Social behavior following traumatic brain injury and its association with emotion recognition, understanding of intentions, and cognitive flexibility

Abstract

Although the adverse consequences of changes in social behavior following traumatic brain injury (TBI) are well documented, relatively little is known about possible underlying neuropsychological deficits. Following a model originally developed for social behavior deficits in schizophrenia, we investigated whether impairments in emotion recognition, understanding of other people's intentions ("theory of mind"), and cognitive flexibility soon after first TBI or 1 year later were associated with self and proxy ratings of behavior following TBI. Each of the three functions was assessed with two separate tests, and ratings of behavior were collected on three questionnaires. Patients with TBI (n 5 33) were impaired in emotion recognition, "theory of mind," and cognitive flexibility compared with matched orthopedic controls (n 5 34). Proxy ratings showed increases in behavioral problems 1 year following injury in the TBI group but not in the control group. However, test performance was not associated with questionnaire data. Severity of the impairments in emotion recognition, understanding intention, and flexibility were unrelated to the severity of behavioral problems following TBI. These findings failed to confirm the used model for social behavior deficits and may cast doubt on the alleged link between deficits in emotion recognition or theory of mind and social functioning. (JINS, 2008, 14, 318-326.)

Theory of Mind in Adults with Traumatic Brain Injury

“…Individuals with the lesion in orbito-frontal cortex caused by TBI remained intact in the affective aspect (10). On the other hand, individuals with TBI were impaired in both aspects of ToM in this task (4,45,53,54). In 'the awareness of social inference test' (cognitive and affective ToM), persons with TBI were impaired (52,53,60,61).…”

“…According to the studies, individuals with TBI were impaired in mentalistic inferences and faux pas stories (4,39,45,46,50,53,54). In some studies, TBI persons were not impaired in the nonmental/physical/logical inferences, no faux pas stories, and logical stories (4,27,36,39,46).…”

“…In some studies, TBI persons were not impaired in the nonmental/physical/logical inferences, no faux pas stories, and logical stories (4,27,36,39,46). On the other hand, individuals with TBI were impaired in the non-mental/physical inferences and no faux pas stories (27,38,41,45). Impairments of persons with TBI in the mental and non-mental inferences indicated that these individuals were not just impaired in ToM, but in inferring ability (38).…”

Application of ERPs neuromarkers for assessment and treatment of a patient with chronic crossed aphasia after severe TBI and long-term coma – Case Report

“…The current generates a transient magnetic field which, in turn, induces a secondary current in the brain that is capable of depolarising neurons [27]. Depending on the frequency and duration of the stimulation, the shape of the coil and the strength of the magnetic field, TMS can stimulate or suppress activity in the cortical regions [28].…”

“…Two non-invasive methods of injecting electrical currents into the brain have proved promising for inducing longlasting plastic changes within the motor systems: transcranial magnetic stimulation (TMS) [27,28] and transcranial direct current stimulation (tDCS) [29]. These techniques represent powerful methods for priming cortical excitability for subsequent motor or cognitive training; thus, their combined use can optimize the plastic changes induced by motorcognitive practice, leading to more remarkable and longlasting clinical gains in rehabilitation [28].…”