RESUMO
Impaired error awareness is related to poorer outcome following traumatic brain injury (TBI). Error awareness deficits are also found in major depressive disorder (MDD), but have not been examined in the MDD that follows a TBI (TBI-MDD). This study assessed neural activity related to error awareness in TBI-MDD. Four groups completed a response inhibition task while EEG was recorded- healthy controls (N = 15), MDD-only (N = 15), TBI-only (N = 16), and TBI-MDD (N = 12). Error related EEG activity was compared using powerful randomisation statistics that included all electrodes and time points. Participants with TBI-MDD displayed less frontally distributed neural activity, suggesting reduced contribution from frontal generating sources. Neural activity during this time window is thought to reflect conscious awareness of errors. The TBI-only and MDD-only groups did not differ from controls, and early error processing was unaffected, suggesting early error detection is intact.
Assuntos
Conscientização , Lesões Encefálicas/psicologia , Depressão/psicologia , Adulto , Afeto , Idoso , Lesões Encefálicas/complicações , Estado de Consciência , Depressão/etiologia , Transtorno Depressivo Maior/fisiopatologia , Transtorno Depressivo Maior/psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Eletroencefalografia , Emoções , Potenciais Evocados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estimulação Luminosa , Desempenho Psicomotor , Adulto JovemRESUMO
The objective of this study was to explore the effects of 1Hz repetitive transcranial magnetic stimulation (rTMS) applied to dorsal lateral prefrontal cortex (DLPFC) on both an EEG index of cortical excitation and inhibition, event-related desynchronization/ synchronization (ERDIS) and on the P300 component of an auditory oddball-induced ERP. Eight normal participants received 15 minutes of 1Hz rTMS at 110% of the resting motor threshold to right DLPFC. ERDIS of alpha and beta bands was measured during an auditory oddball task immediately before and after stimulation. There was significantly less alpha desynchronization post-TMS, and this effect was widespread excepting posterior midline sites. No changes were found to oddball-P300 amplitudes or latencies. In conclusion, the findings of less alpha desynchronization post-TMS are compatible with notions of slow rTMS causing a decrease in cortical excitation.
Assuntos
Eletroencefalografia , Plasticidade Neuronal/fisiologia , Córtex Pré-Frontal/fisiologia , Estimulação Magnética Transcraniana , Adulto , Ritmo alfa , Ritmo beta , Eletromiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos PilotoRESUMO
The purpose of this paper is to discuss how nursing can achieve evidence-based practice when a theory-practice gap exists in nursing today. The paper commences with an introduction to the concept of evidence-based practice and a discussion of the relationships between theory, practice and the theory-practice gap. An analysis of the two concepts will then be presented from within the four pillars of nursing, namely management, practice, research and education. The paper will conclude with a discussion of whether evidence-based practice can be achieved in view of the theory-practice gap.