The neural correlates of cognitive fatigue in traumatic brain injury using functional MRI

Kohl, Alexander D.; Wylie, Glenn R.; Genova, Helen M.; Hillary, Frank G.; DeLuca, John

doi:10.1080/02699050902788519

Cited by 134 publications

(131 citation statements)

References 39 publications

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“…phenomenon is that patients do not experience significant decreased cognitive performance over time, but instead experience persistent fatigue during a task necessitating sustained cognitive effort for a prolonged period. 16,17 When an extended task coincides with a distracting environment, fatigue is thought to be intensified. 16 The f5-day reversal learning phase in rats may serve as a proxy for a prolonged cognitive task in humans.…”

Section: Discussionmentioning

confidence: 99%

Multi-Modal Approach for Investigating Brain and Behavior Changes in an Animal Model of Traumatic Brain Injury

Heffernan

Huang

Sicard

et al. 2013

Journal of Neurotrauma

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Use of novel approaches in imaging modalities is needed for enhancing diagnostic and therapeutic outcomes of persons with a traumatic brain injury (TBI). This study explored the feasibility of using functional magnetic resonance imaging (fMRI) in conjunction with behavioral measures to target dynamic changes in specific neural circuitries in an animal model of TBI. Wistar rats were randomly assigned to one of two groups (traumatic brain injury/sham operation). TBI rats were subjected to the closed head injury (CHI) model. Any observable motor deficits and cognitive deficits associated with the injury were measured using beam walk and Morris water maze tests, respectively. fMRI was performed to assess the underlying post-traumatic cerebral anatomy and function in acute (24 hours after the injury) and chronic (7 and 21 days after the injury) phases. Beam walk test results detected no significant differences in motor deficits between groups. The Morris water maze test indicated that cognitive deficits persisted for the first week after injury and, to a large extent, resolved thereafter. Resting state functional connectivity (rsFC) analysis detected initially diminished connectivity between cortical areas involved in cognition for the TBI group; however, the connectivity patterns normalized at 1 week and remained so at the 3 weeks post-injury time point. Taken together, we have demonstrated an objective in vivo marker for mapping functional brain changes correlated with injury-associated cognitive behavior deficits and offer an animal model for testing potential therapeutic interventions options.

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Section: Discussionmentioning

confidence: 99%

Multi-Modal Approach for Investigating Brain and Behavior Changes in an Animal Model of Traumatic Brain Injury

Heffernan

Huang

Sicard

et al. 2013

Journal of Neurotrauma

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“…In contrast, Vakil et al, demonstrated that both explicit and implicit SRT memory measures are deficient in patients with TBI (Vakil et al, 2002). Additional study, using predictive saccade procedural learning paradigm, also showed significant deficits in learning gains in patients with TBI compared to matched healthy controls (Kohl et al, 2009). Altogether, current literature suggests that while task performance is impaired in patients with TBI, some procedural learning abilities may be relatively preserved (Vakil and Lev-Ran Galon, 2014).…”

Section: Memory Deficits In Tbimentioning

confidence: 99%

Atypical within-session motor procedural learning after traumatic brain injury but well-preserved between-session procedural memory consolidation

Sacher

Cisamariu

Shaklai

et al. 2018

Annals of Physical and Rehabilitation Medicine

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Using the finger-to-thumb opposition sequence (FOS) learning task, we characterized motor skill learning in sub-acute patients hospitalized for rehabilitation following traumatic brain injury (TBI). Ten patients (Trained TBI) and 11 healthy participants (Trained Healthy) were trained using a multi-session protocol: a single session was afforded in the first week of the study, and four daily sessions were afforded during the second week. Intensity of practice was adapted to patients. Performance speed and accuracy were tested before and after each session. Retention was tested 1 month later. Ten patients (Control TBI) had no FOS training and were tested only at the beginning and the end of the 6 week period. Although baseline performance on the FOS was very slow, all three phases of skill learning found in healthy adults (acquisition, between-session consolidation gains, and long-term retention) could be identified in patients with TBI. However, their time-course of learning was atypical. The Trained TBI group improved in speed about double the spontaneous improvements observed in the Control TBI group, with no speed-accuracy tradeoff. Normalized to their initial performance on the FOS, the gains accrued by the Trained TBI group after a first training were comparable to those accrued by healthy adults. Only during the second week with daily training, the rate of improvement of the Trained TBI group lagged behind that of the Trained Healthy group, due to increasing within-sessions losses in performance speed; no such losses were found in healthy participants. The Functional Independence Measure scores at the start of the study correlated with the total gains attained at the end of the study; no correlations were found with severity of injury or explicit memory impairments. Despite within-sessions losses in performance, which we propose reflect cognitive fatigue, training resulted in robust overall learning and long-term retention in patients with moderate-severe TBI. Given that the gains in performance evolved mainly between sessions, as delayed, offline, gains, our results suggest that memory consolidation processes can be effectively engaged in patients with TBI. However, practice protocols and schedules may need to be optimized to better engage the potential for long-term plasticity in these patients.

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“…Impaired processing speed and attention in subjects suffering from long-term cognitive deficits after brain injury may result in an overload of the present brain capacity, with subsequent mental fatigue. Mental activities with demand on concentration appear for many persons after TBI or stroke to need more energy and brain capacity, than is usually expected [41].…”

Section: Mfs and Cognitive Functioningmentioning

confidence: 99%

Evaluation of the Mental Fatigue Scale and its relation to Cognitive and Emotional Functioning after Traumatic Brain Injury or Stroke

Johansson¹

2013

Int J Phys Med Rehabil

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Objective: After traumatic brain injury (TBI) or stroke, long-term mental fatigue may occur with significant impact on work and social interactions. With the intention to measure mental fatigue irrespective of neurological illness, we developed the Mental Fatigue Scale (MFS). The scale incorporates affective, cognitive and sensory symptoms, duration of sleep and daytime variation in symptom severity. In this study, we evaluated the MFS and its relationship to cognitive and emotional functions.Participants: Healthy controls and well-rehabilitated subjects suffering from mental fatigue after mild TBI, TBI or stroke (age 19-69) were included in the study.Results: The results showed MFS to be invariant to age, gender and education. A cutoff score at 10.5 is suggested. Of the cognitive functions measured, information processing speed was found to be a significant predictor for the rating on MFS. We found that a significant effect on depression between controls and brain injured subjects can be a misleading conclusion if the effect of mental fatigue is not considered.Conclusions: We suggest MFS to be linked to mental impairment after brain injury. This study also demonstrated that mental fatigue must be treated as a separate construct and should not be mixed up with depression or anxiety.

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The neural correlates of cognitive fatigue in traumatic brain injury using functional MRI

Abstract: Increased brain activity exhibited by participants with a TBI might represent increased cerebral effort which may be manifested as cognitive fatigue. Functional MRI appears to be a potentially useful tool for understanding the neural mechanisms associated with cognitive fatigue in TBI.

Cited by 134 publications

References 39 publications

Multi-Modal Approach for Investigating Brain and Behavior Changes in an Animal Model of Traumatic Brain Injury

Multi-Modal Approach for Investigating Brain and Behavior Changes in an Animal Model of Traumatic Brain Injury

Atypical within-session motor procedural learning after traumatic brain injury but well-preserved between-session procedural memory consolidation

Evaluation of the Mental Fatigue Scale and its relation to Cognitive and Emotional Functioning after Traumatic Brain Injury or Stroke

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