title: Differential working memory load effects after mild traumatic brain injury.
abstract: The objective of this study was to explore the effects of increasing working memory (WM) processing load on previously observed abnormalities in activation of WM circuitry shortly after mild traumatic brain injury (MTBI). Brain activation patterns in response to increasing WM processing load (auditory n-back: 0-, 1-, 2-, and 3-back conditions) were assessed with fMRI in 18 MTBI patients within 1 month of their injury and in 12 healthy controls. Performance accuracy on these tasks was also measured. Brain activation patterns differed between MTBI patients and controls in response to increasing WM processing loads. Controls maintained their ability to increase activation in regions of WM circuitry with each increase in WM processing load. MTBI patients showed disproportionately increased activation during the moderate processing load condition, but very little increase in activation associated with the highest processing load condition. Task performance did not differ significantly between groups on any task condition. MTBI patients showed a different pattern of allocation of processing resources associated with a high processing load condition compared to healthy controls, despite similar task performance. This suggests that injury-related changes in ability to activate or modulate WM processing resources might underlie some of the memory complaints after MTBI.
authors.affiliation: Section of Neuropsychiatry and Brain Imaging Laboratory, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA.
authors.forename: T W
authors.initials: TW
authors.lastname: McAllister
authors.forename: M B
authors.initials: MB
authors.lastname: Sparling
authors.forename: L A
authors.initials: LA
authors.lastname: Flashman
authors.forename: S J
authors.initials: SJ
authors.lastname: Guerin
authors.forename: A C
authors.initials: AC
authors.lastname: Mamourian
authors.forename: A J
authors.initials: AJ
authors.lastname: Saykin
mesh_terms: D000293:Adolescent; D000328:Adult; D001288:Attention / Q000502:physiology*; D001924:Brain Concussion / Q000175:diagnosis / Q000503:physiopathology*; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000503:physiopathology; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008297:Male; D011939:Mental Recall / Q000502:physiology*; D008875:Middle Aged; D010296:Parietal Lobe / Q000503:physiopathology; D010364:Pattern Recognition, Visual / Q000502:physiology; D011446:Prospective Studies; D011930:Reaction Time / Q000502:physiology; D012016:Reference Values; D012153:Retention, Psychology / Q000502:physiology*; D012691:Serial Learning / Q000502:physiology; D013067:Speech Perception / Q000502:physiology