Functional magnetic resonance imaging of working memory and response inhibition in children with mild traumatic brain
Lauren S Krivitzky1, Tresa M Roebuck-Spencer, Robert M Roth
1Division of Pediatric Neuropsychology, Department of Psychiatry and Behavioral Sciences, Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
Insights
Children with mild traumatic brain injury (mTBI) show altered brain activity, particularly in the cerebellum during inhibitory control tasks. Symptom reporting may indicate recovery and disrupted neural circuitry in pediatric mTBI patients.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Cognitive Neuroscience
Background:
- Mild traumatic brain injury (mTBI) can impair executive functions like working memory and inhibitory control in children.
- Functional magnetic resonance imaging (fMRI) is a valuable tool for investigating neural underpinnings of cognitive deficits post-mTBI.
Purpose of the Study:
- To examine fMRI brain activation patterns in children with mTBI during working memory and inhibitory control tasks.
- To explore the relationship between neural activation, symptom reporting, and executive functioning in pediatric mTBI.
Main Methods:
- A pilot study involving 13 children with symptomatic mTBI and a control group.
- Participants completed the Tasks of Executive Control (TEC) during fMRI scanning.
- Analysis of prefrontal and cerebellar activation in response to varying cognitive demands.
Main Results:
- Both groups exhibited increased prefrontal activation with higher working memory load.
- Children with mTBI showed greater posterior cerebellar activation during inhibitory control tasks.
- mTBI group reported more executive dysfunction on symptom and real-world measures, not traditional cognitive tests.
Conclusions:
- Symptom reporting may serve as a useful indicator of recovery in pediatric mTBI.
- Findings suggest disrupted neural circuitry in children recovering from mTBI.
- Further research with larger sample sizes is warranted to confirm these preliminary findings.
Abstract:
The current pilot study examined functional magnetic resonance imaging (fMRI) activation in children with mild traumatic brain injury (mTBI) during tasks of working memory and inhibitory control, both of which are vulnerable to impairment following mTBI. Thirteen children with symptomatic mTBI and a group of controls completed a version of the Tasks of Executive Control (TEC) during fMRI scanning. Both groups showed greater prefrontal activation in response to increased working memory load. Activation patterns did not differ between groups on the working memory aspects of the task, but children with mTBI showed greater activation in the posterior cerebellum with the addition of a demand for inhibitory control. Children with mTBI showed greater impairment on symptom report and "real world" measures of executive functioning, but not on traditional "paper and pencil" tasks. Likewise, cognitive testing did not correlate significantly with imaging results, whereas increased report of post-concussive symptoms were correlated with increased cerebellar activation. Overall, results provide some evidence for the utility of symptom report as an indicator of recovery and the hypothesis that children with mTBI may experience disrupted neural circuitry during recovery. Limitations of the study included a small sample size, wide age range, and lack of in-scanner accuracy data.
