Retrieval practice improves memory in multiple sclerosis: clinical application of the testing effect.

The testing effect is a robust cognitive phenomenon by which memory retrieval on a test improves subsequent recall more than restudying. Also known as retrieval practice, the testing effect has been studied almost exclusively in healthy undergraduates. The current study investigated whether retrieval practice during testing leads to better delayed recall than restudy among persons with multiple sclerosis (MS), a neurologic disease associated with memory dysfunction. In a within-subjects design, 32 persons with MS and 16 demographically matched healthy controls (HC) studied 48 verbal paired associates (VPA) divided across 3 learning conditions: massed restudy (MR), spaced restudy (SR), and spaced testing (ST). Delayed VPA cued recall was measured after 45 min. There was a large main effect of learning condition (etap2 = .54, p < .001) such that both MS and HC participants produced better delayed recall for VPAs learned through ST relative to MR and SR; and SR relative to MR. This same pattern was observed for MS participants with objective memory impairment (n = 16), thereby providing the first evidence that retrieval practice improves memory more than restudy among persons with neurologically based memory impairment.

[1]  S. Rao,et al.  On the nature of memory disturbance in multiple sclerosis. , 1989, Journal of clinical and experimental neuropsychology.

[2]  M. Faust,et al.  Effectiveness of cognitive rehabilitation following acquired brain injury: a meta-analytic re-examination of Cicerone et al.'s (2000, 2005) systematic reviews. , 2009, Neuropsychology.

[3]  Jeffrey D. Karpicke,et al.  The Critical Importance of Retrieval for Learning , 2008, Science.

[4]  J. DeLuca,et al.  The nature of memory impairments in multiple sclerosis: acquisition versus retrieval. , 1994, Journal of clinical and experimental neuropsychology.

[5]  H. Weiner,et al.  Intensive immunosuppression in progressive multiple sclerosis. A randomized, three-arm study of high-dose intravenous cyclophosphamide, plasma exchange, and ACTH. , 1983, The New England journal of medicine.

[6]  S. Woolf.  The meaning of translational research and why it matters. , 2008, JAMA.

[7]  K. Cherry,et al.  Long-Term Effectiveness of Spaced-Retrieval Memory Training for Older Adults with Probable Alzheimer's Disease , 2005, Experimental aging research.

[8]  R. Benedict,et al.  Validity of the minimal assessment of cognitive function in multiple sclerosis (MACFIMS) , 2006, Journal of the International Neuropsychological Society.

[9]  Jeffrey D. Karpicke,et al.  The Power of Testing Memory Basic Research and Implications for Educational Practice , 2006 .

[10]  Randall W. Engle,et al.  Effects of Domain Knowledge, Working Memory Capacity, and Age on Cognitive Performance: An Investigation of the Knowledge-Is-Power Hypothesis , 2000, Cognitive Psychology.

[11]  J. DeLuca,et al.  Evidenced-based cognitive rehabilitation for persons with multiple sclerosis: a review of the literature. , 2008, Archives of physical medicine and rehabilitation.

[12]  M. McDaniel,et al.  Testing the testing effect in the classroom , 2007 .

[13]  J. Giacino,et al.  Evidence-based cognitive rehabilitation: updated review of the literature from 1998 through 2002. , 2005, Archives of physical medicine and rehabilitation.

[14]  Dennis R. Combs,et al.  Self-generated learning in people with multiple sclerosis: An extension of Chiaravalloti and DeLuca (2002) , 2008, Journal of clinical and experimental neuropsychology.

[15]  H. Ebbinghaus.  Memory A Contribution Toexperimental Psychology , 1913 .

[16]  J. DeLuca,et al.  Acquisition and storage deficits in multiple sclerosis. , 1998, Journal of clinical and experimental neuropsychology.

[17]  D. Delis,et al.  California Verbal Learning Test--Second Edition , 2016 .

[18]  John D. Bransford,et al.  Levels of processing versus transfer appropriate processing , 1977 .

[19]  William L. Cull,et al.  Untangling the benefits of multiple study opportunities and repeated testing for cued recall , 2000 .

[20]  Endel Tulving,et al.  Encoding specificity and retrieval processes in episodic memory. , 1973 .

[21]  A. Compston,et al.  Recommended diagnostic criteria for multiple sclerosis: Guidelines from the international panel on the diagnosis of multiple sclerosis , 2001, Annals of neurology.

[22]  O. Selnes.  A Compendium of Neuropsychological Tests , 1991, Neurology.

[23]  N. Raz,et al.  Memory impairment in multiple sclerosis: a quantitative review. , 1997, Neuropsychology.

[24]  J. DeLuca,et al.  Cognitive impairment in multiple sclerosis , 2008, The Lancet Neurology.

[25]  Roberto Cabeza,et al.  Neural Correlates of Relational Memory: Successful Encoding and Retrieval of Semantic and Perceptual Associations , 2005, The Journal of Neuroscience.

[26]  F. Craik,et al.  Levels of Pro-cessing: A Framework for Memory Research , 1975 .

[27]  A. D. D. Groot.  Thought and Choice in Chess , 1978 .

[28]  Shana K. Carpenter,et al.  Application of the Testing and Spacing Effects to Name Learning , 2005 .

[29]  N. Raz,et al.  Memory in multiple sclerosis: Contextual encoding deficits , 2002, Journal of the International Neuropsychological Society.

[30]  Jeffrey D. Karpicke,et al.  Expanding retrieval practice promotes short-term retention, but equally spaced retrieval enhances long-term retention. , 2007, Journal of experimental psychology. Learning, memory, and cognition.

[31]  Ralph H B Benedict,et al.  Minimal Neuropsychological Assessment of MS Patients: A Consensus Approach , 2002, The Clinical neuropsychologist.

[32]  David A Balota,et al.  Does expanded retrieval produce benefits over equal-interval spacing? Explorations of spacing effects in healthy aging and early stage Alzheimer's disease. , 2006, Psychology and aging.

[33]  Stephen M. Rao,et al.  The development, standardization, and initial validation of the Chicago Multiscale Depression Inventory. , 1998, Journal of personality assessment.

[34]  Jeffrey D. Karpicke,et al.  Test-Enhanced Learning , 2006, Psychological science.