STN-DBS Increases Proactive but Not Retroactive Interference During Verbal Learning in PD.

BACKGROUND: Proactive interference (PI) refers to the interference of previously learned materials with new learning and reflects the failure of inhibitory processes in memory. Retroactive interference (RI) refers to the unfavorable effect of new learning on the later recall of previously learned information. Although subthalamic nucleus deep brain stimulation (STN-DBS) does not affect global cognition in Parkinson's disease (PD), it has negative effects on specific aspects of cognition, including verbal fluency and executive inhibitory control of action.To this end, we set to test the acute effect of STN-DBS on PI and RI during verbal learning. METHODS: Twenty PD patients with STN-DBS were tested on the California Verbal Learning Test-II using an ON/OFF stimulation design. RESULTS: The results showed that stimulation increased PI ON stimulation (P = 0.012) but had no effect on RI (P = 0.816). CONCLUSIONS: Our results extend the role of STN to the inhibitory control that is required during memory encoding or recall for prevention of PI. © 2020 International Parkinson and Movement Disorder Society.

Mapping the needs and psychological outcomes of Slovenian adolescent and young adult cancer patients: An exploratory mixed-method study.

OBJECTIVE: With improving survival rates, it is becoming increasingly important to understand the psychological aspect and needs of young cancer patients and survivors. Our goal was to describe the self-reported levels of psychological distress, subjective illness experience and needs of young Slovenian cancer patients and survivors. METHODS: Seventy-nine participants, aged 19-39 years, answered questionnaires about anxiety, depression, mental defeat, cancer worry and their experience of learning the diagnosis and being treated. We used visualisations to demonstrate the relationship between anxiety and depression. The qualitative responses were summarised using a content analysis approach. RESULTS: Twenty-eight (35%) participants scored in the clinical range for anxiety and fifteen (19%) for depression. Cancer-related worry was common (85% reported at least one worry). Mental defeat was positively associated with measures of psychological distress. Those who felt negative about learning their diagnosis emphasised the need for more time, empathy and dignity. Psychological support during illness was seen as crucial. CONCLUSION: Anxiety and depression remain a problem for a subset of patients. Medical professionals working with young people with cancer should encourage a warm atmosphere as they attend to patients' needs and concerns.

The impact of COVID-19 on the cancer care of adolescents and young adults and their well-being: Results from an online survey conducted in the early stages of the pandemic.

BACKGROUND: Because of the global spread of coronavirus disease 2019 (COVID-19), oncology departments across the world have rapidly adapted their cancer care protocols to balance the risk of delaying cancer treatments and the risk of COVID-19 exposure. COVID-19 and associated changes may have an impact on the psychosocial functioning of patients with cancer and survivors. This study was designed to determine the impact of the COVID-19 pandemic on young people living with and beyond cancer. METHODS: In this cross-sectional study, 177 individuals, aged 18 to 39 years, were surveyed about the impact of COVID-19 on their cancer care and psychological well-being. Participants also reported their information needs with respect to COVID-19. Responses were summarized with a content analysis approach. RESULTS: This was the first study to examine the psychological functioning of young patients and survivors during the first weeks of the COVID-19 pandemic. A third of the respondents reported increased levels of psychological distress, and as many as 60% reported feeling more anxious than they did before COVID-19. More than half also wanted more information tailored to them as young patients with cancer. CONCLUSIONS: The COVID-19 pandemic is rapidly evolving and changing the landscape of cancer care. Young people living with cancer are a unique population and might be more vulnerable during this time in comparison with their healthy peers. There is a need to screen for psychological distress and attend to young people whose cancer care has been delayed. As the lockdown begins to ease, the guidelines about cancer care should be updated according to this population's needs.

Vision training with VEP biofeedback in amblyopia after the critical period.

PURPOSE: The purpose of this study was to investigate the benefits of vision training with visual evoked potentials (VEP) biofeedback in amblyopia after the critical period in 8 to 17-year (11.5 ± 3.1) old children. METHODS: Ten participants with monocular amblyopia after the critical period underwent a 10-week, 20-session vision training program with the Retimax Vision Trainer device. During each session, the participants were instructed to be as focused as possible onto the fixation point in the middle of the screen. The size of the fixation point and the pitch of the background sound were changing according to VEP parameters and thus provided the participants real-time feedback of their visual performance. RESULTS: The mean BCVA improvement across our group was 0.12 LogMAR (p < 0.01). There was also a significant increase in contrast sensitivity to the FACT chart across all spatial frequencies (all p < 0.05). Electrophysiologic data revealed higher steady-state visual evoked potentials (SS-VEP) amplitudes and correspondingly lower fixation point values in the last 2 weeks of training compared to the first 2 weeks (both p < 0.01). Due to unexplainably low VEP amplitude levels in later trainings compared to those in the beginning in two participants, we have not found a significant correlation between the increase in BCVA and the increase in SS-VEP amplitude (p = 0.88). At the follow-up at 2 and 12 months following the end of training, both BCVA and contrast sensitivity remained within the levels achieved at the end of training. In some participants, however, no improvement of BCVA was observed. CONCLUSIONS: The tested vision training approach demonstrates modest but stable improvement of psychophysical parameters as well as objective characteristics in amblyopia after the critical period. Real-time SS-VEP can be used as an objective parameter to monitor participants' attention during vision training stimulation.

Content of non-pharmacological care for systemic sclerosis and educational needs of European health professionals: a EUSHNet survey.

OBJECTIVES: To describe the non-pharmacological care in systemic sclerosis (SSc) provided by European health professionals (HPs) including referrals, treatment targets, interventions, and educational needs. METHODS: In this observational study, European HPs working in SSc care were invited to complete an online survey through announcements by EUSTAR (European League Against Rheumatism (EULAR) Scleroderma Trials and Research) and FESCA (Federation of European Scleroderma Associations), the EULAR HPs' newsletter, websites of national patient and HP associations, and by personal invitation. RESULTS: In total, 56 HPs, from 14 different European countries and 7 different disciplines, responded to the survey. A total of 133 specific indications for referral were reported, 72% of which could be linked to the International Classification of Functioning, Disability and Health domain "body functions and structures". Of the 681 reported treatment targets 45% was related to "body functions and structures". In total, 105 different interventions were reported as being used to address these treatment targets. Almost all (98%) respondents reported having educational needs, with the topics of management of stiffness (67%), pain (60%), and impaired hand function (56%) being mentioned most frequently. CONCLUSIONS: Non-pharmacological care in SSc varies in Europe with respect to the content of interventions, reasons for referral, and treatment targets. Reasons for referral to HPs are not well-aligned to HPs subsequent treatment targets in SSc care suggesting suboptimal communication between physicians and HPs. The wide variations reported indicate a need to consolidate geographically disparate expertise within countries and to develop and improve standards of non-pharmacological care in SSc.