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ObjectivePeople with vestibular disorders frequently experience psychological distress which can impede daily activities and clinical recovery. Although the need for psychological input is widely acknowledged, there are no clinical guidelines, leading to variation in care received. This study examines how psychological aspects of vestibular disorders are currently addressed highlighting any national variation.MethodAn online survey was completed by 101 UK healthcare professionals who treat vestibular disorders. The survey included open and close-ended questions covering service configurations, respondent characteristics, attitudes towards psychological aspects, and clinical practice for cognitive and mental health problems. Results96% of respondents thought there was a psychological component to vestibular disorders. There was a discrepancy between perceived importance of addressing psychological aspects and confidence to undertake this. Those with more years of experience felt more confident addressing psychological aspects. Mental health problems were addressed more frequently than cognitive problems. History taking and questionnaires containing one or two items about psychological distress were the most common assessment approaches. Discussing symptoms and signposting were the most frequent management approaches. Referrals for psychological support were typically to professionals within another service, via the patient’s GP. Qualitative responses highlighted the interdependence of psychological and vestibular disorders which require identification and timely intervention. Barriers to implementation included limited referral pathways and interdisciplinary expertise.ConclusionClinical practice varies and relates to the confidence, experience and expertise of individual health professionals, resources, and appropriate referral pathways. Although psychological distress is frequently identified, suitable psychological treatment is not routinely offered in the UK.

Anodal transcranial direct current stimulation (tDCS) to the left dorsolateral prefrontal cortex (DLPFC) has been shown to improve performance on a multitude of cognitive tasks. These are, however, often simple tasks, testing only one cognitive domain at a time. Therefore, the efficacy of brain stimulation for complex tasks has yet to be understood. Using a task designed to increase learning efficiency, this study investigates whether anodal tDCS over the left DLPFC can modulate both learning ability and subsequent long-term memory retention. Using a within-subject design, participants (N = 25) took part in 6 training sessions over consecutive days in which active or sham stimulation was administered randomly (3 of each). A computer-based task was used, containing flags from countries unknown to the participants. Each training session consisted of the repetition of 8 pairs of flag/country names. Subsequently, in three testing sessions, free, cued, and timed cued recall, participants were assessed on all 48 flags they had learnt. No difference in learning speed between active and sham tDCS was found. Furthermore, in the timed cued recall phase, flags learnt in the sham tDCS sessions were recalled significantly better than flags learnt in the active tDCS sessions. This effect was stronger in the second testing session. It was also found that for the flags answered incorrectly; thus, meaning they were presented more frequently, subsequent long-term retention was improved. These results suggest that for a complex task, anodal tDCS is ineffective at improving learning speed and potentially detrimental to long-term retention when employed during encoding. This serves to highlight the complex nature of brain stimulation, providing a greater understanding of its limitations and drawbacks.

Objectives Many studies have looked at the effects of physical exercise on long-term memory. However, to date, no study has compared the effect of different intensities and protocols of physical exercise and different rest conditions on long-term memory. Methods In three studies (N=59) we measured the extent that physical exercise (in its varying intensities) and wakeful rest (active-rest; in which participants were cognitively engaged while seated and passive-rest; no cognitive engagement while seated) could influence long-term memory. Across all three studies, nearly identical procedures were employed, using the same old/new recognition memory test in order to establish the most effective protocol for cognitive enhancement. In Study 1, the effects of continuous moderate intensity exercise, uninterrupted wakeful rest (passive) and rest with an engagement task (active) were explored. In Study 2, continuous moderate intensity exercise was compared to high-intensity interval training (HIIT) and passive rest. Study 3 observed the effects of low-, moderate- and high-intensity continuous exercise. Results Across the three studies moderate intensity exercise had the greatest positive impact on memory performance. Passive rest was more effective than active rest, however, less than high-intensity interval-training (HIIT). Conclusion Our findings suggest that it is not necessary to physically overexert oneself in order to achieve observable improvements to long-term memory. By also investigating uninterrupted wakeful rest, it reaffirmed the importance of the consolidation period for the formation of long-term memories.

Objectives This experiment assessed the effectiveness of three interventions; neurofeedback, motor imagery and physical training, on their ability to improve visuomotor accuracy, measured by scores achieved on a dart throwing task. Methods Thirty-two female participants, all with no experience in dart throwing, took part and were assigned to either one of the three experimental conditions, or a control group (eight per condition). Training sessions for neurofeedback (NFB) involved participants encouraging both Theta rhythms and Sensorimotor rhythms (SMR). For Motor Imagery (MI), internal (1st person) imagery was used, where participants had to imagine throwing a dart and for physical training (PT) participants physically practised dart throwing. Measurements were recorded pre-intervention, after two weeks (6 sessions) of training (mid-intervention), after 5 weeks (15 sessions) of training (in total; Outcome Measure 1) and again two weeks after training had finished (Outcome Measure 2). Results from Mid-intervention, Outcome Measure 1 and Outcome Measure 2 were compared to baseline scores achieved pre-intervention and showed all three interventions to significantly increase performance on dart throwing compared to the Control group. Conclusion Our findings show that, as well as traditional physical practise, both motor imagery and neurofeedback can effectively improve performance on a fine visuomotor task.