Reduced contribution of executive functions in impaired working memory performance in mild traumatic brain injury patients

• Published in: Clinical neurology and neurosurgery 2013-08, Vol.115 (8), p.1326-1332
• Main Authors: Kumar, Sanjay, Rao, Shobini L, Chandramouli, Bangalore A, Pillai, Shibu
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age; Brain damage; Brain Injuries - complications; Brain Injuries - psychology; Brain injury; Brain research; Cognition & reasoning; Data Interpretation, Statistical; Educational Status; Executive Function; Female; Glasgow Coma Scale; Head injuries; Humans; Inhibition (Psychology); Intelligence Tests; Male; Memory Disorders - etiology; Memory Disorders - psychology; Middle Aged; Neurology; Neuropsychological Tests; Neuropsychology; Neurosurgery; Patients; Psychomotor Performance - physiology; Stroop Test; Tomography, X-Ray Computed; Unconsciousness - etiology; Unconsciousness - psychology; Verbal Behavior; Working memory; Young Adult
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2012.12.038

Abstract Aim Mild traumatic brain injury (MTBI) is associated with often selective impairment of both working memory (WM) and the executive functions (EFs). Research indicates that one of the commonest deficits present in MTBI patients falls in the domain of WM. We aimed to investigate the role of EFs in WM impairment following MTBI. Methods Performance on the tests of EFs and the verbal and visuo-spatial WM of 30 consecutive MTBI patients were compared with age/education/IQ matched 30 normal healthy control participants. Correlation between EFs and WM was studied separately for the MTBI and the control group. Results The MTBI and control group were tested on a range of EF tests and WM. The MTBI group was demonstrated impairment on verbal and visuo-spatial WM and category fluency tests only. Furthermore, the MTBI group had fewer significant correlations between the WM and EFs (5 out of 54 possible correlations) than in the control group (13 out of 54 possible correlations). Conclusions We suggest that MTBI may lead to WM deficits as the contribution of executive processes to support the WM is diminished following MTBI. Such an understanding of the poor WM performance in MTBI patients will be helpful when planning appropriate strategies for cognitive rehabilitation.