literature. Namely, how does the allocation of a fixed number of practice repetitions among multiple sessions impact learning and retention? To address this question, we examined participants' acquisition and retention of declarative knowledge given different study schedules in which the number of practice repetitions increased, decreased, or remained constant across multiple acquisition sessions. The primary result was that retention depended strongly on the total number of sessions in which an item appeared, but not on how practice repetitions were distributed among those sessions. This outcome was consistent with predictions from a computational cognitive model of skill acquisition and retention called the Predictive Performance Equation (PPE). The success of the model in accounting for the patterns of performance across a large set of study schedules suggests that it can be used to tame the complexity of the design space and to identify schedules to enhance knowledge acquisition and retention.
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49
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Negative recency effects in delayed recognition: Spacing, consolidation, and retrieval strategy processes. Mem Cognit 2022; 50:1683-1693. [PMID: 35277835 DOI: 10.3758/s13421-022-01293-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 12/30/2022]
Abstract
While items learned immediately before testing are generally remembered better than prior items in a study list, in delayed testing this relationship is reversed, yielding a negative recency effect. To adjudicate between the strategic rehearsal and spacing accounts of this phenomenon, we examined performance of 169 participants on a delayed recognition test following multiple sessions requiring the study and immediate free recall testing of 16 lists of 16 words. This revealed a strong effect of the amount of spacing between initial study position and initial free recall position on the degree of negative recency, supporting the spacing account. Furthermore, these spacing effects were nonmonotonic, suggesting that they are mediated by consolidation processes. Additional analyses indicate that strategies and rehearsal opportunities may also contribute to the effects of within-list encoding position on subsequent long-term memory, but for recall more than for recognition.
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50
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Zhang Y, Liu RY, Smolen P, Cleary LJ, Byrne JH. Dynamics and Mechanisms of ERK Activation after Different Protocols that Induce Long-Term Synaptic Facilitation in Aplysia. OXFORD OPEN NEUROSCIENCE 2022; 2:kvac014. [PMID: 37649778 PMCID: PMC10464504 DOI: 10.1093/oons/kvac014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/05/2022] [Indexed: 09/01/2023]
Abstract
Phosphorylation of the MAPK family member extracellular signal-regulated kinase (ERK) is required to induce long-term synaptic plasticity, but little is known about its persistence. We examined ERK activation by three protocols that induce long-term synaptic facilitation (LTF) of the Aplysia sensorimotor synapse - the standard protocol (five 5-min pulses of 5-HT with interstimulus intervals (ISIs) of 20 min), the enhanced protocol (five pulses with irregular ISIs, which induces greater and longer-lasting LTF) and the two-pulse protocol (two pulses with ISI 45 min). Immunofluorescence revealed complex ERK activation. The standard and two-pulse protocols immediately increased active, phosphorylated ERK (pERK), which decayed within 5 h. A second wave of increased pERK was detected 18 h post-treatment for all protocols. This late phase was blocked by inhibitors of protein kinase A, TrkB and TGF-β. These results suggest that complex interactions among kinase pathways and growth factors contribute to the late increase of pERK. ERK activity returned to basal 24 h after the standard or two-pulse protocols, but remained elevated 24 h for the enhanced protocol. This 24-h elevation was also dependent on PKA and TGF-β, and partly on TrkB. These results begin to characterize long-lasting ERK activation, plausibly maintained by positive feedback involving growth factors and PKA, that appears essential to maintain LTF and LTM. Because many processes involved in LTF and late LTP are conserved among Aplysia and mammals, these findings highlight the importance of examining the dynamics of kinase cascades involved in vertebrate long-term memory.
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Affiliation(s)
- Yili Zhang
- Department of Neurobiology and Anatomy, W.M. Keck Center for the Neurobiology of Learning and Memory, McGovern Medical School at the University of Texas Health Science Center at Houston, 6431 Fannin Street, Suite MSB 7.046, Houston, TX 77030, United States
| | - Rong-Yu Liu
- Department of Neurobiology and Anatomy, W.M. Keck Center for the Neurobiology of Learning and Memory, McGovern Medical School at the University of Texas Health Science Center at Houston, 6431 Fannin Street, Suite MSB 7.046, Houston, TX 77030, United States
| | - Paul Smolen
- Department of Neurobiology and Anatomy, W.M. Keck Center for the Neurobiology of Learning and Memory, McGovern Medical School at the University of Texas Health Science Center at Houston, 6431 Fannin Street, Suite MSB 7.046, Houston, TX 77030, United States
| | - Leonard J Cleary
- Department of Neurobiology and Anatomy, W.M. Keck Center for the Neurobiology of Learning and Memory, McGovern Medical School at the University of Texas Health Science Center at Houston, 6431 Fannin Street, Suite MSB 7.046, Houston, TX 77030, United States
| | - John H Byrne
- Department of Neurobiology and Anatomy, W.M. Keck Center for the Neurobiology of Learning and Memory, McGovern Medical School at the University of Texas Health Science Center at Houston, 6431 Fannin Street, Suite MSB 7.046, Houston, TX 77030, United States
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