NEUROPSYCHOLOGICAL CORRELATES AND UNDERLYING CORTICAL MECHANISMS OF WORKING MEMORY IN MODERATE TO SEVERE TRAUMATIC BRAIN INJURY

Functional magnetic resonance imaging (fMRI) is a relatively new tool that has been used to examine patterns of neural activation within those with traumatic brain injuries (TBI). A review of relevant literature is presented, including alterations in activity within the frontal and parietal regions that are thought to be compensatory in nature. In addition, possible explanations for discrepancies within this research are discussed. The current study expands upon previous work by incorporating a delayed-match-to-sample (DMS) task within an event-related paradigm and neuropsychological testing to compare 12 individuals with a history of TBI to 12 control participants with orthopedic injuries (OI). Participants in the TBI group were high functioning and in the chronic stage of recovery. Neuropsychological testing revealed statistically significant group differences in measures of working memory, processing speed, memory, and executive functioning. However, groups were comparable in accuracy on the DMS task. Percent signal changes in fMRI data revealed statistically significantly increased activation within the right dorsolateral prefrontal cortex (BA 46) for the TBI group compared to controls. Additional alterations in activation were found between groups within the inferior temporal (BA 37) and parietal (BA 7) regions. Regression analyses showed no relationship between neuropsychological testing and percent signal change within BA 46, but predictive relationships between testing and BA 37 and BA 7. Logistic regression analyses suggest that fMRI data did not add any incremental predictive value beyond neuropsychological testing alone when attempting to predict group (TBI vs. OI) membership