Neuroscience: Memory modification without catastrophe

Adaptive behaviour is supported by changes in neuronal networks. Insight into maintaining these memories - preventing their catastrophic loss - despite further network changes occurring due to novel learning is provided in a new study.

Generalization of procedural motor sequence learning after a single practice trial

When humans begin learning new motor skills, they typically display early rapid performance improvements. It is not well understood how knowledge acquired during this early skill learning period generalizes to new, related skills. Here, we addressed this question by investigating factors influencing generalization of early learning from a skill A to a different, but related skill B. Early skill generalization was tested over four experiments (N = 2095). Subjects successively learned two related motor sequence skills (skills A and B) over different practice schedules. Skill A and B sequences shared ordinal (i.e., matching keypress locations), transitional (i.e., ordered keypress pairs), parsing rule (i.e., distinct sequence events like repeated keypresses that can be used as a breakpoint for segmenting the sequence into smaller units) structures, or possessed no structure similarities. Results showed generalization for shared parsing rule structure between skills A and B after only a single 10-second practice trial of skill A. Manipulating the initial practice exposure to skill A (1 to 12 trials) and inter-practice rest interval (0-30 s) between skills A and B had no impact on parsing rule structure generalization. Furthermore, this generalization was not explained by stronger sensorimotor mapping between individual keypress actions and their symbolic representations. In contrast, learning from skill A did not generalize to skill B during early learning when the sequences shared only ordinal or transitional structure features. These results document sequence structure that can be very rapidly generalized during initial learning to facilitate generalization of skill.

Prefrontal stimulation as a tool to disrupt hippocampal and striatal reactivations underlying fast motor memory consolidation

BACKGROUND

Recent evidence suggests that hippocampal replay in humans support rapid motor memory consolidation during epochs of wakefulness interleaved with task practice.

OBJECTIVES/HYPOTHESES

The goal of this study was to test whether such reactivation patterns can be modulated with experimental interventions and in turn influence fast consolidation. We hypothesized that non-invasive brain stimulation targeting hippocampal and striatal networks via the prefrontal cortex would influence brain reactivation and the rapid form of motor memory consolidation.

METHODS

Theta-burst stimulation was applied to a prefrontal cluster functionally connected to both the hippocampus and striatum of young healthy participants before they learned a motor sequence task in a functional magnetic resonance imaging (fMRI) scanner. Neuroimaging data acquired during task practice and the interleaved rest epochs were analyzed to comprehensively characterize the effect of stimulation on the neural processes supporting fast motor memory consolidation.

RESULTS

Our results collectively show that active, as compared to control, theta-burst stimulation of the prefrontal cortex hindered fast motor memory consolidation. Converging evidence from both univariate and multivariate analyses of fMRI data indicate that active stimulation disrupted hippocampal and caudate responses during inter-practice rest, presumably altering the reactivation of learning-related patterns during the micro-offline consolidation episodes. Last, stimulation altered the link between the brain and the behavioral markers of the fast consolidation process.

CONCLUSION

These results suggest that stimulation targeting deep brain regions via the prefrontal cortex can be used to modulate hippocampal and striatal reactivations in the human brain and influence motor memory consolidation.

Does Cardiorespiratory Fitness Protect Memory from Sleep Deprivation?

INTRODUCTION

Animal studies have demonstrated that physical exercise can protect memory from the effects of sleep deprivation (SD). We examined whether having a high cardiorespiratory fitness (V̇O 2peak ) is associated with an enhanced capacity to encode episodic memory after one night of SD.

METHODS

Twenty-nine healthy young participants were allocated into either an SD group ( n = 19) that underwent 30 h of uninterrupted wakefulness, or a sleep control (SC) group ( n = 10) that followed a regular sleep routine. Following either the SD or SC period, participants were asked to view 150 images as the encoding part of the episodic memory task. Ninety-six hours after viewing the images, participants returned to the laboratory to perform the recognition part of the episodic memory task, which required the visual discrimination of the 150 images previously presented from 75 new images introduced as distractors. Cardiorespiratory fitness (V̇O 2peak ) was assessed with a bike ergometer graded exercise test. Group differences in memory performance were assessed with independent t tests and associations between V̇O 2peak and memory with multiple linear regression.

RESULTS

The SD group showed a significant increase in subjective fatigue (mean difference [MD] [standard error {SE}] = 38.94 [8.82]; P = 0.0001) and a worse capacity to identify the original 150 images (MD [SE] = -0.18 [0.06]; P = 0.005) and discriminate them from distractors (MD [SE] = -0.78 [0.21] P = 0.001). When adjusted for fatigue, higher V̇O 2peak was significantly associated with better memory scores in the SD (R 2 = 0.41; β [SE] = 0.03 [0.01]; P = 0.015) but not in the SC group ( R2 = 0.23; β [SE] = 0.02 [0.03]; P = 0.408).

CONCLUSIONS

These results confirm that SD before encoding impairs the capacity to create robust episodic memories and provide preliminary support to the hypothesis that maintaining high levels of cardiorespiratory fitness could have a protective effect against the disruptive effects of sleep loss on memory.

Acute evening high-intensity interval training may attenuate the detrimental effects of sleep restriction on long-term declarative memory

Recent evidence shows that a nap and acute exercise synergistically enhanced memory. Additionally, human-based cross-sectional studies and animal experiments suggest that physical exercise may mitigate the cognitive impairments of poor sleep quality and sleep restriction, respectively. We evaluated whether acute exercise may offset sleep restriction's impairment of long-term declarative memory compared to average sleep alone. A total of 92 (82% females) healthy young adults (24.6 ± 4.2 years) were randomly allocated to one of four evening groups: sleep restriction only (S5, 5-6 h/night), average sleep only (S8, 8-9 h/night), high-intensity interval training (HIIT) before restricted sleep (HIITS5), or HIIT before average sleep (HIITS8). Groups either followed a 15-min remote HIIT video or rest period in the evening (7:00 p.m.) prior to encoding 80 face-name pairs. Participants completed an immediate retrieval task in the evening. The next morning a delayed retrieval task was given after their subjectively documented sleep opportunities. Long-term declarative memory performance was assessed with the discriminability index (d') during the recall tasks. While our results showed that the d' of S8 (0.58 ± 1.37) was not significantly different from those of HIITS5 (-0.03 ± 1.64, p = 0.176) and HIITS8 (-0.20 ± 1.28, p = 0.092), there was a difference in d' compared to S5 (-0.35 ± 1.64, p = 0.038) at the delayed retrieval. These results suggest that the acute evening HIIT partially reduced the detrimental effects of sleep restriction on long-term declarative memory.

Distinct frequencies balance segregation with interaction between different memory types within a prefrontal circuit

Once formed, the fate of memory is uncertain. Subsequent offline interactions between even different memory types (actions versus words) modify retention.^1,2,3,4,5,6 These interactions may occur due to different oscillations functionally linking together different memory types within a circuit.^{7,8,9,10,11,12,13} With memory processing driving the circuit, it may become less susceptible to external influences.¹⁴ We tested this prediction by perturbing the human brain with single pulses of transcranial magnetic stimulation (TMS) and simultaneously measuring the brain activity changes with electroencephalography (EEG^15,16,17). Stimulation was applied over brain areas that contribute to memory processing (dorsolateral prefrontal cortex, DLPFC; primary motor cortex, M1) at baseline and offline, after memory formation, when memory interactions are known to occur.^1,4,6,10,18 The EEG response decreased offline (compared with baseline) within the alpha/beta frequency bands when stimulation was applied to the DLPFC, but not to M1. This decrease exclusively followed memory tasks that interact, revealing that it was due specifically to the interaction, not task performance. It remained even when the order of the memory tasks was changed and so was present, regardless of how the memory interaction was produced. Finally, the decrease within alpha power (but not beta) was correlated with impairment in motor memory, whereas the decrease in beta power (but not alpha) was correlated with impairment in word-list memory. Thus, different memory types are linked to different frequency bands within a DLPFC circuit, and the power of these bands shapes the balance between interaction and segregation between these memories.

Bioactive impact of manuka honey and bone char incorporated into gelatin and chitosan cryogels in a rat calvarial fracture model

Bone tissue engineered scaffolds are designed to mimic the natural environment for regeneration when typical healing is inhibited. Autografts are the current gold standard for treatment but are limited by available bone and supplementary surgical sites that broaden complications and comorbidities. Cryogels are an ideal scaffold in bone regeneration due to their mechanical integrity and marcoporous structure that elicits angiogenesis and subsequently new bone tissue formation. To aid in bioactivity and osteoinductivity, manuka honey (MH) and bone char (BC) were added to gelatin and chitosan cryogels (CG). Manuka honey has powerful antimicrobial properties to aid against graft infection, and bone char is composed of 90% hydroxyapatite, a well-studied bioactive material. These additives are natural, abundant, easy to use, and cost effective. CG cryogels incorporated with either BC or MH, and plain CG cryogels were implanted into rat calvarial fracture models for cortical bone regeneration analysis. We found indication of bioactivity with both bone char and manuka honey through the presence of woven bone structure in histology stains and micro computed tomography (microCT) data. Overall, plain CG cryogels supported greater bone regeneration capabilities than the BC or MH incorporated cryogels due to a lack of advanced organized tissue formation and collagen deposition after 8 weeks of implantation; however, future work should explore varying additive concentrations and delivery methods to further assess additive potential.

Prefrontal stimulation prior to motor sequence learning alters multivoxel patterns in the striatum and the hippocampus

Motor sequence learning (MSL) is supported by dynamical interactions between hippocampal and striatal networks that are thought to be orchestrated by the prefrontal cortex. In the present study, we tested whether individually-tailored theta-burst stimulation of the dorsolateral prefrontal cortex (DLPFC) prior to MSL can modulate multivoxel response patterns in the stimulated cortical area, the hippocampus and the striatum. Response patterns were assessed with multivoxel correlation structure analyses of functional magnetic resonance imaging data acquired during task practice and during resting-state scans before and after learning/stimulation. Results revealed that, across stimulation conditions, MSL induced greater modulation of task-related DLPFC multivoxel patterns than random practice. A similar learning-related modulatory effect was observed on sensorimotor putamen patterns under inhibitory stimulation. Furthermore, MSL as well as inhibitory stimulation affected (posterior) hippocampal multivoxel patterns at post-intervention rest. Exploratory analyses showed that MSL-related brain patterns in the posterior hippocampus persisted into post-learning rest preferentially after inhibitory stimulation. These results collectively show that prefrontal stimulation can alter multivoxel brain patterns in deep brain regions that are critical for the MSL process. They also suggest that stimulation influenced early offline consolidation processes as evidenced by a stimulation-induced modulation of the reinstatement of task pattern into post-learning wakeful rest.

Hippocampal and striatal responses during motor learning are modulated by prefrontal cortex stimulation

While it is widely accepted that motor sequence learning (MSL) is supported by a prefrontal-mediated interaction between hippocampal and striatal networks, it remains unknown whether the functional responses of these networks can be modulated in humans with targeted experimental interventions. The present proof-of-concept study employed a multimodal neuroimaging approach, including functional magnetic resonance (MR) imaging and MR spectroscopy, to investigate whether individually-tailored theta-burst stimulation of the dorsolateral prefrontal cortex can modulate responses in the hippocampus and the basal ganglia during motor learning. Our results indicate that while stimulation did not modulate motor performance nor task-related brain activity, it influenced connectivity patterns within hippocampo-frontal and striatal networks. Stimulation also altered the relationship between the levels of gamma-aminobutyric acid (GABA) in the stimulated prefrontal cortex and learning-related changes in both activity and connectivity in fronto-striato-hippocampal networks. This study provides the first experimental evidence, to the best of our knowledge, that brain stimulation can alter motor learning-related functional responses in the striatum and hippocampus.

Exercising before a nap benefits memory better than napping or exercising alone

Sleep leads to the enhancement of memory, and physical exercise also improves memory along with beneficial effects on sleep quality. Potentially, sleep and exercise may operate independently upon memory; alternatively, they may operate synergistically to boost memory above and beyond exercise or sleep alone. We tested this hypothesis in 115 young healthy adults (23 ± 3.9 years) randomly allocated to one of the four conditions in a 2 (exercise vs. no exercise) × 2 (nap vs. no nap) design. The exercise intervention consisted of a 40-minute, moderate intensity cycling, while the no exercise condition was an equivalent period of rest. This was followed by a learning session in which participants memorized a set of 45 neutral pictures for a later test. Subsequently, participants were exposed to either a 60-minute sleep period (nap) or an equivalent time of resting wakefulness, followed by a visual recognition test. We found a significant interaction between the effects of exercise and nap (p = 0.014, η p2 = 0.053), without significant main effects of exercise or nap conditions. Participants who experienced both exercise plus nap were significantly more accurate (83.8 ± 2.9) than those who only napped (81.1 ± 5.4, p = 0.027) and those who only exercised (78.6 ± 10.3, p = 0.012). Within the combined nap plus exercise group, higher recognition accuracies were associated with higher sleep spindle densities (r = 0.46, p = 0.015). Our results demonstrate that short-term exercise and a nap improve recognition memory over a nap or exercise alone. Exercise and sleep are not independent factors operating separately upon memory but work together to enhance long-term memory.

A Common Task Structure Links Together the Fate of Different Types of Memories

Our memories frequently have features in common. For example, a learned sequence of words or actions can follow a common rule, which determines their serial order, despite being composed of very different events [1, 2]. This common abstract structure might link the fates of memories together. We tested this idea by creating different types of memory task: a sequence of words or actions that either did or did not have a common structure. Participants learned one of these memory tasks and then they learned another type of memory task 6 h later, either with or without the same structure. We then tested the newly formed memory's susceptibility to interference. We found that the newly formed memory was protected from interference when it shared a common structure with the earlier memory. Specifically, learning a sequence of words protected a subsequent sequence of actions learned hours later from interference, and conversely, learning a sequence of actions protected a subsequent sequence of words learned hours later from interference provided the sequences shared a common structure. Yet this protection of the newly formed memory came at a cost. The earlier memory had disrupted recall when it had the same rather than a different structure to the newly formed and protected memory. Thus, a common structure can determine what is retained (i.e., protected) and what is modified (i.e., disrupted). Our work reveals that a shared common structure links the fate of otherwise different types of memories together and identifies a novel mechanism for memory modification.

Memories replayed: reactivating past successes and new dilemmas

Our experiences continue to be processed 'offline' in the ensuing hours of both wakefulness and sleep. During these different brain states, the memory formed during our experience is replayed or reactivated. Here, we discuss the unique challenges in studying offline reactivation, the growth in both the experimental and analytical techniques available across different animals from rodents to humans to capture these offline events, the important challenges this innovation has brought, our still modest understanding of how reactivation drives diverse synaptic changes across circuits, and how these changes differ (if at all), and perhaps complement, those at memory formation. Together, these discussions highlight critical emerging issues vital for identifying how reactivation affects circuits, and, in turn, behaviour, and provides a broader context for the contributions in this special issue. This article is part of the Theo Murphy meeting issue 'Memory reactivation: replaying events past, present and future'.

47 Five Things About Me

Background

It has long been recognised that when care is centred around the person dignity and personhood are preserved and outcomes are improved. However, the dehumanising effect hospital systems and practices can have on older people persists and there are still frequent reports of harm caused by failures to prioritise what matters to the person.

Local problem

The “what matters to you?” campaign (Dewar & Nolan, 2013) has been championed locally to good effect but a key component of the model; “who you are,” is missing, there is limited evidence of the older person’s voice or identity in their hospital notes or care plans and many report not feeling involved in decisions about their care.

Methods

Engagement with older people, their loved ones and ward staff alongside a review of the published literature enabled effective analysis of the problem and the design of a suitable intervention. The COM-B model was used to identify and support the behavioural changes needed to ensure the intervention was implemented effectively and PDSA cycles of Improvement ensured it was rigorously tested. The Person-Centred Practice Inventory (PCPI) was used to structure the measurement of improvements in person centred care on the ward.

Results

Engagement with older people, their loved ones and ward staff alongside a review of the published literature enabled effective analysis of the problem and the design of a suitable intervention. The COM-B model was used to identify and support the behavioural changes needed to ensure the intervention was implemented effectively and PDSA cycles of Improvement ensured it was rigorously tested. The Person-Centred Practice Inventory (PCPI) was used to structure the measurement of improvements in person centred care on the ward.

Conclusions

This was a rewarding project which achieved its aim of improving person-centred care and the experiences of older people, staff got to know the people they were caring for better which was an enriching experience. The key factor which contributed to its success was the enthusiasm and hard work of the ward staff who participated and their passion to ensure the care they give is person-centred.

Memory instability as a gateway to generalization

Our present frequently resembles our past. Patterns of actions and events repeat throughout our lives like a motif. Identifying and exploiting these patterns are fundamental to many behaviours, from creating grammar to the application of skill across diverse situations. Such generalization may be dependent upon memory instability. Following their formation, memories are unstable and able to interact with one another, allowing, at least in principle, common features to be extracted. Exploiting these common features creates generalized knowledge that can be applied across varied circumstances. Memory instability explains many of the biological and behavioural conditions necessary for generalization and offers predictions for how generalization is produced.

Dual enhancement mechanisms for overnight motor memory consolidation

Our brains are constantly processing past events [1]. These off-line processes consolidate memories, leading in the case of motor skill memories to an enhancement in performance between training sessions. A similar magnitude of enhancement develops over a night of sleep following an implicit task, when a sequence of movements is acquired unintentionally, or following an explicit task, when the same sequence is acquired intentionally [2]. What remains poorly understood, however, is whether these similar offline improvements are supported by similar circuits, or through distinct circuits. We set out to distinguish between these possibilities by applying Transcranial Magnetic Stimulation (TMS), over the primary motor cortex (M1) or the inferior parietal lobule (IPL) immediately after learning in either the explicit or implicit task. These brain areas have both been implicated in encoding aspects of a motor sequence, and subsequently supporting offline improvements over sleep [3-5]. Here we show that offline improvements following the explicit task are dependent upon a circuit that includes M1 but not IPL. By contrast, offline improvements following the implicit task are dependent upon a circuit that includes IPL but not M1. Our work establishes the critical contribution made by M1 and IPL circuits to offline memory processing, and reveals that distinct circuits support similar offline improvements.

Effects of tDCS on motor learning and memory formation: A consensus and critical position paper

Motor skills are required for activities of daily living. Transcranial direct current stimulation (tDCS) applied in association with motor skill learning has been investigated as a tool for enhancing training effects in health and disease. Here, we review the published literature investigating whether tDCS can facilitate the acquisition, retention or adaptation of motor skills. Work in multiple laboratories is underway to develop a mechanistic understanding of tDCS effects on different forms of learning and to optimize stimulation protocols. Efforts are required to improve reproducibility and standardization. Overall, reproducibility remains to be fully tested, effect sizes with present techniques vary over a wide range, and the basis of observed inter-individual variability in tDCS effects is incompletely understood. It is recommended that future studies explicitly state in the Methods the exploratory (hypothesis-generating) or hypothesis-driven (confirmatory) nature of the experimental designs. General research practices could be improved with prospective pre-registration of hypothesis-based investigations, more emphasis on the detailed description of methods (including all pertinent details to enable future modeling of induced current and experimental replication), and use of post-publication open data repositories. A checklist is proposed for reporting tDCS investigations in a way that can improve efforts to assess reproducibility.

Understanding Consolidation through the Architecture of Memories

Following its encoding, a memory undergoes consolidation. It may be possible to deepen our understanding of the mechanisms supporting consolidation by considering the complex architecture of a memory. Any behavior can be split into multiple components. For example, when learning a new skill we simultaneously learn the movement and the goal of that movement. Each of these components has a distinct representation within a memory. The “off-line” processing of each component may follow different rules, providing an explanation for the variety of performance changes supported by consolidation. By viewing a memory as a representation with multiple components, it is possible to bridge the gap between the behavioral changes, which define consolidation, and the biological mechanisms that support those changes. This is partly because different memory components can be mapped onto different neural circuits. With an increased understanding of consolidation, it may become possible to modulate these off-line processes to improve psychiatric and neurological rehabilitation.

Thinking About a Task Is Associated with Increased Connectivity in Regions Activated by Task Performance

We investigated whether functional neuroimaging of quiet "rest" can reveal the neural correlates of conscious thought. Using resting-state functional MRI, we measured functional connectivity during a resting scan that immediately followed performance of a finger tapping motor sequence task. Self-reports of the amount of time spent thinking about the task during the resting scan correlated with connectivity between regions of the motor network activated during task performance. Thus, thinking about a task is associated with coordinated activity in brain regions responsible for that task's performance. More generally, this study demonstrates the feasibility of using the combination of functional connectivity MRI and self-reports to examine the neural correlates of thought.

To Replay, Perchance to Consolidate

After a memory is formed, it continues to be processed by the brain. These “off-line” processes consolidate the memory, leading to its enhancement and to changes in memory circuits. Potentially, these memory changes are driven by off-line replay of the pattern of neuronal activity present when the memory was being formed. A new study by Dhaksin Ramanathan and colleagues, published in PLOS Biology, demonstrates that replay occurs predominately after the acquisition of a new motor skill and that it is related to changes in memory performance and to the subsequent changes in memory circuits. Together, these observations reveal the importance of neuronal replay in the consolidation of novel motor skills.

This Primer examines the implications of a new study showing that the pattern of neuronal activity during the formation of a memory is replayed during sleep, changing memory circuits and enhancing the memory. Read the Research Article.

Resting state connectivity immediately following learning correlates with subsequent sleep-dependent enhancement of motor task performance

There is ongoing debate concerning the functions of resting-state brain activity. Prior work demonstrates that memory encoding enhances subsequent resting-state functional connectivity within task-relevant networks and that these changes predict better recognition. Here, we used functional connectivity MRI (fcMRI) to examine whether task-induced changes in resting-state connectivity correlate with performance improvement after sleep. In two separate sessions, resting-state scans were acquired before and after participants performed a motor task. In one session participants trained on the motor sequence task (MST), a well-established probe of sleep-dependent memory consolidation, and were tested the next day, after a night of sleep. In the other session they performed a motor control task (MCT) that minimized learning. In an accompanying behavioral control study, participants trained on the MST and were tested after either a night of sleep or an equivalent interval of daytime wake. Both the fcMRI and the sleep control groups showed significant improvement of MST performance, while the wake control group did not. In the fcMRI group, increased connectivity in bilateral motor cortex following MST training correlated with this next-day improvement. This increased connectivity did not appear to reflect initial learning since it did not correlate with learning during training and was not greater after MST training than MCT performance. Instead, we hypothesize that this increased connectivity processed the new memories for sleep-dependent consolidation. Our findings demonstrate that physiological processes immediately after learning correlate with sleep-dependent performance improvement and suggest that the wakeful resting brain prepares memories of recent experiences for later consolidation during sleep.

Memory processing: the critical role of neuronal replay during sleep

Patterns of neuronal activity present during learning in the hippocampus are replayed during sleep. A new study highlights the functional importance of this neurophysiological phenomenon by showing that neuronal replay is critical for memory processing over a night of sleep.

Is neuroenhancement by noninvasive brain stimulation a net zero-sum proposition?

In the past several years, the number of studies investigating enhancement of cognitive functions through noninvasive brain stimulation (NBS) has increased considerably. NBS techniques, such as transcranial magnetic stimulation and transcranial current stimulation, seem capable of enhancing cognitive functions in patients and in healthy humans, particularly when combined with other interventions, including pharmacologic, behavioral and cognitive therapies. The "net zero-sum model", based on the assumption that brain resources are subjected to the physical principle of conservation of energy, is one of the theoretical frameworks proposed to account for such enhancement of function and its potential cost. We argue that to guide future neuroenhancement studies, the net-zero sum concept is helpful, but only if its limits are tightly defined.

New insights in human memory interference and consolidation

Learning new facts and skills in succession can be frustrating because no sooner has new knowledge been acquired than its retention is being jeopardized by learning another set of skills or facts. Interference between memories has recently provided important new insights into the neural and psychological systems responsible for memory processing. For example, interference not only occurs between the same types of memories, but can also occur between different types of memories, which has important implications for our understanding of memory organization. Converging evidence has begun to reveal that the brain produces interference independently from other aspects of memory processing, which suggests that interference may have an important but previously overlooked function. A memory's initial susceptibility to interference and subsequent resistance to interference after its acquisition has revealed that memories continue to be processed 'off-line' during consolidation. Recent work has demonstrated that off-line processing is not limited to just the stabilization of a memory, which was once the defining characteristic of consolidation; instead, off-line processing can have a rich diversity of effects, from enhancing performance to making hidden rules explicit. Off-line processing also occurs after memory retrieval when memories are destabilized and then subsequently restabalized during reconsolidation. Studies are beginning to reveal the function of reconsolidation, its mechanistic relationship to consolidation and its potential as a therapeutic target for the modification of memories.

Resting state networks and memory consolidation

Despite their name, resting state networks (RSNs) provide a clear indication that the human brain may be hard-working. Unlike the cardiac and respiratory systems, which greatly reduce their rate of function during periods of inactivity, the human brain may have additional responsibilities during rest. One particularly intriguing function performed by the resting brain is the consolidation of recent learned information, which is known to take place over a period of several hours after learning. We recently reported that resting state brain activity is modulated by recent learning. We measured the brain activity using functional MRI during periods of rest that preceded and followed learning of a sensorimotor task, and found a network of brain areas that changed their resting activity. These areas are known to be involved in the acquisition and memory of such sensorimotor tasks. Furthermore, the changes were specific to a task that required learning, and were not found after motor performance without learning. Here we discuss the implications and possible extensions of this work and its relevance to the study of memory consolidation.

A distraction can impair or enhance motor performance

Humans have a prodigious capacity to perform multiple tasks simultaneously. Being distracted while, for example, performing a complex motor skill adds complexity to a task and thus leads to a performance impairment. Yet, it may not be just the presence or absence of a distraction that affects motor performance. Instead, the characteristics of the distraction may play a critical role in affecting human motor performance. Here, we show that performance of a motor sequence can be substantially enhanced by simultaneously learning an independent color sequence. In contrast, performance of the same motor sequence was impaired by concurrently counting the number of red cues that were in the color sequence. The color and motor sequences had different lengths (10 vs 12 items), different numbers of elements (five vs four elements), and different temporal patterns (randomly intermittent vs continuous) and thus were independent of one another. These observations show that distracting information does not always impair motor performance, and so is not a sufficient explanation for the impaired performance. Instead, the influence that a distraction exerts upon performance is mediated by the type of processes engaged: when similar core processes are engaged, motor performance is enhanced, whereas when very different processes are engaged (i.e., counting and sequence performance), performance is impaired. Thus, these observations deepen our understanding of how a distraction, depending on its characteristics, can either impair or enhance performance and may offer novel approaches to optimizing human cognition.

Sequence skill acquisition and off-line learning in normal aging

It is well known that certain cognitive abilities decline with age. The ability to form certain new declarative memories, particularly memories for facts and events, has been widely shown to decline with advancing age. In contrast, the effects of aging on the ability to form new procedural memories such as skills are less well known, though it appears that older adults are able to acquire some new procedural skills over practice. The current study examines the effects of normal aging on procedural memory more closely by comparing the effects of aging on the encoding or acquisition stage of procedural learning versus its effects on the consolidation, or between-session stage of procedural learning. Twelve older and 14 young participants completed a sequence-learning task (the Serial Reaction Time Task) over a practice session and at a re-test session 24 hours later. Older participants actually demonstrated more sequence skill during acquisition than the young. However, older participants failed to show skill improvement at re-test as the young participants did. Age thus appears to have a differential effect upon procedural learning stages such that older adults' skill acquisition remains relatively intact, in some cases even superior, compared to that of young adults, while their skill consolidation may be poorer than that of young adults. Although the effect of normal aging on procedural consolidation remains unclear, aging may actually enhance skill acquisition on some procedural tasks.

The resting human brain and motor learning

Functionally related brain networks are engaged even in the absence of an overt behavior. The role of this resting state activity, evident as low-frequency fluctuations of BOLD (see [1] for review, [2-4]) or electrical [5, 6] signals, is unclear. Two major proposals are that resting state activity supports introspective thought or supports responses to future events [7]. An alternative perspective is that the resting brain actively and selectively processes previous experiences [8]. Here we show that motor learning can modulate subsequent activity within resting networks. BOLD signal was recorded during rest periods before and after an 11 min visuomotor training session. Motor learning but not motor performance modulated a fronto-parietal resting state network (RSN). Along with the fronto-parietal network, a cerebellar network not previously reported as an RSN was also specifically altered by learning. Both of these networks are engaged during learning of similar visuomotor tasks [9-22]. Thus, we provide the first description of the modulation of specific RSNs by prior learning--but not by prior performance--revealing a novel connection between the neuroplastic mechanisms of learning and resting state activity. Our approach may provide a powerful tool for exploration of the systems involved in memory consolidation.

From creation to consolidation: a novel framework for memory processing

Long after playing squash, your brain continues to process the events that occurred during the game, thereby improving your game, and more generally, enhancing adaptive behavior. Understanding these mysterious processes may require novel theories.

Off-line processing: reciprocal interactions between declarative and procedural memories

The acquisition of declarative (i.e., facts) and procedural (i.e., skills) memories may be supported by independent systems. This same organization may exist, after memory acquisition, when memories are processed off-line during consolidation. Alternatively, memory consolidation may be supported by interactive systems. This latter interactive organization predicts interference between declarative and procedural memories. Here, we show that procedural consolidation, expressed as an off-line motor skill improvement, can be blocked by declarative learning over wake, but not over a night of sleep. The extent of the blockade on procedural consolidation was correlated to participants' declarative word recall. Similarly, in another experiment, the reciprocal relationship was found: declarative consolidation was blocked by procedural learning over wake, but not over a night of sleep. The decrease in declarative recall was correlated to participants' procedural learning. These results challenge the concept of fixed independent memory systems; instead, they suggest a dynamic relationship, modulated by when consolidation takes place, allowing at times for a reciprocal interaction between memory systems.

Inducing motor skill improvements with a declarative task

During sequence learning, individuals show motor-skill acquisition and an ability to verbally describe items within the sequence. We disrupted this latter, declarative component by having participants learn a word list immediately after sequence learning. This induced off-line skill improvements. We conclude that off-line memory processing relies not only on the engagement of neuroplastic mechanisms but also on the disengagement of an interaction between declarative and procedural memory systems.

Functional imaging: is the resting brain resting?

It is often assumed that the human brain only becomes active to support overt behaviour. A new study challenges this concept by showing that multiple neural circuits are engaged even at rest. We highlight two complementary hypotheses which seek to explain the function of this resting activity.

Motor sequence consolidation: constrained by critical time windows or competing components

Skill improvements may develop between practice sessions during memory consolidation. Skill enhancement within an egocentric coordinate frame develops over wake, whereas skill enhancement in an allocentric coordinate frame develops over a night of sleep. We tested whether both types of improvement could develop over two different 24-h intervals: 8 am to 8 am or from 8 pm to 8 pm. We found that for each 24 h interval, only one type of skill improvement was seen. Despite passing through wake and a night of sleep participants only showed skill improvements commensurate with either a night of sleep or a day awake. The nature of the off-line skill enhancement was determined by when consolidation occurred within the normal sleep-wake cycle. We conclude that motor sequence consolidation is constrained either by having critical time windows or by a competitive interaction in which improvements within one co-ordinate frame actively block improvements from developing in the alternative co-ordinate frame.

Measuring safety climate in health care

AIM

To review quantitative studies of safety climate in health care to examine the psychometric properties of the questionnaires designed to measure this construct.

METHOD

A systematic literature review was undertaken to study sample and questionnaire design characteristics (source, no of items, scale type), construct validity (content validity, factor structure and internal reliability, concurrent validity), within group agreement, and level of analysis.

RESULTS

Twelve studies were examined. There was a lack of explicit theoretical underpinning for most questionnaires and some instruments did not report standard psychometric criteria. Where this information was available, several questionnaires appeared to have limitations.

CONCLUSIONS

More consideration should be given to psychometric factors in the design of healthcare safety climate instruments, especially as these are beginning to be used in large scale surveys across healthcare organisations.

Off-line learning and the primary motor cortex

We are all familiar with acquiring skills during practice, but skill can also continue to develop between practice sessions. These "off-line" improvements are frequently supported by sleep, but they can be time dependent when a skill is acquired unintentionally. The magnitude of these over-day and overnight improvements is similar, suggesting that a similar mechanism may support both types of off-line improvements. However, here we show that disruption of the primary motor cortex with repetitive transcranial magnetic stimulation blocks off-line improvements over the day but not overnight. This suggests that a memory may be rescued overnight and subsequently enhanced or that different aspects of a skill, with differential dependencies on the primary motor cortex, are enhanced over day and overnight. Off-line improvements of similar magnitude are not supported by similar mechanisms; instead, the mechanisms engaged may depend on brain state.

The time course of off-line motor sequence learning

The acquisition of motor skill occurs with practice, but skill can also increase between sessions, a process termed "off-line learning". Here, we investigated the amount of time required for the off-line development of skills. Participants were tested on an implicit version of the Serial Reaction Time Task and re-tested 1, 4 or 12 h later. Only those re-tested 4 h or 12 h after initial testing showed off-line improvements. This demonstrates that implicitly acquired skills can increase between sessions and the process occurs over hours.

Off-line learning of motor skill memory: a double dissociation of goal and movement

Acquiring a new skill requires learning multiple aspects of a task simultaneously. For example, learning a piano sonata requires learning the musical notes and being able to implement this goal by learning the appropriate sequence of finger movements. After practice, skill continues to develop off-line during a period of consolidation. Here we show that different aspects of a procedural memory are processed separately during consolidation: Only the movement sequence is enhanced over the day; whereas only the goal is enhanced over a night of sleep. This double dissociation suggests that distinct systems, enhancing different aspects of a procedural memory, support improvements during consolidation. Consolidation is not a single process; instead, there are multiple routes to off-line learning, and the engagement of these distinct mechanisms is determined by when consolidation takes place.

The Effects of Repetitive Transcranial Magnetic Stimulation (rTMS) on Procedural Memory and Dysphoric Mood in Patients With Major Depressive Disorder

OBJECTIVE

To study the effects of depression and treatment with repetitive transcranial magnetic stimulation (rTMS) on sequence learning.

BACKGROUND

Prefrontal dysfunction in depression may affect sequence learning and be amenable to normalization by rTMS.

METHOD

The serial reaction time test (SRTT) was administered to 19 patients with major depressive disorder (MDD) and 20 nondepressed control participants. MDD patients were examined before and following treatment with rTMS to the left dorsolateral prefrontal cortex in daily sessions of 1600 stimuli at 10 Hz and at an intensity of 110% of the motor threshold. Treatment occurred over a 2-week interval of time.

RESULTS

MDD and nondepressed groups differed significantly with respect to baseline response speed. Following treatment with rTMS, MDD participants demonstrated significantly improved mood, improved response speed, and improved procedural learning.

CONCLUSIONS

Findings suggest that rTMS over a 2-week period improves performance on tasks of response speed and procedural memory in patients with MDD. These cognitive effects are greater in those patients who showed a significant antidepressant effect to rTMS intervention.

Skill Learning: Putting Procedural Consolidation in Context

Information acquired during skill learning continues to be processed long after practice has ceased. An important aspect of this processing is thought to be the transformation of a memory from a fragile to a stable state: a concept challenged by a recent study.

Awareness Modifies the Skill-Learning Benefits of Sleep

Behind every skilled movement lies months of practice. However, practice alone is not responsible for the acquisition of all skill; performance can improve between, not just within, practice sessions. An important principle shaping these offline improvements may be an individual's awareness of learning a new skill. New skills, such as a sequence of finger movements, can be learned unintentionally (with little awareness for the sequence, implicit learning) or intentionally (explicit learning). We measured skill in an implicit and explicit sequence-learning task before and after a 12 hr interval. This interval either did (8 p.m. to 8 a.m.) or did not (8 a.m. to 8 p.m.) include a period of sleep. Following explicit sequence learning, offline skill improvements were only observed when the 12 hr interval included sleep. This overnight improvement was correlated with the amount of NREM sleep. The same improvement could also be observed in the evening (with an interval from 8 p.m. to 8 p.m.), so it was not coupled to retesting at a particular time of day and cannot therefore be attributed to circadian factors. In contrast, in the implicit learning task, offline learning was observed regardless of whether the 12 hr interval did or did not contain a period of sleep. However, these improvements were not observed with only a 15 min interval between sessions. Therefore, the practice available within each session cannot account for these skill improvements. Instead, sufficient time is necessary for offline learning to occur. These results show a behavioral dissociation, based upon an individual's awareness for having learned a sequence of finger movements. Offline learning is sleep dependent for explicit skills but time dependent for implicit skills.

Studies in cognition: the problems solved and created by transcranial magnetic stimulation

The application of transcranial magnetic stimulation (TMS) to investigate important questions in cognitive neuroscience has increased considerably in the last few years. TMS can provide substantial insights into the nature and the chronometry of the computations performed by specific cortical areas during various aspects of cognition. However, the use of TMS in cognitive studies has many potential perils and pitfalls. Although TMS can help bridge the gap between psychological models and brain-based arguments of cognitive functions, hypothesis-driven carefully designed experiments that acknowledge the current limitations of TMS are critical.

A prospective study of early diagnostic investigations in the diagnosis of ankylosing spondylitis

This study was designed to assess the relative values current of locally available investigations in the early diagnosis of inflammatory sacroiliitis. Consecutive patients attending routine rheumatology clinics in Aberdeen clinically considered by consultant rheumatologists to have inflammatory back disease but with insufficient criteria to firmly establish a diagnosis of ankylosing spondylitis were included. Patients were assessed using a standard questionnaire, clinical examination of spinal movements, plain radiology of the sacroiliac joints, computerised tomographic scanning of the sacroiliac joints and HLA-B27 typing. Patients were systematically followed up using repeated clinical and radiological examination for five years. Plain film evidence of grade 2 radiological sacroiliitis (bilateral or unilateral) was found to be the most reliable predictor for the development of ankylosing spondylitis satisfying the New York criteria at 5 year follow up. CT scanning and HLA-B27 typing were of no added value in this series and the clinical questionnaire lacked specificity. It is concluded that the combination of clinical history, examination and plain film radiology are currently reliable criteria for diagnosing the subsequent development of ankylosing spondylitis satisfying established criteria.

Prefrontal cortex: procedural sequence learning and awareness

Activation of the prefrontal cortex has been linked to awareness during sequence-learning tasks. A recent study, however, finds activation of the prefrontal cortex during such tasks regardless of awareness. So what is the neurophysiological basis of awareness, and what is the role of the prefrontal cortex in sequence learning?

Aspects of sensory guidance in sequence learning

We explored the effects of sensory information upon procedural learning using three versions of the serial reaction-time task (SRTT): a standard task where the position of the stimulus cued the response; a non-standard task where the color of the stimulus was related to the correct response; and a combined task where both the color and position simultaneously cued the response. Despite these differences, each task had the same temporal pattern of a repeating ten-item sequence. We refer to each of these tasks based upon the cues available for guiding learning: position, color, and combined tasks. Procedural sequence learning was greater for the combined than for the other two tasks, suggesting that learning is enhanced when multiple sources of sensory information cue consistently and simultaneously for the same response. Transfer of skill occurred across all the tasks, except from the position to the color task. These results suggest that a fundamental neural algorithm is responsible for acquiring knowledge about a temporal sequence of responses rather than forming an associative relationship amongst stimuli.

The role of the dorsolateral prefrontal cortex during sequence learning is specific for spatial information

Many studies have implicated the dorsolateral prefrontal cortex in the acquisition of skill, including procedural sequence learning. However, the specific role it performs in sequence learning has remained uncertain. This type of skill has been intensively studied using the serial reaction time task. We used three versions of this task: a standard task where the position of the stimulus cued the response; a non-standard task where the color of the stimulus was related to the correct response; and a combined task where both the color and position simultaneously cued the response. We refer to each of these tasks based upon the cues available for guiding learning as position, color and combined tasks. The combined task usually shows an enhancement of skill acquisition, a result of being driven by two simultaneous and congruent cues. Prior to the performance of each of these tasks the function of the dorsolateral prefrontal cortex was disrupted using repetitive transcranial magnetic stimulation. This completely prevented learning within the position task, while sequence learning occurred to a similar extent in both the color and combined tasks. So, following prefrontal stimulation the expected learning enhancement in the combined task was lost, consistent with only a color cue being available to guide sequence learning in the combined task. Neither of these effects was observed following stimulation at the parietal cortex. Hence the critical role played by the dorsolateral prefrontal cortex in sequence learning is related exclusively to spatial cues. We suggest that the dorsolateral prefrontal cortex operates over the short term to retain and manipulate spatial information to allow cortical and subcortical structures to learn a predictable sequence of actions. Such functions may emerge from the broader role the dorsolateral prefrontal cortex has in spatial working memory. These results argue against the dorsolateral prefrontal cortex constituting part of the neuronal substrate responsible for general aspects of implicit or explicit sequence learning.