title: The impact of symptomatic mild traumatic brain injury on complex everyday activities and the link with alterations in cerebral functioning: Exploratory case studies.
abstract: The objective of the study was to explore the neurophysiological correlates of altered functional independence using functional magnetic resonance imaging (fMRI) and event-related potentials (ERP) after a mild traumatic brain injury (mTBI). The participants consisted of three individuals with symptomatic mTBI (3.9 ± 3.6 months post-mTBI) and 12 healthy controls. The main measures used were the Instrumental Activities of Daily Living (IADL) Profile observation-based assessment; a visual externally ordered working memory task combined to event-related potentials (ERP) and fMRI recordings; neuropsychological tests; post-concussion symptoms questionnaires; and the Activities of Daily Living (ADL) Profile interview. Compared to normal controls, all three patients had difficulty with a real-world complex budgeting activity due to deficits in planning, ineffective strategy use and/or a prolonged time to detect and correct errors. Reduced activations in the right mid-dorsolateral prefrontal cortex on fMRI as well as abnormal frontal or parietal components of the ERP occurred alongside these deficits. Results of this exploratory study suggest that reduced independence in complex everyday activities in symptomatic mTBI may be at least partly explained by a decrease in brain activation in the prefrontal cortex, abnormal ERP, or slower reaction times on working memory tasks. The study presents an initial attempt at combining research in neuroscience with ecological real-world evaluation research to further our understanding of the difficulties in complex everyday activities experienced by individuals with mTBI.
authors.affiliation: a School of Rehabilitation , Université de Montréal , Montreal , Canada.|b Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal , Montreal , Canada.
authors.forename: Carolina
authors.initials: C
authors.lastname: Bottari
authors.affiliation: c Montreal Sacred Heart Hospital Research Center , Montreal , Canada.|d Department of Psychology , Université de Montréal , Montreal , Canada.
authors.forename: Nadia
authors.initials: N
authors.lastname: Gosselin
authors.affiliation: e Cognitive Neuroscience Unit , Montreal Neurological Institute , Montreal , Canada.|f Department of Psychology , McGill University Health Centre , Montreal , Canada.
authors.forename: Jen-Kai
authors.initials: JK
authors.lastname: Chen
authors.affiliation: e Cognitive Neuroscience Unit , Montreal Neurological Institute , Montreal , Canada.|f Department of Psychology , McGill University Health Centre , Montreal , Canada.|g Department of Neurology and Neurosurgery , McGill University , Montreal , Canada.
authors.forename: Alain
authors.initials: A
authors.lastname: Ptito
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001924:Brain Concussion / Q000150:complications* / Q000000981:diagnostic imaging / Q000523:psychology*; D001931:Brain Mapping; D003072:Cognition Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D004569:Electroencephalography; D005071:Evoked Potentials / Q000502:physiology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology; D009483:Neuropsychological Tests; D010100:Oxygen / Q000097:blood; D055815:Young Adult
chemical_list: D010100:Oxygen
keywords: Brain injuries; Cognitive deficits; Concussion; Neuropsychology; Rehabilitation