Clocking the social mind by identifying mental processes in the IAT with electrical neuroimaging

Why do people take longer to associate the word “love” with outgroup words (incongruent condition) than with ingroup words (congruent condition)? Despite the widespread use of the implicit association test (IAT), it has remained unclear whether this IAT effect is due to additional mental processes in the incongruent condition, or due to longer duration of the same processes. Here, we addressed this previously insoluble issue by assessing the spatiotemporal evolution of brain electrical activity in 83 participants. From stimulus presentation until response production, we identified seven processes. Crucially, all seven processes occurred in the same temporal sequence in both conditions, but participants needed more time to perform one early occurring process (perceptual processing) and one late occurring process (implementing cognitive control to select the motor response) in the incongruent compared with the congruent condition. We also found that the latter process contributed to individual differences in implicit bias. These results advance understanding of the neural mechanics of response time differences in the IAT: They speak against theories that explain the IAT effect as due to additional processes in the incongruent condition and speak in favor of theories that assume a longer duration of specific processes in the incongruent condition. More broadly, our data analysis approach illustrates the potential of electrical neuroimaging to illuminate the temporal organization of mental processes involved in social cognition.

Transcutaneous Electrical Nerve Stimulation for Treating Neurogenic Lower Urinary Tract Dysfunction: A Systematic Review

CONTEXT Transcutaneous electrical nerve stimulation (TENS) is a promising therapy for non-neurogenic lower urinary tract dysfunction and might also be a valuable option in patients with an underlying neurological disorder. OBJECTIVE We systematically reviewed all available evidence on the efficacy and safety of TENS for treating neurogenic lower urinary tract dysfunction. EVIDENCE ACQUISITION The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. EVIDENCE SYNTHESIS After screening 1943 articles, 22 studies (two randomised controlled trials, 14 prospective cohort studies, five retrospective case series, and one case report) enrolling 450 patients were included. Eleven studies reported on acute TENS and 11 on chronic TENS. In acute TENS and chronic TENS, the mean increase of maximum cystometric capacity ranged from 69ml to 163ml and from 4ml to 156ml, the mean change of bladder volume at first detrusor overactivity from a decrease of 13ml to an increase of 175ml and from an increase of 10ml to 120ml, a mean decrease of maximum detrusor pressure at first detrusor overactivity from 18 cmH20 to 72 cmH20 and 8 cmH20, and a mean decrease of maximum storage detrusor pressure from 20 cmH20 to 58 cmH2O and from 3 cmH20 to 8 cmH2O, respectively. In chronic TENS, a mean decrease in the number of voids and leakages per 24h ranged from 1 to 3 and from 0 to 4, a mean increase of maximum flow rate from 2ml/s to 7ml/s, and a mean change of postvoid residual from an increase of 26ml to a decrease of 85ml. No TENS-related serious adverse events have been reported. Risk of bias and confounding was high in most studies. CONCLUSIONS Although preliminary data suggest TENS might be effective and safe for treating neurogenic lower urinary tract dysfunction, the evidence base is poor and more reliable data from well-designed randomised controlled trials are needed to make definitive conclusions. PATIENT SUMMARY Early data suggest that transcutaneous electrical nerve stimulation might be effective and safe for treating neurogenic lower urinary tract dysfunction, but more reliable evidence is required.