Declarative and nondeclarative sequence learning tasks: closed-head injured patients versus control participants

Patients who sustained closed-head injury (CHI) have been shown to have impaired memory for temporal order when measured under intentional, but not incidental, retrieval conditions. A group of 26 patients who sustained CHI and a matched control group of 26 individuals were tested on a declarative sequence learning task--"Chain Making" (CM), and a nondeclarative sequence learning task--Tower of Hanoi puzzle (TOHP). The TOHP is a problem solving task that requires planning and a strategic approach. The latter are cognitive processes known to be impaired following frontal lobe damage, as has been frequently documented in CHI patients. The goal of the present study was to test whether CHI patients' nondeclarative learning as measured by the TOHP task is preserved, as seen in amnesic patients, or impaired, as would be predicted following frontal lobe damage. Half of the participants in each group underwent active training, and the other half went through passive training of the tasks. The results demonstrate that the control group outperformed the CHI group (in most measures) in both declarative and nondeclarative sequence learning tasks. The effect of type of training differed for the two tasks: while performance of the control group on the TOHP was better under passive training (CHI patients did not improve on either one of the training modes), performance on the CM task was better under active training for both groups. The results are discussed in light of the role of the frontal lobes in memory generally, and in sequence learning particularly.