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Functional Magnetic Resonance Imaging of Working Memory and Response Inhibition in Children with Mild Traumatic Brain Injury

Published online by Cambridge University Press:  12 October 2011

Lauren S. Krivitzky
Affiliation:
Division of Pediatric Neuropsychology, Department of Psychiatry and Behavioral Sciences, Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
Tresa M. Roebuck-Spencer
Affiliation:
University of Oklahoma, Norman, Oklahoma
Robert M. Roth
Affiliation:
Brain Imaging Laboratory, Department of Psychiatry, Dartmouth Medical School, Hanover, New Hampshire
Kaitlin Blackstone
Affiliation:
Division of Pediatric Neuropsychology, Department of Psychiatry and Behavioral Sciences, Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
Chad P. Johnson
Affiliation:
Division of Pediatric Neuropsychology, Department of Psychiatry and Behavioral Sciences, Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
Gerard Gioia*
Affiliation:
Division of Pediatric Neuropsychology, Department of Psychiatry and Behavioral Sciences, Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
*
Correspondence and reprint requests to: Gerard Gioia, Children's National Medical Center, 15245 Shady Grove Road, Suite 350, Rockville, MD 20852. E-mail: ggioia@cnmc.org

Abstract

The current pilot study examined functional magnetic resonance imaging (fMRI) activation in children with mild traumatic brain injury (mTBI) during tasks of working memory and inhibitory control, both of which are vulnerable to impairment following mTBI. Thirteen children with symptomatic mTBI and a group of controls completed a version of the Tasks of Executive Control (TEC) during fMRI scanning. Both groups showed greater prefrontal activation in response to increased working memory load. Activation patterns did not differ between groups on the working memory aspects of the task, but children with mTBI showed greater activation in the posterior cerebellum with the addition of a demand for inhibitory control. Children with mTBI showed greater impairment on symptom report and “real world” measures of executive functioning, but not on traditional “paper and pencil” tasks. Likewise, cognitive testing did not correlate significantly with imaging results, whereas increased report of post-concussive symptoms were correlated with increased cerebellar activation. Overall, results provide some evidence for the utility of symptom report as an indicator of recovery and the hypothesis that children with mTBI may experience disrupted neural circuitry during recovery. Limitations of the study included a small sample size, wide age range, and lack of in-scanner accuracy data. (JINS, 2011, 17, 1143–1152)

Type
Regular Articles
Copyright
Copyright © The International Neuropsychological Society 2011

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