Abstract
Objective: Deficits in memory and learning skills are frequently reported following traumatic brain injury (TBI). The goal of the present focused review is to present memory studies of moderate-to-severe TBI that found, within the same sample, that one memory component is preserved, while another is impaired, demonstrating a dissociation. By reviewing these studies, we would like to claim that the breakdown of memory processes following TBI could unmask underlying sub-processes and components that seem inseparable in intact memory. Methods: The search criterion for this focused review was studies of memory functions following TBI (mostly moderate-severe) that reported on dissociations of various memory processes within the same sample, so that one process was impaired while another was preserved. Results: We found studies that adhered to the search criterion in several domains of memory: Working memory, episodic memory, verbal learning, priming, contextual memory and visual search. Conclusions: Characterization of the memory breakdown following TBI could contribute not only to the assessment and rehabilitation of this population but also to our understanding of the composition of intact memory system. These studies, although presenting a single dissociation, can still contribute to the validation of several dissociations introduced in the memory literature.
Highlights
Understanding brain-behavior relationships, on the one hand, is dependent on the study of brain structure and function, and on the other hand, depends on the analysis of behavioral and cognitive processes
The search criterion was memory studies with moderate-to-severe traumatic brain injury (TBI) that found within the same sample a dissociation between a different aspect of the memory process, by demonstrating that one aspect is preserved while the other is impaired following the injury
We have argued that characterization of the memory breakdown following TBI could contribute to the assessment and rehabilitation of this population and to our understanding of the composition of intact memory system
Summary
Understanding brain-behavior relationships, on the one hand, is dependent on the study of brain structure and function, and on the other hand, depends on the analysis of behavioral and cognitive processes. In the context of neuropsychological assessment, the Boston process approach (Milberg et al, 2009) made a very similar assertion, namely, not to equate a “test” with a “process” As demonstrated by these authors, the study of the test performance process (e.g., Block design subtest of the WAIS and the Rey-Complex figure test), rather than looking only at the final score, reflects the impaired cognitive process, and leads to a conclusion of whether a right or left hemisphere dysfunction is present. Such a detailed neuropsychological evaluation, aimed at resolution of the cognitive process, is critical for making predictions about daily life performance following brain injury (for review, see Vakil, 2012). The “process dissociation” framework (Jacoby, 1991) and the “Boston process approach” (Milberg et al, 2009) teach us that in order to study the brainbehavior relationship successfully, either in the context of brain research or neuropsychological assessment and rehabilitation, it is important to refine the resolution of our brain activity measurement tools, and to sharpen resolution of the cognitive processes being tested
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