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创伤性脑损伤中工作记忆负荷的参数操作:行为和神经关联

Parametric manipulation of working memory load in traumatic brain injury: behavioral and neural correlates.

作者信息

Perlstein William M, Cole Michael A, Demery Jason A, Seignourel Paul J, Dixit Neha K, Larson Michael J, Briggs Richard W

机构信息

Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida 32610, USA.

出版信息

J Int Neuropsychol Soc. 2004 Sep;10(5):724-41. doi: 10.1017/S1355617704105110.

Abstract

Traumatic brain injury (TBI) is often associated with enduring impairments in high-level cognitive functioning, including working memory (WM). We examined WM function in predominantly chronic patients with mild, moderate and severe TBI and healthy comparison subjects behaviorally and, in a small subset of moderate-to-severe TBI patients, with event-related functional magnetic resonance imaging (fMRI), using a visual n-back task that parametrically varied WM load. TBI patients showed severity-dependent and load-related WM deficits in performance accuracy, but not reaction time. Performance of mild TBI patients did not differ from controls; patients with moderate and severe TBI were impaired, relative to controls and mild TBI patients, but only at higher WM-load levels. fMRI results show that TBI patients exhibit altered patterns of activation in a number of WM-related brain regions, including the dorsolateral prefrontal cortex and Broca's area. Examination of the pattern of behavioral responding and the temporal course of activations suggests that WM deficits in moderate-to-severe TBI are due to associative or strategic aspects of WM, and not impairments in active maintenance of stimulus representations. Overall, results demonstrate that individuals with moderate-to-severe TBI exhibit WM deficits that are associated with dysfunction within a distributed network of brain regions that support verbally mediated WM.

摘要

创伤性脑损伤(TBI)常与高水平认知功能的持久性损害相关,包括工作记忆(WM)。我们对主要为慢性的轻度、中度和重度TBI患者以及健康对照者进行了行为学上的WM功能检查,并对一小部分中重度TBI患者使用事件相关功能磁共振成像(fMRI)进行检查,采用视觉n-back任务,该任务的WM负荷呈参数变化。TBI患者在表现准确性上显示出与严重程度相关和与负荷相关的WM缺陷,但反应时间没有差异。轻度TBI患者的表现与对照组无差异;中度和重度TBI患者相对于对照组和轻度TBI患者存在损害,但仅在较高的WM负荷水平下。fMRI结果显示,TBI患者在包括背外侧前额叶皮层和布洛卡区在内的多个与WM相关的脑区表现出激活模式改变。对行为反应模式和激活时间进程的检查表明,中重度TBI患者的WM缺陷是由于WM的联想或策略方面,而非刺激表征的主动维持受损。总体而言,结果表明,中重度TBI患者表现出WM缺陷,这与支持言语介导WM的脑区分布式网络内的功能障碍有关。

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