Impact of an Influenza and Pneumococcal Vaccination Course on Enhancing Pharmacists' Knowledge.

Visual working memory (vWM) involves holding and manipulating a limited amount of visual information briefly (, ). Its performance has been linked to attentional control (, ), which is the ability to prioritize goal-relevant information and suppress distractions. The neural basis of attentional control in vWM paradigms has been studied using techniques such as transcranial magnetic stimulation (TMS). Neurophysiological changes induced by TMS have been associated with changes in attention and vWM performance (, , , , ). Yet, evidence for enhancing vWM through attentional control modulation has only been observed with targets and distractors of neutral emotional valence. Showing such improvements with emotional distractors would be particularly relevant since these are known to influence attention significantly (, , ). In this study, we sought to enhance attentional control over emotional and neutral auditory distractors via TMS, combined with electroencephalography (EEG), to investigate the impact of this improvement on vWM performance. As mentioned, the neural basis of WM has been previously studied with TMS (see ). Stimulating the dorsolateral prefrontal cortex (DLPFC) has been shown to improve WM performance with neutral target items (Vanderhasselt 2014, , , ). One study showed TMS-related improvements in both spatial n-back and digit span tasks, emphasizing the DLPFC’s general role in WM (). A meta-analysis indicated that the increase in n-back task accuracy after TMS stimulation is small but statistically significant (). Another meta-analysis showed that stimulating both the right and left prefrontal cortex (PFC) with transcranial direct current stimulation (tDCS) can enhance WM (). These benefits from TMS and tDCS have been observed in experimental paradigms without distractors. Other TMS studies demonstrate that the PFC allocates cognitive resources toward targets and away from distractors in vWM paradigms (, , , , ). The first cognitive control mechanism can be qualified as “target amplification” and the second as “distractor inhibition” (, , ). showed that perturbing the right DLPFC with TMS increased parietal activity related to visual target processing in a delayed-recognition task, but crucially only when distractors were present, suggesting that the PFC allocates resources to enhance target representation in the presence of irrelevant distractors. Similarly, found that stimulating the left PFC disrupted item prioritization in a memory-guided saccade task, as the performance for relevant and irrelevant items was similar after TMS. showed that disrupting the inferior frontal junction with TMS decreased vWM accuracy and reduced the visual P1 amplitude evoked by target items, a marker of attentional resources. demonstrated that TMS targeting the left middle frontal gyrus improved vWM by amplifying retro-cued item representations during a change-detection task. Overall, the PFC, including DLPFC, plays a key role in attentional control during vWM processing.