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a Neuropsychology and
Neuroscience Laboratory, Kessler Medical Rehabilitation Research and
Education Corporation, 1199 Pleasant Valley Way, West Orange, NJ,
07052, USA, b Department of Physical Medicine and
Rehabilitation, UMDNJ-New Jersey Medical School, USA, c Department of Radiology, d Department
of Neuroscience, e Department of
Psychiatry, f Department of Psychology at Rutgers University,
USA
Correspondence to: Dr J DeLuca delucajo{at}umdnj.edu
Received 19 June 2000 and in revised form 10 January 2001;
Accepted 23 January
2001
OBJECTIVES
To
examine patterns of brain activation while performing a working memory
task in persons with moderate to severe traumatic brain injury (TBI)
and healthy controls. It is well established that working memory is an
area of cognition that is especially vulnerable to disruption after
TBI. Although much has been learned about the system of cerebral
representation of working memory in healthy people, little is known
about how this system is disrupted by TBI.
METHODSFunctional
magnetic resonance imaging (fMRI) was used to assess brain activation
during a working memory task (a modified version of the paced auditory
serial addition test) in nine patients with TBI and seven healthy controls.
RESULTSPatients
with TBI were able to perform the task, but made significantly more
errors than healthy controls. Cerebral activation in both groups was
found in similar regions of the frontal, parietal, and temporal lobes,
and resembled patterns of activation found in previous neuroimaging
studies of working memory in healthy persons. However, compared with
the healthy controls, the TBI group displayed a pattern of cerebral
activation that was more regionally dispersed and more lateralised to
the right hemisphere. Differences in lateralisation were particularly
evident in the frontal lobes.
CONCLUSIONSImpairment
of working memory in TBI seems to be associated with alterations in
functional cerebral activity.
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