J Neurol Neurosurg Psychiatry 2001;71:161-168 ( August )

Functional magnetic resonance imaging of working memory impairment after traumatic brain injury

C Christodoulou^{a b}, J DeLuca^{a b d}, J H Ricker^{a b}, N K Madigan^a, B M Bly^{c f}, G Lange^{c e}, A J Kalnin^c, W-C Liu^c, J Steffener^e, B J Diamond^{a b}, A C Ni^a

^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

OBJECTIVESTo 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.


Keywords: traumatic brain injury; working memory; functional magnetic resonance imaging

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© 2001 by Journal of Neurology, Neurosurgery, and Psychiatry
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