Characterising error-awareness of attentional lapses and inhibitory control failures in patients with traumatic brain injury

Abstract

Awareness deficits are a significant problem following traumatic brain injury (TBI). This study examined error processing as candidate marker of awareness and compared the performance of 18 TBI participants and 18 controls using an online error-monitoring task while participants performed simple go/no-go tasks. Error-monitoring performance was compared where the no-go target was part of (a) a predictive sequence, (b) predictive sequence plus a dual-task element and (c) a random sequence. Results showed that the TBI participants, in contrast to control participants, were significantly impaired at monitoring their errors during both predictive sequence tasks but were not impaired on the random sequence task. These findings suggest that following TBI, when an error is more impulsive it may be more easily monitored, whereas when an error is characterised by attentional drift, subsequent error-processing mechanisms may fail to engage. Higher levels of online error-awareness were also associated with lower levels of anxiety, fewer symptoms of frontal dysfunction and greater competence in everyday functioning.

Recent advances in structural and functional brain imaging studies of attention-deficit/hyperactivity disorder

“…Error-related processing remains a relatively unexplored area of cognitive function in ADHD. One important next step to further our understanding of these results may be to investigate the potential role for error awareness in the group differences observed; studies (eg, [24]) have suggested that this meta-cognitive ability is a sensitive index of the integrity of executive control.…”

Neuropsychology and clinical neuroscience of persistent post-concussive syndrome

“…Such assessments are also taking advantage of computerized and virtual assessment techniques as well as the ability to automate the assessment (Cernich et al, 2007;Iverson et al, 2005;Schatz & Putz, 2006;Slobounov et al, 2006). Likewise, various cognitive neuroscience measures either by themselves or combined with functional neuroimaging methods hold great promise for more accurate assessment of the effects of TBI on behavior and cognition (Bergemalm & Lyxell, 2005;Casson et al, 2006;Chan, 2001;Chen et al, 2007;Cicerone et al, 2006;Dockree et al, 2006b;Jantzen et al, 2004;Mendez et al, 2005;O'Keeffe et al, 2007a;O'Keeffe et al, 2007b;Scheibel et al, 2007;Suh et al, 2006). These types of studies applied to PPCS will likely advance the field rather than another round of testing with traditional "clinical" neuropsychological measures (Heitger et al, 2004(Heitger et al, , 2005.…”

Awareness of deficits and error processing after traumatic brain injury

“…Toward this end, recent studies indicate impaired awareness of errors during task performance in survivors of traumatic brain injury [14][15][16], with such deficits related to increased difficulties in everyday functioning and cognitive abilities [15]. The cognitive mechanisms behind these error-awareness deficits remain understudied, although recent work in survivors of traumatic brain injury shows decreased electrodermal responses to unaware, as opposed to aware errors [15], where unaware errors refer to error trials on which the participants felt that they made an accurate response. This finding was replicated in a sample of individuals with attention-deficit/hyperactivity disorder in a study that also showed a reduced-amplitude Pe component on unaware error trials [10].…”