Towards Validation of a New Computerised Test of Goal Neglect: Preliminary Evidence from Clinical and Neuroimaging Pilot Studies

• Published in: PloS one 2016-01, Vol.11 (1), p.e0148127-e0148127
• Main Authors: Cullen, Breda, Brennan, David, Manly, Tom, Evans, Jonathan J
• Format: Article
• Language: English
• Subjects: Activation; Adult; Adults; Apathy; Biology and Life Sciences; Brain; Brain damage; Brain injuries; Brain Injuries - diagnosis; Brain Injuries - pathology; Brain Injuries - physiopathology; Brain injury; Brain Mapping; Cognition & reasoning; Correlation analysis; Demographics; Diagnosis; Female; Functional magnetic resonance imaging; Goals; Head injuries; Humans; Hypotheses; Magnetic Resonance Imaging; Male; Medical imaging; Medicine and Health Sciences; Memory; Mental health; Methods; Middle Aged; Neuroimaging; Neuroimaging - methods; Neurology; People and Places; Pilot Projects; Prefrontal cortex; Prefrontal Cortex - pathology; Prefrontal Cortex - physiopathology; Psychological Tests; Rehabilitation; Research and Analysis Methods; Social Sciences; Studies; Switching; Traumatic brain injury
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0148127

Goal neglect is a significant problem following brain injury, and is a target for rehabilitation. It is not yet known how neural activation might change to reflect rehabilitation gains. We developed a computerised multiple elements test (CMET), suitable for use in neuroimaging paradigms. Pilot correlational study and event-related fMRI study. In Study 1, 18 adults with acquired brain injury were assessed using the CMET, other tests of goal neglect (Hotel Test; Modified Six Elements Test) and tests of reasoning. In Study 2, 12 healthy adults underwent fMRI, during which the CMET was administered under two conditions: self-generated switching and experimenter-prompted switching. Among the clinical sample, CMET performance was positively correlated with both the Hotel Test (r = 0.675, p = 0.003) and the Modified Six Elements Test (r = 0.568, p = 0.014), but not with other clinical or demographic measures. In the healthy sample, fMRI demonstrated significant activation in rostro-lateral prefrontal cortex in the self-generated condition compared with the prompted condition (peak 40, 44, 4; ZE = 4.25, p(FWEcorr) = 0.026). These pilot studies provide preliminary evidence towards the validation of the CMET as a measure of goal neglect. Future studies will aim to further establish its psychometric properties, and determine optimum pre- and post-rehabilitation fMRI paradigms.