Short-term retention of words as a function of encoding depth.

The traditional short- and long-term storage view of information processing and the levels-of-processing view both discuss the forgetting of information over time. In the traditional stage view, there is loss of at least poorly encoded information across several seconds when the information cannot be rehearsed (e.g., Ricker et al., 2020, Learning, Memory, and Cognition, 46, 60-76). In the levels-of-processing approach, information that is encoded in a shallow manner is lost more quickly over time than deeply-encoded information (Craik & Lockhart, 1972, Journal of Verbal Learning and Verbal Behavior, 11, 671-684.). Previous studies of the depth of encoding, however, have mostly been conducted using delayed tests, so there are few studies directly comparing the rate of forgetting over time for information as a function of different depths of encoding. We manipulated the level of processing with immediate recall in a modified Brown-Peterson task. An effect of the level of processing was robust, but evidence of forgetting across retention intervals was not always observed. When encoding time was curtailed (in Experiments 3 and 4), we found main effects of both the level of processing and the retention interval, but no interaction between the two variables. The results suggest that the depth-of-encoding effect may occur during the initial encoding of items, but without differential forgetting within the range of retention intervals that we examined (0-18 s), in contrast to the suggestion by Craik and Lockhart. Further work is needed to determine whether the depth-of-processing effect would grow over longer intervals.

Listen up, kids! How mind wandering affects immediate and delayed memory in children.

Mind wandering occurs when attention becomes disengaged from the here-and-now and directed toward internally generated thoughts; this is often associated with poorer performance on educationally significant tasks. In this study, 8- to 9-year-old children (N = 60) listened to audio stories embedded with intermittent thought probes that were used to determine if participants' thoughts were on or off task. The key objective was to explore the impact of probe-caught mind wandering on both immediate and delayed memory retention. Children reported being off task approximately 24% of the time. Most inattention episodes were classified as task-unrelated thoughts (i.e., 'pure' instances of mind wandering, 9%) or attentional failures due to distractions (9%). Higher frequency of mind wandering was strongly associated with poorer memory recall, and task-unrelated thoughts strongly predicted how well children could recall components of the audio story both immediately after the task and after a 1-week delay. This study is the first to demonstrate the impact of mind wandering on delayed memory retention in children. Results suggest that exploring mind wandering in the foundational years of schooling could provide the necessary empirical foundation for the development of practical interventions geared toward detecting and refocusing lapses of attention in educational contexts.

Using systems modeling to facilitate undergraduate physiology student learning and retention of difficult concepts.

Physiology concepts, such as acid-base balance, may be difficult for students to understand. Systems modeling, a cognitive tool, allows students to visualize their mental model of the problem space to enhance learning and retention. We performed a within-subjects three-period randomized control comparison of systems modeling versus written discussion activities in an undergraduate asynchronous online Anatomy and Physiology II course. Participants (n = 108) were randomized to groups with differing treatment orders across three course units: endocrine, immune, and acid-base balance. Participants demonstrated content understanding through either constructing systems modeling diagrams (M) or written discussion posts (W) in a MWM, MMW, or WMM sequence. For each of three units, student performance was assessed on 6 standardized multiple-choice questions embedded within a 45-question exam. The same 6 questions per unit, 18 questions in total, were again assessed on the 75-question final exam. The groups demonstrated no significant difference in performance in the endocrine unit exam [mean difference (MD) = -0.036]. However, the modeling group outperformed the writing group in the immune unit exam (MD = 0.209) and widened the gap in the acid-base balance unit exam (MD = 0.243). On the final exam, performance was again higher for the modeling group on acid-base balance content, as mean difference increased to 0.306 despite the final exam content for acid-base balance being significantly more difficult compared to other units [modeling: F(2) = 29.882, P < 0.001; writing: F(2) = 25.450, P < 0.001]. These results provide initial evidence that participation in systems modeling activities may enhance student learning of difficult physiology content as evidenced by improved multiple-choice question performance.NEW & NOTEWORTHY Physiology educators often intuitively utilize systems thinking and modeling while teaching difficult concepts. Guiding students in development of their own systems modeling skills by enhancing their visualization of their mental model of the problem space may improve performance on multiple-choice test questions.

A systematic review of medical practitioners' retention and application of basic sciences to clinical practice.

BACKGROUND: Medical education offers the foundational base for future healthcare professionals, with basic sciences playing a pivotal role in providing essential knowledge and skills for clinical practice. However, the long-term retention and application of this knowledge in clinical practice remain a significant challenge. This systematic review synthesised global evidence from diverse studies on the short / long-term retention and clinical application of basic sciences among medical doctors. METHODS: A comprehensive search was conducted across six databases, including Web of Science, Scopus, Medline, CINAHL, Emcare, and Informit. The review included studies that encompassed a variety of study designs, participant groups, and educational interventions. The Quality Assessment with Diverse Studies (QuADS) tool was utilised to assess the quality of the reviewed studies. RESULTS: A total of 10 studies were included in the review. The findings revealed that rehearsals significantly optimise the retention of basic science knowledge among medical practitioners. Retention varied by discipline, with medical practitioners retaining more knowledge in anatomy (mean scores ranging from 45.0 to 82.9%), while microbiology had the lowest retention score (39.1%). Factors influencing retention included age, gender, and curriculum type. Educational interventions such as targeted courses, integration of basic sciences with clinical skills, generative retrieval and continuous quality improvement in the curriculum were found to enhance both knowledge retention and clinical reasoning. The concept of 'encapsulated knowledge' demonstrates that integrated basic science knowledge helps in synthesising clinical presentations, reducing the need for detailed recall as clinical experience increases. The reviewed studies primarily involved interns and surgeons, leaving a significant gap in research for specialties like internal medicine and primary care/ general practice. CONCLUSION: Detailed retention of basic science knowledge may diminish over time; however, the conceptual framework remains essential for ongoing learning and clinical reasoning. This review's findings highlight the need for specialised educational interventions to improve long-term retention. Continuous professional development and targeted educational techniques are vital for maintaining clinical competence and applying basic science knowledge effectively throughout a medical career. Further research is needed to address gaps in specialty-specific knowledge application and the impact of different instructional methods.

Does an instructional video as a stand-alone tool promote the acquisition of practical clinical skills? A randomised simulation research trial of skills acquisition and short-term retention.

BACKGROUND: The effectiveness of instructional videos as a stand-alone tool for the acquisition of practical skills is yet unknown because instructional videos are usually didactically embedded. Therefore, we evaluated the acquisition of the skill of a humeral intraosseous access via video in comparison to that of a self-study with an additional retention test. METHODS: After ethical approval, we conducted two consecutive studies. Both were designed as randomised controlled two-armed trials with last-year medical students as independent samples at our institutional simulation centre of a tertiary university hospital centre. In Study 1, we randomly assigned 78 participants to two groups: Vid-Self participants watched an instructional video as an intervention, followed by a test, and after seven days did a self-study as a control, followed by a test. Self-Vid ran through the trial in reverse order. In Study 2, we investigated the influence of the sequence of the two teaching methods on learning success in a new sample of 60 participants: Vid-Self watched an instructional video and directly afterward did the self-study followed by a test, whereas Self-Vid ran through that trial in reverse order. In Studies 1 and 2, the primary outcome was the score (worst score = 0, best score = 20) of the test after intervention and control. The secondary outcome in Study 1 was the change in score after seven days. RESULTS: Study 1: The Vid-Self (Participants n = 42) was superior to the Self-Vid (n = 36) (mean score 14.8 vs. 7.7, p < 0.001). After seven days, Self-vid outperformed Vid-Self (mean score 15.9 vs. 12.5, p < 0.001). Study 2: The Vid-Self (n = 30) and Self-Vid (n = 30) scores did not significantly differ (mean 16.5 vs. mean 16.5, p = 0.97). CONCLUSION: An instructional video as a stand-alone tool effectively promotes the acquisition of practical skills. The best results are yielded by a combination of an instructional video and self-study right after each other, irrespective of sequence. TRIAL REGISTRATIONS: ClinicalTrials.gov: NCT05066204 (13/04/2021) (Study 1) and NCT04842357 (04/10/2021) (Study 2).

Knowledge and Skill Retention in First-Year MBBS Students After Basic Life Support Training: A One-Year Longitudinal Study.

BACKGROUND: The Indian National Medical Council has incorporated the Basic Life Support (BLS) course in the foundation course of the undergraduate (MBBS) medical curriculum. However, medical teachers raise concerns about how training would affect the retention of Basic Life Support (BLS) abilities in the longer run. So, the current study assesses the knowledge and retention of BLS skills among first-year MBBS students over one year. METHODS: We included one hundred first-year MBBS students in our study who were trained for BLS, including theory, demonstrations and hands-on training using mannequins. Theoretical knowledge was assessed using pre-test and post-test questionnaires. At the same time, the skills were evaluated using Directly Observed Procedural Skills (DOPS) scores before, just after the training session, and again after one month, six months, and one year. Course feedback was also taken from the students after completing the sessions. RESULTS: There was a statistically significant difference between pre-and post-test knowledge scores, indicating that training improved their knowledge. (p < 0.001) There was also a statistically significant difference between pre-and post-test skills using DOPS (p < 0.001). There was no significant difference in the score when DOPS was conducted at one month, but a significant decrease in their skills was seen at six months and one year when compared with the Post Skill Score. (P < 0.001) CONCLUSIONS: The first-year medical students' knowledge and skills were enhanced by BLS training coupled with practical sessions. Such waning skills necessitate repeating the training at periodic intervals to reinform retention of skills acquired during BLS training.

Fostering retention of word learning: The number of training sessions children retrieve words positively relates to post-training retention.

During vocabulary instruction, it is important to teach words until their representations are robust enough to be retained. For adults, the number of training sessions a target item is successfully retrieved during training predicts the likelihood of post-training retention. To assess this relationship in children, we reanalyzed data from Gordon et al. (2021b, 2022). Four- to six-year-old children completed six training days with word form-object pairs and were tested one month later. Results indicate that the number of training sessions that a word form was retrieved was positively related to post-training retention. We discuss implications for vocabulary instruction and interventions.

Evaluation of the retention of knowledge, skills and competency of post-neonatal resuscitation training among house officers.

INTRODUCTION: The Neonatal Resuscitation Programme (NRP) was first introduced in Malaysia in 1996 to train doctors and nurses working in paediatrics and obstetrics departments who are involved with the care of newborns soon after delivery. Prompt and effective neonatal resuscitation has been documented to reduce mortality and neonatal asphyxia. The programme has been revised every five years and is now in the 8th edition. NRP training was made into a key performance indicator (KPI) by the Ministry of Health in 2016 for all house officers to be trained in this programme during their 2-year posting and this is usually conducted during the paediatric posting. This study aims to evaluate the retention of their knowledge, skills and competency at 3, 6, and 9 months after the initial NRP training. MATERIALS AND METHODS: A total of 34 house officers were enrolled in the study on joining the paediatric unit of Hospital Kulim. They were given the "Textbook of NRP" to prepare for the theory paper that consisted of 30 multiplechoice questions (MCQs). Two to four weeks later they went through a day of training on the resuscitation of the newborn using low-fidelity simulation manikins. They were taught to recognise a newborn who needed resuscitation after delivery, prepared the equipment for resuscitation and learned the skills of resuscitation. The skills included the initial steps, bag valve mask ventilation, intubation, cardiac massage, umbilical vein cannulation and use of medications. They were also taught the performance of objective structured clinical examination (OSCE) A and B. They were evaluated at 3, 6, and 9 months after the completion of their training using the MCQs and the performance checklist in the NRP textbook. RESULTS: The results showed that there was a significant reduction in their knowledge retention as shown by their performance in multiple choice questions. Similarly, there was a significant loss of competency in their skills and competency in resuscitation using bag mask ventilation, intubation and performance of OSCE A and OSCE B. However, their performance at initial steps showed no significant reduction. CONCLUSION: In view of the observed deterioration a refresher course in NRP before transferring out to the districts is recommended to improve their overall performance.

Enhancing learning and retention through the distribution of practice repetitions across multiple sessions.

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.

Protecting memory from misinformation: Warnings modulate cortical reinstatement during memory retrieval.

Exposure to even subtle forms of misleading information can significantly alter memory for past events. Memory distortion due to misinformation has been linked to faulty reconstructive processes during memory retrieval and the reactivation of brain regions involved in the initial encoding of misleading details (cortical reinstatement). The current study investigated whether warning participants about the threat of misinformation can modulate cortical reinstatement during memory retrieval and reduce misinformation errors. Participants watched a silent video depicting a crime (original event) and were given an initial test of memory for the crime details. Then, participants listened to an auditory narrative describing the crime in which some original details were altered (misinformation). Importantly, participants who received a warning about the reliability of the auditory narrative either before or after exposure to misinformation demonstrated less susceptibility to misinformation on a final test of memory compared to unwarned participants. Warned and unwarned participants also demonstrated striking differences in neural activity during the final memory test. Compared to participants who did not receive a warning, participants who received a warning (regardless of its timing) demonstrated increased activity in visual regions associated with the original source of information as well as decreased activity in auditory regions associated with the misleading source of information. Stronger visual reactivation was associated with reduced susceptibility to misinformation, whereas stronger auditory reactivation was associated with increased susceptibility to misinformation. Together, these results suggest that a simple warning can modulate reconstructive processes during memory retrieval and reduce memory errors due to misinformation.

Using child-friendly movie stimuli to study the development of face, place, and object regions from age 3 to 12 years.

Scanning young children while they watch short, engaging, commercially-produced movies has emerged as a promising approach for increasing data retention and quality. Movie stimuli also evoke a richer variety of cognitive processes than traditional experiments, allowing the study of multiple aspects of brain development simultaneously. However, because these stimuli are uncontrolled, it is unclear how effectively distinct profiles of brain activity can be distinguished from the resulting data. Here we develop an approach for identifying multiple distinct subject-specific Regions of Interest (ssROIs) using fMRI data collected during movie-viewing. We focused on the test case of higher-level visual regions selective for faces, scenes, and objects. Adults (N = 13) were scanned while viewing a 5.6-min child-friendly movie, as well as a traditional localizer experiment with blocks of faces, scenes, and objects. We found that just 2.7 min of movie data could identify subject-specific face, scene, and object regions. While successful, movie-defined ssROIS still showed weaker domain selectivity than traditional ssROIs. Having validated our approach in adults, we then used the same methods on movie data collected from 3 to 12-year-old children (N = 122). Movie response timecourses in 3-year-old children's face, scene, and object regions were already significantly and specifically predicted by timecourses from the corresponding regions in adults. We also found evidence of continued developmental change, particularly in the face-selective posterior superior temporal sulcus. Taken together, our results reveal both early maturity and functional change in face, scene, and object regions, and more broadly highlight the promise of short, child-friendly movies for developmental cognitive neuroscience.

Somatosensory cortex participates in the consolidation of human motor memory.

Newly learned motor skills are initially labile and then consolidated to permit retention. The circuits that enable the consolidation of motor memories remain uncertain. Most work to date has focused on primary motor cortex, and although there is ample evidence of learning-related plasticity in motor cortex, direct evidence for its involvement in memory consolidation is limited. Learning-related plasticity is also observed in somatosensory cortex, and accordingly, it may also be involved in memory consolidation. Here, by using transcranial magnetic stimulation (TMS) to block consolidation, we report the first direct evidence that plasticity in somatosensory cortex participates in the consolidation of motor memory. Participants made movements to targets while a robot applied forces to the hand to alter somatosensory feedback. Immediately following adaptation, continuous theta-burst transcranial magnetic stimulation (cTBS) was delivered to block retention; then, following a 24-hour delay, which would normally permit consolidation, we assessed whether there was an impairment. It was found that when mechanical loads were introduced gradually to engage implicit learning processes, suppression of somatosensory cortex following training almost entirely eliminated retention. In contrast, cTBS to motor cortex following learning had little effect on retention at all; retention following cTBS to motor cortex was not different than following sham TMS stimulation. We confirmed that cTBS to somatosensory cortex interfered with normal sensory function and that it blocked motor memory consolidation and not the ability to retrieve a consolidated motor memory. In conclusion, the findings are consistent with the hypothesis that in adaptation learning, somatosensory cortex rather than motor cortex is involved in the consolidation of motor memory.

Are witnesses able to avoid highly accessible misinformation? Examining the efficacy of different warnings for high and low accessibility postevent misinformation.

The reliability of eyewitness memory continues to be an area of concern, particularly in situations that involve conflicting sources of information (e.g., the misinformation effect; Loftus et al., 1978, Journal of Experimental Psychology: Human Learning and Memory, 4[1], 19-31). To mitigate the negative effects of misinformation, researchers have examined the efficacy of warnings that highlight the unreliability of postevent information. However, warnings have proven less effective for highly accessible misinformation (Eakin et al., 2003, Journal of Experimental Psychology: Learning, Memory, and Cognition, 29[5], 813-825). In the present study, we examined the effects of different types of warnings for low accessibility misinformation in a standard single test misinformation paradigm, and highly accessible misinformation in a repeated testing misinformation paradigm (Chan et al., 2009, Psychological Science, 20[1], 66-73). We modeled these warnings after Eakin et al. (2003) to include both general warnings and specific question-by-question warnings. We found that warnings were effective in both types of misinformation paradigms. Additionally, memory accuracy in situations where participants were exposed to misleading information was improved when specific and general warnings were combined. We argue that both retrieval blocking of low accessibility items and enhanced contextual discrimination account for these findings.

Varying retrieval conditions to study survival processing.

The survival processing advantage is a mnemonic benefit resulting from processing items for their relevance to survival. One explanation of the survival processing advantage is the richness-of-encoding hypothesis: Survival processing enhances retention by generating ideas (elaborative and distinctive processing), increasing the number of retrieval cues. Without retrieval, encoding is futile. Hence, the present experiments varied retrieval conditions - via transfer appropriate processing (TAP) tasks - predicting that the survival processing advantage could be reversed. In Experiment 1a, reducing the transfer appropriateness of survival processing caused significantly lower recognition scores after survival processing than after processing of word associates. Experiment 1b replicated a survival processing advantage and found a survival processing disadvantage. In Experiment 2, survival processing was pitted against a gift desirability task and retrieval mode was varied. Survival processing yielded superior memory on a standard free recall test, but the survival processing advantage was eliminated when an unusual retrieval mode was encouraged. Results affirm the importance of context-dependent retrieval.

Retrograde enhancement of episodic learning by a postlearning stimulus.

Evidence suggests encoding of recent episodic experiences may be enhanced by a subsequent salient event. We tested this hypothesis by giving rats a 3-min unsupervised experience with four odors and measuring retention after different delays. Animals recognized that a novel element had been introduced to the odor set at 24 but not 48 h. However, when odor sampling was followed within 5 min by salient light flashes or bedding odor, the memory lasted a full 2 d. These results describe a retroactive influence of salience to promote storage of episodic information and introduce a unique model for studying underlying plasticity mechanisms.

Sleep for preserving and transforming episodic memory.

Sleep is known to support memory consolidation. Here we review evidence for an active system consolidation occurring during sleep. At the beginning of this process is sleep's ability to preserve episodic experiences preferentially encoded in hippocampal networks. Repeated neuronal reactivation of these representations during slow-wave sleep transforms episodic representations into long-term memories, redistributes them toward extrahippocampal networks, and qualitatively changes them to decontextualized schema-like representations. Electroencephalographic (EEG) oscillations regulate the underlying communication: Hippocampal sharp-wave ripples coalescing with thalamic spindles mediate the bottom-up transfer of reactivated memory information to extrahippocampal regions. Neocortical slow oscillations exert a supraordinate top-down control to synchronize hippocampal reactivations of specific memories to their excitable up-phase, thus allowing plastic changes in extrahippocampal regions. We propose that reactivations during sleep are a general mechanism underlying the abstraction of temporally stable invariants from a flow of input that is solely structured in time, thus representing a basic mechanism of memory formation.

Retention rate and effectiveness of secukinumab vs TNF inhibitor in ankylosing spondylitis patients with prior TNF inhibitor exposure.

OBJECTIVES: The choice of second-line biologics for AS patients previously treated with a TNF inhibitor (TNFi) remains unclear. Here, we compared drug retention and clinical efficacy between AS patients who switched biologics to secukinumab and those who switched to a different TNFi. METHODS: AS patients enrolled in the Korean College of Rheumatology BIOlogics registry were included, and patients with non-radiographic axial spondyloarthritis were excluded. Patients with previous TNFi exposure were divided into the secukinumab group and the TNFi switching group. Drug retention and clinical efficacy [BASDAI50, Assessment of Spondylo-Arthritis International Society (ASAS)20, ASAS40, AS disease activity score (ASDAS) <2.1, ASDAS clinically important improvement and ASDAS major improvement] were assessed at the 1 year follow-up. Propensity score (PS)-matched and covariate-adjusted logistic regression analyses were performed. RESULTS: Two hundred and forty-six had available 1 year follow-up data. Secukinumab as third- or later-line biologic was more frequent than alternative TNFi (54% vs 14%). PS-matched and multiple covariate-adjusted analyses showed that the odds ratio (OR) for drug discontinuation was comparable between the secukinumab and TNFi switching groups [OR 1.136 (95% CI 0.843, 1.531) and 1.000 (95% CI 0.433-2.308), respectively]. The proportion of patients who achieved BASDAI50 was also comparable between the two groups [OR 0.833 (95% CI 0.481, 1.441) in PS-matched analysis]. Other clinical efficacy parameters were also comparable. In the subgroup analysis of AS patients with previous TNFi discontinuation due to ineffectiveness, all clinical efficacy parameters were comparable between the two groups. CONCLUSION: In AS patients with previous exposure to a TNFi, switching biologics to secukinumab and switching to an alternative TNFi resulted in comparable drug retention and clinical efficacy.

Ontogeny of spontaneous recognition memory in rodents.

Spontaneous recognition memory tasks explore thewhat,whereandwhencomponents of recognition memory. These tasks are widely used in rodents to assess cognitive function across the lifespan. While several neurodevelopmental and mental disorders present symptom onset in early life, very little is known about how memories are expressed in early life, and as a consequence how they may be affected in pathological conditions. In this review, we conduct an analysis of the studies examining the expression of spontaneous recognition memory in young rodents. We compiled studies using four different tasks: novel object recognition, object location, temporal order recognition and object place. First, we identify major sources of variability between early life spontaneous recognition studies and classify them for later comparison. Second, we use these classifications to explore the current knowledge on the ontogeny of each of these four spontaneous recognition memory tasks. We conclude by discussing the possible implications of the relative time of onset for each of these tasks and their respective neural correlates. In compiling this research, we hope to advance on establishing a developmental timeline for the emergence of distinct components of recognition memory, while also identifying key areas of focus for future research. Establishing the ontogenetic profile of rodent spontaneous recognition memory tasks will create a necessary blueprint for cognitive assessment in animal models of neurodevelopmental and mental disorders, a first step towards improved and earlier diagnosis as well as novel intervention strategies.

Punishments and rewards both modestly impair visuomotor memory retention.

While the effects of rewards on memory appear well documented, the effects of punishments remain uncertain. Based on neuroimaging data, this study tested the hypothesis that, as compared to a neutral condition, a context allowing successful punishment avoidance would enhance memory to a similar extent as rewards. In a fully within-subject and counter-balanced design, participants (n = 18) took part in 3 distinct learning sessions during which the delivery of performance-contingent monetary punishments and rewards was manipulated. Specifically, participants had to reach towards visual targets while compensating for a gradually introduced visual deviation. Accuracy at achieving targets was either punished (Hit: "+0$"; Miss: "-0.5$), rewarded (Hit: "+0.5$"; Miss: "-0$"), or associated with neutral binary feedback (Hit: "Hit"; Miss: "Miss"). Retention was assessed through reach aftereffects both immediately and 24 h after initial acquisition. The results disconfirmed the hypothesis by showing that the punishment and reward learning sessions both impaired retention as compared to the neutral session, suggesting that both types of incentives similarly impaired memory formation and consolidation. Two alternative but complementary interpretations are discussed. One interpretation is that the presence of punishments and rewards induced a negative learning context, which - based on neurobiological data - could have been sufficient to interfere with memory formation and consolidation. Another interpretation is that punishments and rewards emphasized the disrupting effects of target hits on implicit learning processes, therefore yielding retention impairments. Altogether, these results suggest that incentives can have counter-productive effects on memory.

Timing matters: Transcranial direct current stimulation after extinction learning impairs subsequent fear extinction retention.

BACKGROUND: Transcranial direct current stimulation (tDCS) has previously been shown to improve fear extinction learning and retention when administered prior to or during extinction learning. This study investigates whether tDCS immediately following extinction learning improves efficacy of extinction memory retention. METHODS: 30 participants completed a 2-day fear learning and extinction paradigm, where they acquired fear of a stimulus conditioned to an aversive electric shock on day 1. Extinction learning occurred on day 1, with tDCS or sham tDCS administered immediately following the learning phase. Participants returned for a second day test of extinction memory recall. Skin conductance was measured as the primary outcome. RESULTS/CONCLUSIONS: Participants in the tDCS group showed impaired fear extinction retention on day 2, marked by significant generalisation of fear to the safety stimulus. This contrasts with earlier studies showing improved extinction retention when stimulation occurred during encoding of extinction learning, compared to immediate consolidation as in our study. These findings may have important implications for the use of tDCS during exposure therapy for anxiety and trauma disorders.