Abstract
We investigated differences in brain activation associated with cognitive fatigue between persons with traumatic brain injury (TBI) and healthy controls (HCs). Twenty-two participants with moderate-severe TBI and 20 HCs performed four blocks of a difficult working memory task and four blocks of a control task during fMRI imaging. Cognitive fatigue, assessed before and after each block, was used as a covariate to assess fatigue-related brain activation. The TBI group reported more fatigue than the HCs, though their performance was comparable. Regarding brain activation, the TBI group showed a Task X Fatigue interaction in the caudate tail resulting from a positive correlation between fatigue and brain activation for the difficult task and a negative relationship for the control task. The HC group showed the same Task X Fatigue interaction in the caudate head. Because we had prior hypotheses about the caudate, we performed a confirmatory analysis of a separate dataset in which the same subjects performed a processing speed task. A relationship between Fatigue and brain activation was evident in the caudate for this task as well. These results underscore the importance of the caudate nucleus in relation to cognitive fatigue.
Highlights
Traumatic Brain Injury (TBI) is one of the most prevalent causes of neurological insult in the US, with over 1.7 million cases reported annually[1], and it is a growing problem in other countries[2]
In that work[8], we showed that individuals with traumatic brain injury (TBI) recruit the fronto-striatal network more during performance of a demanding cognitive task compared to healthy participants, including ventromedial prefrontal cortex (VMPFC), parietal areas, and the basal ganglia
For response time (RT), there was a main effect of Task (F(1,95.79) = 1313.00, p < 0.0001), resulting from individuals in the TBI group responding with longer latencies during the symbol-digit modalities task (SDMT) task (RT = 2004.1) than during the control task (RT = 936.0)
Summary
Traumatic Brain Injury (TBI) is one of the most prevalent causes of neurological insult in the US, with over 1.7 million cases reported annually[1], and it is a growing problem in other countries[2]. Cognitive fatigue can be defined as a subjective lack of mental energy that is perceived by the individual (or caregiver) to interfere with usual and desired activities[12] It has been known for over a century that individuals who have sustained neurological damage frequently report cognitive fatigue[13], yet a comprehensive and accurate model for studying fatigue remains elusive. In that work[8], we showed that individuals with TBI recruit the fronto-striatal network more during performance of a demanding cognitive task compared to healthy participants, including ventromedial prefrontal cortex (VMPFC), parietal areas, and the basal ganglia This network has been previously shown to be involved in cognitive fatigue[16,17,18,19]. Cognitive fatigue has been associated with a network of areas in the striatum and PFC including vmPFC, nucleus accumbens and anterior cingulate cortex (ACC) in children who have sustained a TBI32
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