Academic journal article International Journal of Psychological Studies

Event-Related Brain Potentials Depict Cognitive Disturbances in Children with Mild Traumatic Brain Injury

Academic journal article International Journal of Psychological Studies

Event-Related Brain Potentials Depict Cognitive Disturbances in Children with Mild Traumatic Brain Injury

Article excerpt

Abstract

Mild traumatic brain injury (MTBI) is a common cause of short-term cognitive disturbances in children that rarely are related to objective neurophysiological markers. With the aim of correlating cognitive processing with event-related brain potential variation, visual Continuous Performance Tests (CPT) were administered to 15 children with MTBI and a matched control group. All the patients had suffered post-traumatic loss of consciousness lasting less than 15 minutes, and they were evaluated within 5-to-15 days post-trauma. A few additional neuropsychological tests were also administered to both groups. Behavioral results showed that the injured children achieved poorer scores for phonological and verbal fluency tasks and no interference effect in a computerized version of the Stroop test. They had fewer correct responses on CPT-AX, where a warning signal preceded targets. The N90, P240 and P390 ERP components varied significantly between groups while performing CPT-AX. Present findings could be interpreted as reflecting disturbances that impede injured children from using contextual information efficiently. The higher amplitude of the slow late positivity observed in the control group might reflect updating memory preparatory processes that could increase subsequent cognitive operational competence. The ERP assessment could be helpful to demonstrate early neurophysiological disturbances subsequent to a MTBI in children.

Keywords: brain trauma, cognition, children, ERP, CPT

1. Introduction

Traumatic brain injury (TBI) is widely recognized as a major cause of disability in the pediatric population. In particular, mild TBI (MTBI) is one of only a few medical disorders in which a benign misleading diagnosis obtained at the time of injury can be related to future long-term complications.

The clinical criteria for classifying TBI have been revised on various occasions by different authors (Davis, Mullen, Makela, Taylor, Cohen, & Rivara, 1994; Goldberg et al., 2011; Howard & Shapiro, 2011) and a variety of organizations, including the American Congress of Rehabilitation Medicine (1993). The latter defined MTBI as a head injury that might include loss of consciousness lasting less than 30 minutes, loss of memory, or altered mental states around the time of the accident (24 hours), and/or transient or intransient focal neurological deficit with a Glasgow Coma Scale ranging from 13-to-15 points.

TBI in children may disrupt the subsequent development of new abilities and alter previously developed ones because vulnerability to brain injury in childhood can affect maturational processes which might lead to deficits in cognitive development (Giza & Prins, 2006). The sequelae subsequent to a MTBI in childhood could include cognitive and somatic symptoms, as well as emotional and behavioral difficulties affecting academic, behavioral, and interpersonal functioning. Cognitive sequelae may include problems in such areas as: attention, the speed of cognitive and working memory processing, response inhibition, calculation, verbal learning, episodic memory, visuomotor speed, reading, executive functioning and visual delayed recognition (McAllister, Sparling, Flashman, Guerin, Mamourian, & Saykin, 2001; Levin et al., 2008; Babikian & Asarnow, 2009; Krivitzky, Roebuck-Spencer, Roth, Blackstone, Johnson, & Gioia, 2011). It has been determined that somatic and emotional symptoms including fatigue, headache, dizziness, sensitivity to light and noise, irritability, behavioral disinhibition, increased anxiety and depression might also be related to TBI (Kirkwood, Yeates, Taylor, Randolph, McCrea, & Anderson, 2008; Ayr, Yeates, Taylor, & Browne, 2009; Konrad et al., 2010; Howard & Shapiro, 2011; Anderson, Godfreya, Rosenfeldd, & Catroppaa, 2012). Furthermore, children with MTBI are more likely to develop attention deficit/hyperactivity disorder, conduct disorder/oppositional defiant disorder, substance abuse, and mood disorders (McKinlay, Grace, Horwood, Fergusson, & MacFarlane, 2009). …

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