Skip to main content
PMC home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 2001 Aug;71(2):161–168. doi: 10.1136/jnnp.71.2.161

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

C Christodoulou 1, J DeLuca 1, J Ricker 1, N Madigan 1, B Bly 1, G Lange 1, A Kalnin 1, W Liu 1, J Steffener 1, B Diamond 1, A Ni 1
PMCID: PMC1737512  PMID: 11459886

Abstract

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.
METHODS—Functional 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.
RESULTS—Patients 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.
CONCLUSIONS—Impairment of working memory in TBI seems to be associated with alterations in functional cerebral activity.



Full Text

The Full Text of this article is available as a PDF (203.9 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Braver T. S., Cohen J. D., Nystrom L. E., Jonides J., Smith E. E., Noll D. C. A parametric study of prefrontal cortex involvement in human working memory. Neuroimage. 1997 Jan;5(1):49–62. doi: 10.1006/nimg.1996.0247. [DOI] [PubMed] [Google Scholar]
  2. Burbaud P., Degreze P., Lafon P., Franconi J. M., Bouligand B., Bioulac B., Caille J. M., Allard M. Lateralization of prefrontal activation during internal mental calculation: a functional magnetic resonance imaging study. J Neurophysiol. 1995 Nov;74(5):2194–2200. doi: 10.1152/jn.1995.74.5.2194. [DOI] [PubMed] [Google Scholar]
  3. Chollet F., Weiller C. Imaging recovery of function following brain injury. Curr Opin Neurobiol. 1994 Apr;4(2):226–230. doi: 10.1016/0959-4388(94)90077-9. [DOI] [PubMed] [Google Scholar]
  4. Cohen J. D., Perlstein W. M., Braver T. S., Nystrom L. E., Noll D. C., Jonides J., Smith E. E. Temporal dynamics of brain activation during a working memory task. Nature. 1997 Apr 10;386(6625):604–608. doi: 10.1038/386604a0. [DOI] [PubMed] [Google Scholar]
  5. Fontaine A., Azouvi P., Remy P., Bussel B., Samson Y. Functional anatomy of neuropsychological deficits after severe traumatic brain injury. Neurology. 1999 Dec 10;53(9):1963–1968. doi: 10.1212/wnl.53.9.1963. [DOI] [PubMed] [Google Scholar]
  6. Jansen H. M., van der Naalt J., van Zomeren A. H., Paans A. M., Veenma-van der Duin L., Hew J. M., Pruim J., Minderhoud J. M., Korf J. Cobalt-55 positron emission tomography in traumatic brain injury: a pilot study. J Neurol Neurosurg Psychiatry. 1996 Feb;60(2):221–224. doi: 10.1136/jnnp.60.2.221. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Kaplan C. P., Corrigan J. D. The relationship between cognition and functional independence in adults with traumatic brain injury. Arch Phys Med Rehabil. 1994 Jun;75(6):643–647. doi: 10.1016/0003-9993(94)90186-4. [DOI] [PubMed] [Google Scholar]
  8. Langfitt T. W., Obrist W. D., Alavi A., Grossman R. I., Zimmerman R., Jaggi J., Uzzell B., Reivich M., Patton D. R. Computerized tomography, magnetic resonance imaging, and positron emission tomography in the study of brain trauma. Preliminary observations. J Neurosurg. 1986 May;64(5):760–767. doi: 10.3171/jns.1986.64.5.0760. [DOI] [PubMed] [Google Scholar]
  9. Levin H. S., Gary H. E., Jr, Eisenberg H. M., Ruff R. M., Barth J. T., Kreutzer J., High W. M., Jr, Portman S., Foulkes M. A., Jane J. A. Neurobehavioral outcome 1 year after severe head injury. Experience of the Traumatic Coma Data Bank. J Neurosurg. 1990 Nov;73(5):699–709. doi: 10.3171/jns.1990.73.5.0699. [DOI] [PubMed] [Google Scholar]
  10. Manoach D. S., Schlaug G., Siewert B., Darby D. G., Bly B. M., Benfield A., Edelman R. R., Warach S. Prefrontal cortex fMRI signal changes are correlated with working memory load. Neuroreport. 1997 Jan 20;8(2):545–549. doi: 10.1097/00001756-199701200-00033. [DOI] [PubMed] [Google Scholar]
  11. McAllister T. W., Saykin A. J., Flashman L. A., Sparling M. B., Johnson S. C., Guerin S. J., Mamourian A. C., Weaver J. B., Yanofsky N. Brain activation during working memory 1 month after mild traumatic brain injury: a functional MRI study. Neurology. 1999 Oct 12;53(6):1300–1308. doi: 10.1212/wnl.53.6.1300. [DOI] [PubMed] [Google Scholar]
  12. McDowell S., Whyte J., D'Esposito M. Working memory impairments in traumatic brain injury: evidence from a dual-task paradigm. Neuropsychologia. 1997 Oct;35(10):1341–1353. doi: 10.1016/s0028-3932(97)00082-1. [DOI] [PubMed] [Google Scholar]
  13. Ohyama M., Senda M., Kitamura S., Ishii K., Mishina M., Terashi A. Role of the nondominant hemisphere and undamaged area during word repetition in poststroke aphasics. A PET activation study. Stroke. 1996 May;27(5):897–903. doi: 10.1161/01.str.27.5.897. [DOI] [PubMed] [Google Scholar]
  14. Papanicolaou A. C., Moore B. D., Deutsch G., Levin H. S., Eisenberg H. M. Evidence for right-hemisphere involvement in recovery from aphasia. Arch Neurol. 1988 Sep;45(9):1025–1029. doi: 10.1001/archneur.1988.00520330117020. [DOI] [PubMed] [Google Scholar]
  15. Paulesu E., Frith C. D., Frackowiak R. S. The neural correlates of the verbal component of working memory. Nature. 1993 Mar 25;362(6418):342–345. doi: 10.1038/362342a0. [DOI] [PubMed] [Google Scholar]
  16. Petrides M., Alivisatos B., Meyer E., Evans A. C. Functional activation of the human frontal cortex during the performance of verbal working memory tasks. Proc Natl Acad Sci U S A. 1993 Feb 1;90(3):878–882. doi: 10.1073/pnas.90.3.878. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Ruff R. M., Marshall L. F., Crouch J., Klauber M. R., Levin H. S., Barth J., Kreutzer J., Blunt B. A., Foulkes M. A., Eisenberg H. M. Predictors of outcome following severe head trauma: follow-up data from the Traumatic Coma Data Bank. Brain Inj. 1993 Mar-Apr;7(2):101–111. doi: 10.3109/02699059309008164. [DOI] [PubMed] [Google Scholar]
  18. Rypma B., D'Esposito M. The roles of prefrontal brain regions in components of working memory: effects of memory load and individual differences. Proc Natl Acad Sci U S A. 1999 May 25;96(11):6558–6563. doi: 10.1073/pnas.96.11.6558. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Salmon E., Van der Linden M., Collette F., Delfiore G., Maquet P., Degueldre C., Luxen A., Franck G. Regional brain activity during working memory tasks. Brain. 1996 Oct;119(Pt 5):1617–1625. doi: 10.1093/brain/119.5.1617. [DOI] [PubMed] [Google Scholar]
  20. Saykin A. J., Flashman L. A., Frutiger S. A., Johnson S. C., Mamourian A. C., Moritz C. H., O'Jile J. R., Riordan H. J., Santulli R. B., Smith C. A. Neuroanatomic substrates of semantic memory impairment in Alzheimer's disease: patterns of functional MRI activation. J Int Neuropsychol Soc. 1999 Jul;5(5):377–392. doi: 10.1017/s135561779955501x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Seidman L. J., Breiter H. C., Goodman J. M., Goldstein J. M., Woodruff P. W., O'Craven K., Savoy R., Tsuang M. T., Rosen B. R. A functional magnetic resonance imaging study of auditory vigilance with low and high information processing demands. Neuropsychology. 1998 Oct;12(4):505–518. doi: 10.1037//0894-4105.12.4.505. [DOI] [PubMed] [Google Scholar]
  22. Stuss D. T., Ely P., Hugenholtz H., Richard M. T., LaRochelle S., Poirier C. A., Bell I. Subtle neuropsychological deficits in patients with good recovery after closed head injury. Neurosurgery. 1985 Jul;17(1):41–47. doi: 10.1227/00006123-198507000-00007. [DOI] [PubMed] [Google Scholar]
  23. Teasdale G., Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974 Jul 13;2(7872):81–84. doi: 10.1016/s0140-6736(74)91639-0. [DOI] [PubMed] [Google Scholar]
  24. Weiller C., Ramsay S. C., Wise R. J., Friston K. J., Frackowiak R. S. Individual patterns of functional reorganization in the human cerebral cortex after capsular infarction. Ann Neurol. 1993 Feb;33(2):181–189. doi: 10.1002/ana.410330208. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES