Parametric manipulation of working memory load in traumatic brain injury: Behavioral and neural correlates

2004 ◽  
Vol 10 (5) ◽  
pp. 724-741 ◽  
Author(s):  
WILLIAM M. PERLSTEIN ◽  
MICHAEL A. COLE ◽  
JASON A. DEMERY ◽  
PAUL J. SEIGNOUREL ◽  
NEHA K. DIXIT ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Working Memory ◽  
Brain Injury ◽  
Memory Load ◽  
Brain Regions ◽  
Small Subset ◽  
Chronic Patients ◽  
Mild Tbi ◽  
Severe Tbi ◽  
High Level

Traumatic brain injury (TBI) is often associated with enduring impairments in high-level cognitive functioning, including working memory (WM). We examined WM function in predominantly chronic patients with mild, moderate and severe TBI and healthy comparison subjects behaviorally and, in a small subset of moderate-to-severe TBI patients, with event-related functional magnetic resonance imaging (fMRI), using a visualn-back task that parametrically varied WM load. TBI patients showed severity-dependent and load-related WM deficits in performance accuracy, but not reaction time. Performance of mild TBI patients did not differ from controls; patients with moderate and severe TBI were impaired, relative to controls and mild TBI patients, but only at higher WM-load levels. fMRI results show that TBI patients exhibit altered patterns of activation in a number of WM-related brain regions, including the dorsolateral prefrontal cortex and Broca's area. Examination of the pattern of behavioral responding and the temporal course of activations suggests that WM deficits in moderate-to-severe TBI are due to associative or strategic aspects of WM, and not impairments in active maintenance of stimulus representations. Overall, results demonstrate that individuals with moderate-to-severe TBI exhibit WM deficits that are associated with dysfunction within a distributed network of brain regions that support verbally mediated WM. (JINS, 2004,10, 724–741.)

Working memory for emotions in adolescents and young adults with traumatic brain injury

2021 ◽  
pp. 1-15
Author(s):  
Lindsey Byom ◽  
Meaghan S. Whaln ◽  
Lyn Turkstra
Keyword(s):  
Traumatic Brain Injury ◽  
Working Memory ◽  
Young Adults ◽  
Brain Injury ◽  
Social Cognitive ◽  
Memory Load ◽  
Adolescents And Young Adults ◽  
Significant Group ◽  
Identity Recognition ◽  
Severe Tbi

Abstract Objective: The objective of this preliminary study was to investigate the interaction between working memory and social cognition in adolescents and young adults with traumatic brain injury (TBI). It was hypothesized that participants with or without TBI would better recognize social information when working memory or social cognitive load was low and that adolescents and young adults with TBI would be more affected by increased cognitive demand than their uninjured peers. Design: In this experimental study, eight adolescents and young adults with complicated mild-severe TBI (aged 14–22 years) and eight age- and sex-matched typically developing (TD) adolescents completed computer-based n-back tasks requiring recognition of either face identity or facial affect, with 0-back, 1-back and 2-back conditions. Results: The TBI group had lower scores overall than the TD group, and scores for both groups were lower for affect recognition than identity recognition. Scores for both groups were lower in conditions with a higher working memory load. There was a significant group by working memory interaction, with larger group differences in high-working memory conditions. Conclusions: Adolescents and young adults with TBI are at risk for social cognitive impairments and the ability to recognize affect may be influenced by working memory demands.

scholarly journals Modulation of working memory load distinguishes individuals with and without balance impairments following mild traumatic brain injury

Brain Injury ◽  
2017 ◽  
Vol 32 (2) ◽  
pp. 191-199 ◽  
Author(s):  
Elizabeth J. Woytowicz ◽  
Chandler Sours ◽  
Rao P. Gullapalli ◽  
Joseph Rosenberg ◽  
Kelly P. Westlake
Keyword(s):  
Traumatic Brain Injury ◽  
Working Memory ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Memory Load ◽  
Working Memory Load

scholarly journals Distinct patterns of structural damage underlie working memory and reasoning deficits after traumatic brain injury

Brain ◽  
2020 ◽  
Vol 143 (4) ◽  
pp. 1158-1176 ◽  
Author(s):  
Amy E Jolly ◽  
Gregory T Scott ◽  
David J Sharp ◽  
Adam H Hampshire
Keyword(s):  
Machine Learning ◽  
Traumatic Brain Injury ◽  
Working Memory ◽  
Brain Injury ◽  
Cognitive Deficits ◽  
Axonal Injury ◽  
Diffuse Axonal Injury ◽  
Brain Regions ◽  
Graph Theoretic ◽  
Cognitive Problems

Abstract It is well established that chronic cognitive problems after traumatic brain injury relate to diffuse axonal injury and the consequent widespread disruption of brain connectivity. However, the pattern of diffuse axonal injury varies between patients and they have a correspondingly heterogeneous profile of cognitive deficits. This heterogeneity is poorly understood, presenting a non-trivial challenge for prognostication and treatment. Prominent amongst cognitive problems are deficits in working memory and reasoning. Previous functional MRI in controls has associated these aspects of cognition with distinct, but partially overlapping, networks of brain regions. Based on this, a logical prediction is that differences in the integrity of the white matter tracts that connect these networks should predict variability in the type and severity of cognitive deficits after traumatic brain injury. We use diffusion-weighted imaging, cognitive testing and network analyses to test this prediction. We define functionally distinct subnetworks of the structural connectome by intersecting previously published functional MRI maps of the brain regions that are activated during our working memory and reasoning tasks, with a library of the white matter tracts that connect them. We examine how graph theoretic measures within these subnetworks relate to the performance of the same tasks in a cohort of 92 moderate-severe traumatic brain injury patients. Finally, we use machine learning to determine whether cognitive performance in patients can be predicted using graph theoretic measures from each subnetwork. Principal component analysis of behavioural scores confirm that reasoning and working memory form distinct components of cognitive ability, both of which are vulnerable to traumatic brain injury. Critically, impairments in these abilities after traumatic brain injury correlate in a dissociable manner with the information-processing architecture of the subnetworks that they are associated with. This dissociation is confirmed when examining degree centrality measures of the subnetworks using a canonical correlation analysis. Notably, the dissociation is prevalent across a number of node-centric measures and is asymmetrical: disruption to the working memory subnetwork relates to both working memory and reasoning performance whereas disruption to the reasoning subnetwork relates to reasoning performance selectively. Machine learning analysis further supports this finding by demonstrating that network measures predict cognitive performance in patients in the same asymmetrical manner. These results accord with hierarchical models of working memory, where reasoning is dependent on the ability to first hold task-relevant information in working memory. We propose that this finer grained information may be useful for future applications that attempt to predict long-term outcomes or develop tailored therapies.

Perfil epidemiológico, clínico e desfecho de pacientes com traumatismo cranioencefálico / Epidemiological, clinical profile and outcome of patients with traumatic brain injury

2021 ◽  
Vol 66 (1u) ◽  
pp. 1
Author(s):  
Jeniffer Araújo Valentim da Silva ◽  
Marcele Pescuma Capeletti Padula ◽  
Camila Waters
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hospital Stay ◽  
Clinical Treatment ◽  
Clinical Profile ◽  
Average Hospital Stay ◽  
Mild Tbi ◽  
Average Hospital ◽  
Firearm Injury ◽  
Severe Tbi

Objetivo: Identificar o perfil epidemiológico, clínico e o desfecho dos pacientes com Traumatismo Cranioencefálico (TCE). Métodos: Pesquisa retrospectiva realizada com pacientes com idade maior ou igual a 18 anos, que estiveram internados na Instituição no ano de 2017, vítimas de TCE por qualquer etiologia. Resultados: Analisados 268 prontuários, sendo 78,7% do sexo masculino, com uma média de idade de 51 anos e maior incidência na faixa etária dos 31 a 50 anos (38,4%). A maioria (76,1%) chegou ao Pronto Socorro (PS) pelo Serviço de Atendimento Móvel de Urgência (SAMU), com uma média da Escala de Coma de Glasgow de 12 pontos, sendo que 78,0% apresentavam TCE leve (13 a 15 pontos), 14,2% apresentavam TCE grave (3 a 8 pontos) e 7,8% apresentavam TCE moderado (9 a 12 pontos). A maioria (57,5%) apresentou o TCE por queda, seguido de 16,0% por atropelamento, 12,0% por agressão, 5,9% por politrauma de mecanismos desconhecidos, 5,6% por acidente de moto, 1,9% por acidente automobilístico e 1,1% por ferimento por arma de fogo. A maioria (84,3%) ficou internada no hospital por até 10 dias, com uma média de internação hospitalar de seis dias, 92,9% receberam tratamento clínico (conservador) e 85,8% receberam alta hospitalar. Conclusões: Prevaleceram indivíduos do sexo masculino, com uma média de idade de 51 anos, encaminhados ao PS pelo SAMU, vítimas de TCE leve, ocasionado por queda, com uma média de internação hospitalar de seis dias, recebendo tratamento clínico e com desfecho de alta hospitalar.Palavras chave: Perfil de saúde, Lesões encefálicas traumáticas, Traumatismo cerebrovascularABSTRACTObjective: To identify the epidemiological, clinical profile and outcome of patients with Traumatic Brain Injury (TBI). Methods: Retrospective research conducted with patients aged 18 years or older, who were admitted to the Institution in 2017, victims of TBI due to any etiology. Results: 268 medical records were analyzed, of wich 78,7% were male, with an average age of 51 years and a higher incidence in the age group from 31 to 50 years (38,4%). The majority (76,1%) arrived at the Emergency Room (ER) through the Mobile Emergency Service (SAMU), with an average of the Glasgow Coma Scale of 12 points, with 78,0% having mild TBI (13 at 15 points), 14,2% had severe TBI (3 to 8 points) and 7,8% had moderate TBI (9 to 12 points). The majority (57,5%) presented TBI due a fall, followed by 16,0% due to being run over, 12,0% due to aggression, 5,9% due to polytrauma of unknown mechanisms, 5,6% due to motorcycle accident, 1,9% due to automobile accident and 1,1% due to firearm injury. The majority (84,3%) stayed in the hospital for up to 10 days, with an average hospital stay of six days, 92,9% received clinical treatment and 85,8% were discharged. Conclusions: Male individuals prevailed, with an average age of 51 years, referred to ER by SAMU, victims of mild TBI, caused by a fall, with an average hospital stay of six days, receiving clinical treatment and with outcome of discharge hospital.Keywords: Health profile, Traumatic brain injury, Cerebrovascular trauma

scholarly journals Intracranial Pressure Monitoring in Severe Traumatic Brain Injury – Results of a Canadian Survey

2000 ◽  
Vol 27 (2) ◽  
pp. 143-147 ◽  
Author(s):  
Ramesh Sahjpaul ◽  
Murray Girotti
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Prospective Trial ◽  
Icp Monitoring ◽  
Pressure Monitoring ◽  
Level Of Confidence ◽  
Routine Monitoring ◽  
Severe Tbi ◽  
High Level

ABSTRACT:Objective:The purpose of this study was to obtain information from Canadian neurosurgeons regarding their opinions on, and utilization of, intracranial pressure (ICP) monitoring for severe traumatic brain injury (TBI).Methods:A brief survey was sent to practicing Canadian neurosurgeons questioning them about their utilization of, and confidence in, intracranial pressure monitoring in the management of patients with severe TBI.Results:One hundred and ninety-six surveys were mailed. There were 103 responses for a response rate of 52.6%. The vast majority of responding neurosurgeons (98.1%) utilized ICP monitoring in the management of patients with severe TBI, with most (63.4%) using it in more than 75% of their patients, 14.9% using it in 50-75% of patients, 14.9% in 25-50% of patients, and 6.9% using it in less than 25% of patients. The level of confidence that routine monitoring improves outcome from severe TBI ranged from 23.3% having a low level of confidence, 56.3% having an intermediate level of confidence, to 20.4% having a high level of confidence. Most respondents (78.6%) felt that some form of prospective trial evaluating the role of ICP monitoring in improving outcome from severe TBI was warranted; 17.4% felt such a trial was not warranted and 3.9% were uncertain.Conclusions:While ICP monitoring has gained almost universal acceptance among responding Canadian neurosurgeons, their level of confidence that routine monitoring improves outcome from severe TBI was quite variable, with only 20.4% of respondents having a high level of confidence. Over 75% of respondents felt that some form of prospective trial evaluating the utility of ICP monitoring is warranted. This information is being used in consideration of a prospective trial addressing this issue.

Peer Relationships of Children with Traumatic Brain Injury

2013 ◽  
Vol 19 (5) ◽  
pp. 518-527 ◽  
Author(s):  
Keith Owen Yeates ◽  
Cynthia A. Gerhardt ◽  
Erin D. Bigler ◽  
Tracy Abildskov ◽  
Maureen Dennis ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
White Matter ◽  
Peer Relationships ◽  
Social Information Processing ◽  
Peer Acceptance ◽  
Brain Regions ◽  
Severe Tbi ◽  
Orthopedic Injuries ◽  
Mutual Friend

AbstractThis study examined peer relationships in children with traumatic brain injury (TBI) relative to children with orthopedic injuries (OI), and explored whether differences in peer relationships correlated with white matter volumes. Classroom procedures were used to elicit peer perceptions of social behavior, acceptance, and friendships for eighty-seven 8- to 13-year-old children, 15 with severe TBI, 40 with complicated mild/moderate TBI, and 32 with OI. Magnetic resonance imaging (MRI) and voxel-based morphometry (VBM) were used to investigate volumetric correlates of peer relationship measures. Children with severe TBI were rated higher in rejection-victimization than children with OI, and were less likely than children with OI to have a mutual friendship in their classroom (47% vs. 88%). Children with TBI without a mutual friend were rated lower than those with a mutual friend on sociability-popularity and prosocial behavior and higher on rejection-victimization, and had lower peer acceptance ratings. Mutual friendship ratings were related to white matter volumes in several posterior brain regions, but not to overall brain atrophy. Severe TBI in children is associated with detrimental peer relationships that are related to focal volumetric reductions in white matter within regions of the brain involved in social information-processing. (JINS, 2013, 19, 1–10)

Assessment of Neuropsychological Function in Veterans with Blast-related Mild Traumatic Brain Injury and Sub-concussive Blast Exposure

2020 ◽  
Author(s):  
Ashley N Clausen ◽  
Heather C Bouchard ◽  
VA Mid-Atlantic MIRECC Workgroup ◽  
Kathleen A. Welsh-Bohmer ◽  
Rajendra A Morey
Keyword(s):  
Traumatic Brain Injury ◽  
Working Memory ◽  
Brain Injury ◽  
Processing Speed ◽  
Head Injuries ◽  
Neuropsychological Performance ◽  
Long Term Effects ◽  
Mild Tbi ◽  
Blast Exposure ◽  
Current Medication

Abstract Objective: Nearly 20% of Veterans report deployment-related traumatic brain injury (TBI) with most deployment injuries stemming from blast exposure. While Veterans with TBI report cognitive complaints and may acutely display impaired neuropsychological performance, there is little evidence examining the effects of so-called sub-concussive blast exposure, which does not meet clinical symptom criteria for mild TBI during the acute period following exposure. We compared chronic effects of combat blast-related mild TBI and combat-related sub-concussive injuries on neuropsychological performance in Veterans.Methods: Post-9/11 Veterans with sub-concussive (n=33) and mild TBI (n=26) from combat-related blast-exposure in addition to and without control Veterans (n=33) without combat-related blast-exposure, completed neurocognitive assessments of intellectual and executive functioning, processing speed, response inhibition, and working memory via NIH toolbox. Veterans also completed assessment of current clinical psychopathology. The Quantification of Cumulative Blast Exposure was used to assess the number of blast exposure and their severity as well as non-blast-related head injuries. Veteran’s self-reported their history of non-blast head injuries and current medication. Huber Robust Regressions were employed to compare neuropsychological performance across groups. Results: Veterans with combat-related mild TBI and sub-concussive blast exposure displayed significantly poorer performance on measures of processing speed compared to controls. After adjusting for PTSD symptoms, those with combat-related mild TBI exhibited slower processing speed than controls; however, this result was not statistically significant after FDR correction.Conclusion: Veterans in the mild TBI group exhibited poorer processing speed and working memory relative to controls even when controlling for PTSD. However, cognition did not significantly differ between the sub-concussive and control groups or between sub-concussive and mild TBI groups. These results suggest that traditional cognitive assessment may not be sensitive enough to detect long-term effects of sub-concussive blast exposure.

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