Sustained attention following traumatic brain injury: Use of the Psychomotor Vigilance Task

• Published in: Journal of clinical and experimental neuropsychology 2013-02, Vol.35 (2), p.210-224
• Main Authors: Sinclair, Kelly L., Ponsford, Jennie L., Rajaratnam, Shantha M. W., Anderson, Clare
• Format: Article
• Language: English
• Subjects: Acoustic Stimulation; Adolescent; Adult; Adult and adolescent clinical studies; Aged; Attention Deficit Disorder with Hyperactivity - diagnosis; Attention Deficit Disorder with Hyperactivity - etiology; Biological and medical sciences; Brain Injuries - complications; Case-Control Studies; Daytime sleepiness; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes; Fatigue; Fatigue - etiology; Female; Humans; Information-processing speed; Injuries of the nervous system and the skull. Diseases due to physical agents; Male; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Neurology; Neuropsychological Tests; Organic mental disorders. Neuropsychology; Psychology. Psychoanalysis. Psychiatry; Psychomotor Performance - physiology; Psychomotor Vigilance Task; Psychopathology. Psychiatry; Reaction Time; Severity of Illness Index; Sleep Apnea, Central - etiology; Sleep disturbance; Sustained attention; Traumas. Diseases due to physical agents; Traumatic brain injury; Young Adult
• ISSN: 1380-3395; 1744-411X
• DOI: 10.1080/13803395.2012.762340

Objective: Deficits in sustained attention are common following traumatic brain injury (TBI), as a result of primary (i.e., neuropathology) and/or secondary factors (i.e., fatigue, sleep disturbance, depressed mood). The extent to which secondary factors play a role in attention deficits is relatively unexamined. Moreover, the Psychomotor Vigilance Task (PVT) is seldom used in TBI assessment despite its sensitivity to secondary factors observed following injury. The primary aim of the current study was to examine the usefulness of the auditory PVT in identifying attentional difficulties in patients with TBI compared with noninjured controls, and also to explore the impact of fatigue, sleep quality, and daytime sleepiness on sustained attention performances. Method: Participants (n = 20 per group) completed the auditory PVT and self-report measures of fatigue, sleep quality, daytime sleepiness, and depression. Results: Compared to controls, patients with TBI had widespread PVT deficits including slower response times, increased response variability and attention lapses, and delayed responding in the slowest 10% of responses. Distribution analyses suggested this was likely due to generalized cognitive slowing. Self-reported secondary factors had varying impacts on aspects of PVT performance, with self-reported fatigue exhibiting a more global impact on attention performance. Conclusions: The auditory PVT is a sensitive measure of sustained attention deficits in patients with TBI, with aspects of performance influenced by fatigue, sleep disturbance, and depression.