Research Reports - The impact of symptomatic mild traumatic brain injury on complex everyday activities and the link with alterations in cerebral functioning

Neuropsychol Rehabil. 2015 Dec 9:1-20. [Epub ahead of print]

Bottari C(1,)(2), Gosselin N(3,)(4), Chen JK(5,)(6), Ptito A(5,)(6,)(7).

The objective of the study was to explore the neurophysiological correlates of
altered functional independence using functional magnetic resonance imaging
(fMRI) and event-related potentials (ERP) after a mild traumatic brain injury
(mTBI). The participants consisted of three individuals with symptomatic mTBI
(3.9 ± 3.6 months post-mTBI) and 12 healthy controls. The main measures used were
the Instrumental Activities of Daily Living (IADL) Profile observation-based
assessment; a visual externally ordered working memory task combined to
event-related potentials (ERP) and fMRI recordings; neuropsychological tests;
post-concussion symptoms questionnaires; and the Activities of Daily Living (ADL)
Profile interview. Compared to normal controls, all three patients had difficulty
with a real-world complex budgeting activity due to deficits in planning,
ineffective strategy use and/or a prolonged time to detect and correct errors.
Reduced activations in the right mid-dorsolateral prefrontal cortex on fMRI as
well as abnormal frontal or parietal components of the ERP occurred alongside
these deficits. Results of this exploratory study suggest that reduced
independence in complex everyday activities in symptomatic mTBI may be at least
partly explained by a decrease in brain activation in the prefrontal cortex,
abnormal ERP, or slower reaction times on working memory tasks. The study
presents an initial attempt at combining research in neuroscience with ecological
real-world evaluation research to further our understanding of the difficulties
in complex everyday activities experienced by individuals with mTBI.

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