Impact and experiences of vestibular disorders and psychological distress: Qualitative findings from patients, family members and healthcare professionals.

INTRODUCTION: People with vestibular disorders frequently experience reduced quality of life and challenges with activities of daily living. Anxiety, depression and cognitive problems often co-present with vestibular disorders and can aggravate symptoms and prolong clinical recovery. We aimed to gain in-depth insights into the impact of vestibular disorders and the contribution of psychological factors by exploring multistakeholder perspectives. METHODS: Semistructured interviews were conducted between October 2021 and March 2022 with 47 participants in the United Kingdom including: 20 patients (age M = 50.45 ± 13.75; 15 females), nine family members (age M = 61.0 ± 14.10; four females), and 18 healthcare professionals. Data were analysed using framework analysis. RESULTS: Vestibular disorders impact diverse aspects of patients' lives including work, household chores, socialising, and relationships with family and friends. Being unable to engage in valued activities or fulfil social roles contributes to feelings of grief and frustration, affecting identity, confidence, and autonomy. Anxiety and low mood contribute to negative thought processes, avoidance, and social withdrawal, which can impede clinical recovery through reduced activity levels, and end engagement with treatment. Coping strategies were thought to help empower patients to self-manage their symptoms and regain a sense of control, but these require oversight from healthcare providers. CONCLUSIONS: Daily activity limitations, social participation restrictions, and psychological distress can interact to impact quality of life, sense of self, and clinical recovery amongst people with vestibular disorders. Information and resources could aid societal awareness of the impact of vestibular disorders and help patients and families feel understood. An individualised and comprehensive approach that concurrently addresses mental, physical, social, and occupational needs is likely to be beneficial. PATIENT OR PUBLIC CONTRIBUTION: Two group meetings were held at the beginning and end of the study with a patient and public involvement network formed of people with vestibular disorders and family members. These individuals commented on the study aims, interview schedule, participant recruitment practices, and interpretation of the themes identified. Two core patient members were involved at all stages of the research. These individuals contributed to the formulation of the interview schedule, development and application of the coding scheme, development and interpretation of themes, and preparation of the final manuscript.

ERP evidence of age-related differences in emotional processing.

The present study used event-related potentials (ERPs) to examine differences in the temporal dynamics of emotion processing in young and older adults, with a specific focus on the positivity effect, that is, the preferential processing of positive over negative information. To this aim, we used a language paradigm that allowed us to investigate early ERP components as well as later components, namely the N400 and the late positive complex (LPC). Young and older adults were presented with neutral sentence stems with positive, negative or neutral/semantically-incongruent critical word endings while their electrical brain activity was recorded. There were no effects of emotional valence on early ERP components. Instead, a positivity effect was evident in young adults indexed by reduced N400s for positive sentence endings. Perhaps due to reduced semantic processing abilities, older adults did not show any N400 effect. ERP effects in this group were evident at a later processing stage and took the form of larger LPCs for neutral/incongruent information. Overall, there was no effect of emotional valence on either the N400 or the LPC in older adults. Our data suggest that with age, more effortful semantic processing may deplete resources for emotional processing.

The effects of different protocols of physical exercise and rest on long-term memory.

Whilst there are many studies comparing the different effects of exercise on long-term memory, these typically adopt varying intensities, durations, and behavioural measures. Furthermore, few studies provide direct comparisons between exercise and different types of rest. Therefore, by providing a standardised methodological design, this study will ascertain the most effective intensity and protocol of exercise for the modulation of long-term memory, whilst directly comparing it to different types rest. This was achieved using the same old/new recognition memory test and an 80-90 min retention interval. Three experiments were performed (total N = 59), each with a three-armed crossover design measuring the extent to which physical exercise and wakeful rest can influence long-term memory performance. In Experiment 1, the effects of continuous moderate intensity exercise (65-75% HRmax), passive rest (no cognitive engagement) and active rest (cognitively engaged) were explored. In Experiment 2, continuous moderate intensity exercise was compared to a type of high-intensity interval training (HIIT) and passive rest. Experiment 3 observed the effects of low- (55-65% HRmax), moderate- and high-intensity (75-85% HRmax) continuous exercise. Across the three experiments moderate intensity exercise had the greatest positive impact on memory performance. Although not significant, HIIT was more effective than passive-rest, and passive rest was more effective than active rest. 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 wakeful rest, we reaffirmed the importance of the cognitive engagement during consolidation for the formation of long-term memories.