Evidence against combined effects of stress and brain stimulation on working memory

The effect of stress on working memory has been traced back to a modulation of the prefrontal cortex (PFC). We investigated the effects of neuromodulation of the left dorsolateral prefrontal cortex (lDLPFC) after exposure to psychosocial stress through the Socially Evaluated Cold Pressure Test (SECPT). The hypothesis was that neuromodulation interacts with the stress intervention, to either boost performance even under stressed conditions or compensate negative stress effects. Fifty-nine participants were randomly divided into two groups. One group received active, anodal, offline transcranial direct current stimulation (tDCS) over the lDLPFC while the other group received sham stimulation. Participants performed a lexical n-back task, before and after the SECPT and tDCS intervention. The first n-back task was used as a baseline measurement and the second n-back task was performed during recovery from stress when cortisol levels are at their peak, but still under the influence of tDCS aftereffects. Additionally, after the psychosocial stress phase participants were post-hoc divided into cortisol responders and nonresponders. Results showed that generally stress increased lexical n-back task performance as indicated by faster correct reaction times and higher accuracy but that this was not modulated by tDCS. Crucially, using Bayes analysis we obtained evidence against the influence of anodal tDCS on stressed individual's working memory performance

Comparison of Allen Carr's Easyway programme with a specialist behavioural and pharmacological smoking cessation support service: a randomized controlled trial.

BACKGROUND AND AIMS: A combination of behavioural and pharmacological support is judged to be the optimal approach for assisting smoking cessation. Allen Carr's Easyway (ACE) is a single-session pharmacotherapy-free programme that has been in operation internationally for 38 years. We compared the effectiveness of ACE with specialist behavioural and pharmacological support delivered to the national standard in England. DESIGN: A two-arm, parallel-group, single-blind, randomized controlled trial. SETTING: London, UK, between February 2017 and May 2018. PARTICIPANTS: A total of 620 participants (310 in ACE and 310 in the combined behavioural and pharmacological support condition) were included in the analysis. Adult (≥ 18 years) smokers wanting to quit were randomized in a 1 : 1 ratio. Mean age for the total sample was 40.8 years, with 53.4% being male. Participant baseline characteristics (ethnicity, educational level, number of previous quit attempts, nicotine dependence) were evenly balanced between treatment groups. INTERVENTION AND COMPARATOR: The intervention was the ACE method of stopping smoking. This centres on a 4.5-6-hour session of group-based support, alongside subsequent text messages and top-up sessions if needed. It aims to make it easy to stop smoking by convincing smokers that smoking provides no benefits for them. The comparator was a specialist stop smoking service (SSS) providing behavioural and pharmacological support in accordance with national standards. MEASUREMENTS: The primary outcome was self-reported continuous abstinence for 26 weeks from the quit/quit re-set date verified by exhaled breath carbon monoxide measurement < 10 parts per million (p.p.m.). Primary analysis was by intention to treat. Secondary outcomes were: use of pharmacotherapy, adverse events and continuous abstinence up to 4 and 12 weeks. FINDINGS: A total of 468 participants attended treatment (255 ACE versus 213 SSS, P < 0.05). Of those who did attend treatment, 100 completed 6-month measures (23.7% ACE versus 20.7% SSS). Continuous abstinence to 26 weeks was 19.4% (60 of 310) in the ACE intervention and 14.8% (46 of 310) in the SSS intervention [risk difference for ACE versus SSS 4.5% (95% confidence interval (CI) = -1.4 to 10.4%, odds ratio (OR) = 1.38)]. The Bayes factor for superiority of the ACE condition was 1.24. CONCLUSION: There was no clear evidence of a difference in the efficacies of the Allen Carr's Easyway (ACE) and specialist smoking cessation support involving behavioural support and pharmacotherapy

Do alcohol product labels stating lower strength verbal description, percentage alcohol‐by‐volume, or their combination affect wine consumption? A bar laboratory adaptive randomised controlled trial

A previous research study concluded that wine and beer labelled as lower in strength increase consumption compared with the same drinks labelled as regular strength. The label included both a verbal and numerical descriptor of strength. The present study aimed to estimate the effect of each of these label components. Adaptive, parallel group randomised controlled trial, comprising an internal pilot sample (N = 90) and a confirmatory sample (N = 57). University bar laboratory in London UK. One-hundred and forty-seven weekly wine drinkers were sampled from a nationally representative English panel. Participants were randomised to one of three groups to taste test wine in a bar-laboratory, varying only in the label displayed: (i) verbal descriptor only (Super Low); (ii) numerical descriptor only (4%ABV); and (iii) verbal descriptor and numerical descriptor combined (Super Low 4%ABV) [each group n = 49]. The primary outcome was total volume (ml) of wine consumed. Participants randomised to the numerical descriptor label group (4%ABV: M = 155.12ml, B = 20.30, 95% CI = 3.92, 36.69, p-value = 0.016) and combined verbal and numerical descriptor label group (Super Low 4%ABV: M = 154.59ml, B = 20.68, 95%CI = 4.32, 37.04, p-value = 0.014) drank significantly greater amounts than those randomised to the verbal descriptor label group (Super Low: M = 125.65ml). This bar laboratory study estimated that a greater quantity of 'lower' strength wine was consumed when the label included a numerical strength descriptor compared with a verbal only strength descriptor. [Abstract copyright: This article is protected by copyright. All rights reserved.

Effects of single-session transcranial direct current stimulation on reactive response inhibition

Transcranial direct current stimulation (tDCS) is widely used to explore the role of various cortical regions for reactive response inhibition. In recent years, tDCS studies reported polarity-, time- and stimulation-site dependent effects on response inhibition. Given the large parameter space in which study designs, tDCS procedures and task procedures can differ, it is crucial to systematically explore the existing tDCS literature to increase the current understanding of potential modulatory effects and limitations of different approaches. We performed a systematic review on the modulatory effects of tDCS on response inhibition as measured by the Stop-Signal Task. The final dataset shows a large variation in methodology and heterogeneous effects of tDCS on performance. The most consistent result across studies is a performance enhancement due to anodal tDCS over the right prefrontal cortex. Partially sub-optimal choices in study design, methodology and lacking consistency in reporting procedures may impede valid conclusions and obscured the effects of tDCS on response inhibition in some previous studies. Finally, we outline future directions and areas to improve research

The (gami)fictional ego-center: Projecting the location of the self into an avatar

A rich body of research suggests that self-associated stimuli are preferentially processed and therefore responses to such stimuli are typically faster and more accurate. In addition, people have an understanding of what they consider their "Self" and where it is located, namely near the head and upper torso-further boosting the processing of self-related stimuli if they are presented near the felt location of the self. We were interested in whether the same mechanism can be found when people transfer their "Self" into a static avatar. We investigated this in two studies with N = 33 and N = 39 young, healthy adults, respectively. Taken together, the results showed that (i) people indeed show enhanced processing for self-avatar-related stimuli and (ii) that self-associations are stronger if the to-be-associated stimuli are closer to the avatar's upper torso-suggesting some kind of a projected location of the self in the avatar. This implies that attention is not equally distributed across the avatar. Beyond a theoretical level, this also has implications for practical use. For example, digital games opting for a non-traditional user interface where information is displayed on or in the direct vicinity of the character should take this effect into account when choosing which information to present where (i.e., present the most crucial piece of information close to the self-center of the avatar)

Do alcohol product labels stating lower strength verbal description, percentage alcohol‐by‐volume, or their combination affect wine consumption? A bar laboratory adaptive randomised controlled trial

Background and Aims A previous research study concluded that wine and beer labelled as lower in strength increase consumption compared with the same drinks labelled as regular strength. The label included both a verbal and numerical descriptor of strength. The present study aimed to estimate the effect of each of these label components. Design Adaptive, parallel group randomised controlled trial, comprising an internal pilot sample (n1 = 90) and a confirmatory sample (n2 = 57). Setting University bar laboratory in London, United Kingdom (UK). Participants A total of 147 weekly wine drinkers were sampled from a nationally representative English panel. Intervention Participants were randomised to one of three groups to taste test wine in a bar‐laboratory, varying only in the label displayed: (i) verbal descriptor only (Super Low); (ii) numerical descriptor only (4% alcohol by volume (ABV)); and (iii) verbal descriptor and numerical descriptor combined (Super Low 4%ABV) (each group n = 49). Measurements The primary outcome was total volume (ml) of wine consumed. Findings Participants randomised to the numerical descriptor label group (4%ABV: M = 155.12 ml, B = 20.30; 95% CI = 3.92, 36.69; P value = 0.016) and combined verbal and numerical descriptor label group (Super Low 4%ABV: M = 154.59 ml, B = 20.68; 95% CI = 4.32, 37.04; P value = 0.014) drank significantly greater amounts than those randomised to the verbal descriptor label group (Super Low: M = 125.65 ml). Conclusions This bar laboratory study estimated that a greater quantity of ‘lower’ strength wine was consumed when the label included a numerical strength descriptor compared with a verbal only strength descriptor

Shocking advantage! Improving digital game performance using non-invasive brain stimulation

As digital gaming has grown from a leisure activity into a competitive endeavor with college scholarships, celebrity, and large prize pools at stake, players search for ways to enhance their performance, including through coaching, training, and employing tools that yield a performance advantage. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that is presently being explored by esports athletes and competitive gamers. Although shown to modulate cognitive processing in standard laboratory tasks, there is little scientific evidence that tDCS improves performance in digital games, which are visually complex and attentionally demanding environments. We applied tDCS between two sessions of the Stop-Signal Game (SSG; Friehs, Dechant, Vedress, Frings, Mandryk, 2020). The SSG is a custom-built infinite runner that is based on the Stop-Signal Task (SST; Verbruggen et al., 2019). Consequently, the SSG can be used to evaluate response inhibition as measured by Stop-Signal Reaction Time (SSRT), but in an enjoyable 3D game experience. We used anodal, offline tDCS to stimulate the right dorsolateral prefrontal cortex (rDLPFC); a 9 cm² anode was always positioned over the rDLPFC while the 35 cm² cathode was placed over the left deltoid. We hypothesized that anodal tDCS would enhance neural processing (as measured by a decrease in SSRT) and improve performance, while sham stimulation (i.e., the control condition with a faked stimulation) should lead to no significant change. In a sample of N = 45 healthy adults a significant session x tDCS-condition interaction emerged in the expected direction. Subsequent analysis confirmed that the statistically significant decrease in SSRT after anodal tDCS to the rDLPFC was not due to a general change in reaction times. These results provide initial evidence that tDCS can influence performance in digital games

Doing public health differently: How can public health departments engage with local communities through social media interventions?

Objectives This paper evaluates a collaborative intervention between public health professionals and local social media administrators, in which the social media site Facebook was used with a view to strengthening engagement with and, dissemination of, core messages and building trust and resilience within local communities during the COVID-19 pandemic. Study design A qualitative design was used, exploring the research question: how does collaboration between public health professionals and local social network group administrators create community engagement during a global crisis? Methods Fourteen semi-structured interviews were conducted with public health staff and online group administrators. Data was analysed using framework analysis. Results Collaboration between public health professionals and local group administrators created both opportunities and challenges. Local group administrators had wide reach and trust within the local community, but message credibility was enhanced through local authority involvement. Such collaborations contain inherent tensions due to perceived risks to social capital and independence but can be successful if receiving strong risk-tolerant support from the local authority. Findings are discussed in the context of Bourdieu's theory of social capital to examine how public health information can be delivered by trusted social media actors in communication tailored to the local community. Conclusions Social media provides new channels of communication for delivery of public health messages, enabling new ways of working which create long-term engagement and community building. Although the intervention was developed quickly in response to the COVID-19 pandemic, participants felt it could be mobilised to address a wider range of issues

Effectiveness of an online intervention for parents/guardians of children aged 4-7 years who are concerned about their child's emotional and behavioural development: protocol for an online randomised controlled trial (EMERGENT study).

The demand for resources to support emotional and behavioural development in early childhood is ever increasing. However, conventional interventions are lacking in resources and have significant barriers. The Embers the Dragon programme helps address the growing unmet need of children requiring support. The delivery of the current project seeks to help support parents, reduce the burden placed on pressed services (eg, Child and Adolescent Mental Health Services) and to help improve the emotional and behavioural development of children. This project aims to investigate the efficacy and acceptability of Embers on parenting and children's psychosocial outcomes. 364 parents/guardians of children aged between 4 and 7 will be recruited via the internet, schools and general practitioners (GPs). This is an online waitlist-controlled trial with three arms: (1) control arm, (2) access to Embers arm and (3) access to Embers+school. Participants will be randomised (1:1) into (1) or (2) to evaluate the use of Embers at home. To evaluate scalability in schools, (3) will be compared with (2), and (1) to test efficacy against treatment as usual (not receiving the intervention). Qualitative interviews will also be conducted. Primary outcomes are the Parental Self-efficacy Scale, Strengths and Difficulties Questionnaire and qualitative interviews. Outcomes will be compared between the three groups at baseline, 8, 16 and 24 weeks. Ethical approval has been granted by the London South Bank University ethics panel (ETH2324-0004). To recruit via GPs, NHS ethical approval has been applied for, and the IRAS (331410) application is under consideration by the Central Bristol REC. The results of the project will be submitted for publication in a peer-reviewed journal. Parents/guardians will provide informed consent online prior to taking part in the study. For the interviews, assent will be taken from children by the researchers on the day. ISRCTN58327872. [Abstract copyright: © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

The influence of tDCS on perceived bouncing/streaming

Processing ambiguous situations is a constant challenge in everyday life and sensory input from different modalities needs to be integrated to form a coherent mental representation on the environment. The bouncing/streaming illusion can be studied to provide insights into the ambiguous perception and processing of multi-modal environments. In short, the likelihood of reporting bouncing rather than streaming impressions increases when a sound coincides with the moment of overlap between two moving disks. Neuroimaging studies revealed that the right posterior parietal cortex is crucial in cross-modal integration and is active during the bouncing/streaming illusion. Consequently, in the present study, we used transcranial direct current stimulation to stimulate this brain area. In the active stimulation conditions, a 9 cm2 electrode was positioned over the P4-EEG position and the 35 cm2 reference positioned over the left upper arm. The stimulation lasted 15 min. Each participant did the bouncing/streaming task three times: before, during and after anodal or sham stimulation. In a sample of N = 60 healthy, young adults, we found no influence of anodal tDCS. Bayesian analysis showed strong evidence against tDCS effects. There are two possible explanations for the finding that anodal tDCS over perceptual areas did not modulate multimodal integration. First, upregulation of multimodal integration is not possible using tDCS over the PPC as the integration process already functions at maximum capacity. Second, prefrontal decision-making areas may have overruled any modulated input from the PPC as it may not have matched their decision-making criterion and compensated for the modulation