Lasting deficit in inhibitory control with mild traumatic brain injury

Benjamin Xu,Oluwole Awosika,Sarah Levy,Rita Volochayev,Leonardo G Cohen,Marco Sandrini,John A Butman,Dzung L Pham

doi:10.1038/s41598-017-14867-y

Benjamin Xu, Oluwole Awosika + Show 6 more

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https://doi.org/10.1038/s41598-017-14867-y

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Being able to focus on a complex task and inhibit unwanted actions or interfering information (i.e., inhibitory control) are essential human cognitive abilities. However, it remains unknown the extent to which mild traumatic brain injury (mTBI) may impact these critical functions. In this study, seventeen patients and age-matched healthy controls (HC) performed a variant of the Stroop task and attention-demanding 4-choice response tasks (4CRT) with identical stimuli but two contexts: one required only routine responses and the other with occasional response conflicts. The results showed that mTBI patients performed equally well as the HC when the 4CRT required only routine responses. However, when the task conditions included occasional response conflicts, mTBI patients with even a single concussion showed a significant slow-down in all responses and higher error rates relative to the HC. Results from event-related functional magnetic resonance imaging (efMRI) revealed altered neural activity in the mTBI patients in the cerebellum-thalamo-cortical and the fronto-basal-ganglia networks regulating inhibitory control. These results suggest that even without apparent difficulties in performing complex attention-demanding but routine tasks, patients with mTBI may experience long-lasting deficits in regulating inhibitory control when situations call for rapid conflict resolutions.

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IntroductionThe ability to focus on a complex task and suppress interfering information or unwanted response quickly (i.e., inhibitory control) are essential cognitive functions for carrying out daily and other important activities (e.g., driving a car, crossing busy streets, or patrolling in a combat zoon)
The ability to focus on a complex task and suppress interfering information or unwanted response quickly are essential cognitive functions for carrying out daily and other important activities
The results showed that mild traumatic brain injury (mTBI) patients performed as the healthy controls (HC) in the 4-choice response task (4CRT) when only the “go” responses were required

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Introduction

The ability to focus on a complex task and suppress interfering information or unwanted response quickly (i.e., inhibitory control) are essential cognitive functions for carrying out daily and other important activities (e.g., driving a car, crossing busy streets, or patrolling in a combat zoon). Patients with severe traumatic brain injury (TBI) typically show symptoms of various cognitive difficulties including memory, attention, inhibitory control, and other executive functions[1,2]. These difficulties often co-occur with extensive brain lesions or with significant difficulties in maintaining task-relevant attention[3,4]. MTBI accounts for about 80% of all traumatic brain injuries in the United States[9] It remains a question whether patients with chronic mTBI may suffer from long-lasting impact on cognitive functions, in maintaining (i.e., sustained) attention and inhibitory control. Participants performed, on a separate day, a variant of the Stroop task examining the ability to suppress interfering information as an additional task for measuring the inhibitory control function. (See Methods for details and the rationale of the task design)

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