Research Reports - Effect of age on working memory performance and cerebral activation after mild traumatic brain injury

Radiology. 2015 Oct 6:150612. [Epub ahead of print]

Chen DY(1), Hsu HL(1), Kuo YS(1), Wu CW(1), Chiu WT(1), Yan FX(1), Wang WS(1),
Chen CJ(1), Tseng YC(1).

Purpose To evaluate the age effect on working memory (WM) performance and
functional activation after mild traumatic brain injury (MTBI). Materials and
Methods This study was approved by the local research ethics committee. All
participants provided written informed consent. N-back WM cerebral activation was
assessed with functional magnetic resonance (MR) imaging in 13 younger (mean age,
26.2 years ± 2.9; range, 21-30 years) and 13 older (mean age, 57.8 years ± 6.6;
range, 51-68 years) patients with MTBI and 26 age- and sex-matched control
subjects. Two functional MR images were obtained within 1 month after injury and
6 weeks after the initial study. Group comparison and regression analysis were
performed among postconcussion symptoms, neuropsychologic tests, and WM activity
in both groups. Results In younger patients, initial hyperactivation was seen in
the right precuneus and right inferior parietal gyrus (P = .047 and P = .025,
respectively) in two-back greater than one-back conditions compared with younger
control subjects, whereas in older patients, hypoactivation was seen in the right
precuneus and right inferior frontal gyrus (P = .013 and P =.019, respectively)
compared with older control subjects. Increased WM activity was associated with
increased postconcussion symptoms in the right precuneus (r = 0.57; P = .026) and
right inferior frontal gyrus (r = 0.60; P = .019) and poor WM performance in the
right precuneus (r = -0.55; P = .027) in younger patients at initial studies but
not in older patients. At follow-up examinations, partial recovery of activation
pattern and decreased postconcussion symptoms (P = .04) were observed in younger
patients but not in older patients. Conclusion The different manifestations of
postconcussion symptoms at functional MR imaging between younger and older
patients confirmed the important role of age in the activation, modulation, and
allocation of WM processing resources after MTBI. These findings also supported
that younger patients have better neural plasticity and clinical recovery than do
older patients.  

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