Effects of traumatic brain injury on a virtual reality social problem solving task and relations to cortical thickness in adolescence

Abstract

Social problem solving was assessed in 28 youth ages 12-19 years (15 with moderate to severe traumatic brain injury (TBI), 13 uninjured) using a naturalistic, computerized virtual reality (VR) version of the Interpersonal Negotiations Strategy interview (Yeates, Schultz, & Selman, 1991). In each scenario, processing load condition was varied in terms of number of characters and amount of information. Adolescents viewed animated scenarios depicting social conflict in a virtual microworld environment from an avatar's viewpoint, and were questioned on four problem solving steps: defining the problem, generating solutions, selecting solutions, and evaluating the likely outcome. Scoring was based on a developmental scale in which responses were judged as impulsive, unilateral, reciprocal, or collaborative, in order of increasing score. Adolescents with TBI were significantly impaired on the summary VR-Social Problem Solving (VR-SPS) score in Condition A (2 speakers, no irrelevant information), p = 0.005; in Condition B (2 speakers + irrelevant information), p = 0.035; and Condition C (4 speakers + irrelevant information), p = 0.008. Effect sizes (Cohen's d) were large (A = 1.40, B = 0.96, C = 1.23). Significant group differences were strongest and most consistent for defining the problems and evaluating outcomes. The relation of task performance to cortical thickness of specific brain regions was also explored, with significant relations found with orbitofrontal regions, the frontal pole, the cuneus, and the temporal pole. Results are discussed in the context of specific cognitive and neural mechanisms underlying social problem solving deficits after childhood TBI.

Social Function in Children and Adolescents after Traumatic Brain Injury: A Systematic Review 1989–2011

“…Other studies reported only a specific severity grouping, such as severe TBI , or mild TBI (Anderson et al, 2001). Not all studies documented cause of injury, but those that did reported that most instances of TBI were due to motor vehicle accidents (passenger and pedestrian), or falls (Anderson et al, 2001;Fletcher et al, 1990;Ganesalingam et al, 2006Ganesalingam et al, ,2007aGanesalingam et al, ,2007bHanten et al, 2011;Max et al, 1998;Papero et al, 1993;Stronach and Turkstra, 2008). With the exception of Hanten and associates (2008), and Newsome and colleagues (2010), the studies did not report on lesion/pathology location with regard to social competence in the TBI groups, and when brain imaging data were included the information was relatively non-specific (e.g., frontal or subcortical).…”

“…Severe: GCS £ 8 Moderate: GCS score 9-12 or higher with abnormal neuroimaging Hanten et al (2008) Moderate: GCS score 9-12 or 13-15 with brain lesions indicated by CT; Severe: GCS 3-8 Hanten et al (2011) Severe: GCS score 3-8 Moderate: GCS score 9-12 or GCS score 13-15 with brain lesions indicated by CT scans…”

Virtual reality-based therapy for the treatment of balance deficits in patients receiving inpatient rehabilitation for traumatic brain injury

“…[35,36] Despite the broad use of VR-based therapy for balance-focused rehabilitation in neurologically similar populations, the use of VR for the physical rehabilitation of patients with TBI has been limited, [35][36][37]97] with the majority of research focusing on cognitive rehabilitation. [31,[98][99][100][101][102][103][104][105][106] Applications of VR have sparsely been used for physical rehabilitation [37] and functional training, including completing kitchen activities, [32,98] using automatic teller machines, [107] driving [108][109][110] and wayfinding. [111] In regards to balance, VR has been investigated as a tool to assess deficits post injury in athletes with mild TBI, [112][113][114] and as a therapeutic technique to treat long-term balance deficits in patients more than six months post TBI.…”

Executive Functions and Theory of Mind as Predictors of Social Adjustment in Childhood Traumatic Brain Injury

“…1 Childhood TBI is also linked to deficits in social information processing (SIP) across domains that include executive function, 2 theory of mind, 3 and social problem-solving. 4 For example, children with TBI exhibit problems making inferences about the mental states of others and show impairments on traditional theory of mind tasks. 3 Theory of mind is closely linked with executive functions such as working memory and inhibitory control, especially early in childhood.…”