Traumatic brain injury often negatively impacts episodic memory; however studies of the neural substrates of this impairment have been limited. In this study, both encoding and recognition of visually presented stimuli were examined with functional magnetic resonance imaging. Twelve adults with chronic complicated mild, moderate, and severe injuries were compared with a matched group of twelve controls. Behavioral task performance did not differentiate the groups. During neuroimaging, however, the group of individuals with traumatic brain injury exhibited increased activation, as well as increased bilaterality and dispersion as compared to controls. Findings are discussed in terms of increased resource recruitment. Traumatic brain injury (TBI) is defined as an injury to the brain incurred through externally inflicted trauma. Such injuries may result in significant impairment of an individual's physical, cognitive and psychosocial functioning. One specific type of cognitive ability known to be compromised after TBI is episodic memory (Himanen, Porthin, Isoniemi, Helenius, & Kurki, 2006;Levin et al., 1990;Millis & Ricker, 1994;Wiegner & Donders, 1999;Wright, Schmitter-Edgecombe & Woo, 2010). As classically defined (e.g., by Baddeley, Harris, Sunderland, Watts & Wilson, 1987), the term episodic memory describes the ability to recall information regarding previously experienced stimuli, or events linked to a specific point in time. While the term "episodic memory" encompasses several types of cognitive tasks and operations, in the clinical setting, episodic memory is most frequently assessed by having individuals learn a stimulus set for recall and/or recognition at a later point in time.While it may be argued that other persisting cognitive deficits after TBI may cause even greater functional disablement than episodic memory (i.e., executive control deficits), individuals with TBI have been shown to have significant awareness of memory difficulties (Anderson & Schmitter-Edgecombe, 2009). In addition, assistance with memory issues has been one of the most frequently cited needs of individuals at one year post injury (e.g., Corrigan, Whiteneck, & Mellick, 2004). This awareness of need may be due to the fact that episodic memory difficulties can have a significant impact on daily living: in day to day functioning, impairment in episodic memory may contribute to difficulties with learning and retaining new information, as well as recall of functional tasks, appointments, assignments and obligations. While such difficulties may range from mild to severe, it is important to note that the diffuse and complex nature of TBI may result in multiple areas of cognitive deficit, with additive effects. As a result, even mild episodic memory impairment, when combined with executive control and other cognitive difficulties, may potentially have a
NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript significant impact on the ability of an individual to complete household tasks or function in some employ...