Tracking the recovery of visuospatial attention deficits in mild traumatic brain injury

Abstract

The goal of the current investigation was to probe the deficits in the alerting, orienting and executive components of visuospatial attention in individuals who have recently suffered a mild traumatic brain injury (mTBI) and to assess the rate and degree of recovery for each of these components over a month post-injury. A group design was employed to assess and compare the performance of participants (12 males, 8 females; mean age: 21 +/- 1.74 years) identified with mTBI relative to control subjects matched for gender, age, height, weight and activity level. Participants performed the attentional network test, designed to isolate the constituents of attention into alerting, orienting and executive components. Reaction times (RTs) and response accuracy were the main dependent variables. The results showed that the orienting and executive components were significantly affected by mTBI immediately after the injury, whereas the alerting component was not. Furthermore, participants with mTBI recovered from the deficits in the orienting component of attention within a week of their injury, whereas the deficits in the executive component remained throughout the month post-injury. In addition, the RT cost to generate accurate compared with inaccurate responses was significantly larger in participants with mTBI than in controls, and this difference was maintained throughout the 1 month testing period. These findings indicate that the regions of the brain associated with the orienting and executive components of visuospatial attention may be most susceptible to neural damage resulting from mTBI. Moreover, the lack of recovery in the executive component indicates that the degree and time course for recovery may be regionally specific.

Concussion and Concurrent Cognitive and Sport-specific Task Performance in Youth Ice Hockey Players: A Single-case Pilot Study

“…These concussed participants were significantly slower in responding to visual stimuli despite equivalent accuracy when required to do two or more things at once. These findings support results reported in previous studies examining the influence of combined locomotor and cognitive task performance on cognitive outcomes in athletes following concussion [16,18,[25][26][27]] however, the current study demonstrates this influence in youth athletes for the first time.…”

“…Further, when considering all conditions collapsed, no concussed participants demonstrated significantly more total response errors than non-injured controls, compared to two of the four concussed participants who demonstrated significantly greater total DTC than non-injured controls. Halterman et al [26] found a similar contrast in cognitive performance results when examining reaction time and response accuracy on a visuospatial task, reporting significantly slower reaction times in concussed athletes compared to healthy controls, however no difference between groups specific to response accuracy. It is possible that measures of reaction time, such as that used to calculate DTC within the current study, can be considered more sensitive than measures of response errors, where this increased sensitivity allows for the recognition of post-concussion performance deficits.…”

Default-Mode Network Disruption in Mild Traumatic Brain Injury

“…In addition, the reduced posterior functional connectivity of the DMN might indicate subtle axonal pathway injury (56,57). We also found a highly significant correlation between reduced posterior connectivity and decreased cognitive flexibility, as measured with a Trail Making Test B in patients with MTBI, due to the highly involved cognitive processes of this network (20,58,59 (29). On the basis of single-participant analysis, the regions of decreased functional connectivity within the DMN at functional MR imaging in the present study were found to be predominantly located in the posterior part of the brain, including the cuneus, left calcarine cortex (V1), and PCC.…”

The Gaming of Concussions: A Unique Intervention in Postconcussion Syndrome

“…[26][27][28][29][30][31] Visual symptoms are included in 1 of the 3 categories often used to describe proposed subtypes of concussion, though visual symptoms may be placed in the cognitive or somatic category. [26][27][28][29][30][31] Patients with closed-head injuries were less tolerant of luminance (brightness) than control participants at 1366 lux (a measure of lumens per square meter; 1 foot candle ¼ 11 lux) versus 1783 lux. 26 In a study using resting-state functional magnetic resonance imaging in patients with closed-head injuries and matched controls, a cluster of increased functional connectivity in the right frontoparietal network was noted in the injured group.…”

“…31 Visuospatial attention deficits are demonstrable in some patients with concussion. 27,33 Visuospatial attention can be separated into alerting, orienting, and executive components. The alerting component functions to maintain vigilance throughout performance of a continuous task-a new stimulus appears in a region of the visual field.…”