Dysfunctional Timing in Traumatic Brain Injury Patients: Co-occurrence of Cognitive, Motor, and Perceptual Deficits.

Laura Verga,Sven Stapert,Ieke Winkens,Michael Schwartze,Sonja A Kotz

doi:10.3389/fpsyg.2021.731898

Abstract

Timing is an essential part of human cognition and of everyday life activities, such as walking or holding a conversation. Previous studies showed that traumatic brain injury (TBI) often affects cognitive functions such as processing speed and time-sensitive abilities, causing long-term sequelae as well as daily impairments. However, the existing evidence on timing capacities in TBI is mostly limited to perception and the processing of isolated intervals. It is therefore open whether the observed deficits extend to motor timing and to continuous dynamic tasks that more closely match daily life activities. The current study set out to answer these questions by assessing audio motor timing abilities and their relationship with cognitive functioning in a group of TBI patients (n = 15) and healthy matched controls. We employed a comprehensive set of tasks aiming at testing timing abilities across perception and production and from single intervals to continuous auditory sequences. In line with previous research, we report functional impairments in TBI patients concerning cognitive processing speed and perceptual timing. Critically, these deficits extended to motor timing: The ability to adjust to tempo changes in an auditory pacing sequence was impaired in TBI patients, and this motor timing deficit covaried with measures of processing speed. These findings confirm previous evidence on perceptual and cognitive timing deficits resulting from TBI and provide first evidence for comparable deficits in motor behavior. This suggests basic co-occurring perceptual and motor timing impairments that may factor into a wide range of daily activities. Our results thus place TBI into the wider range of pathologies with well-documented timing deficits (such as Parkinson’s disease) and encourage the search for novel timing-based therapeutic interventions (e.g., employing dynamic and/or musical stimuli) with high transfer potential to everyday life activities.

Highlights

Neurocognitive timing refers to the capacity to encode, decode, and process events in time and to temporally align with the environment (Grondin, 2010; Grondin et al, 2018)
Symbol Digit Modalities Test traumatic brain injury (TBI) patients performed at an average score of 45.67 ± 11.63, which is at the lower normality boundary
We report a correlation between SDMT scores and the adaptation index, reflecting lower adaptation abilities in patients with higher processing speed scores

Summary

Introduction

Neurocognitive timing refers to the capacity to encode, decode, and process events in time and to temporally align with the environment (Grondin, 2010; Grondin et al, 2018). Even subtle impairments in timing abilities may have a profound impact on brain function, as evidenced by perceptual, cognitive, and motor symptoms arising from timing deficits in otherwise seemingly unrelated pathologies (e.g., Attention Deficit Hyperactivity Disorder, Toplak and Tannock, 2005; Parkinson’s Disease, PD, Benoit et al, 2014; Autism Spectrum Disorder, Falter and Noreika, 2011; Falter et al, 2011; Allman and Falter, 2015). This converging evidence sparked a growing interest in timing abilities as a possible cause for cognitive deficits in various neurological conditions and to develop novel therapeutic intervention strategies with a high transfer potential to numerous cognitive functions and, daily life activities. A music-based training program that employs rhythmic auditory cueing has proven effective in ameliorating both impaired motor and non-motor timing abilities in Parkinson’s Disease (Nombela et al, 2013; Benoit et al, 2014; Kotz and Gunter, 2015; Dalla Bella, 2018)

Methods

Results

Discussion

Conclusion