Everyday memory following traumatic brain injury

Measures of Subjective Memory for People with Epilepsy: A Systematic Review of Measurement Properties

People with epilepsy frequently express concern about the burden of memory problems in their everyday lives. Self-report memory questionnaires may provide valuable insight into individuals' perceptions of their everyday memory performance and changes over time. Yet, despite their potential utility, the measurement properties of self-report memory questionnaires have not been evaluated in epilepsy. This systematic review aimed to provide a critical appraisal of the measurement properties of self-report memory questionnaires for adults with epilepsy. Following protocol registration (PROSPERO CRD42020210967), a systematic search of PubMed, EMBASE, Web of Science, CINAHL, and PsychInfo from database inception until 27 May 2021 was conducted. Eligible studies were published in English-language peer-reviewed journals, recruited adults with epilepsy, and reported on the development or evaluation of the measurement properties of a self-report memory questionnaire. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology was used to evaluate each study of a measurement property, and results were qualitatively synthesised. In total, 80 articles and one test manual were located containing 153 studies of measurement properties pertinent to 23 self-report memory questionnaires. Overall, no scale could be recommended outright for the evaluation of subjective memory symptoms in adults with epilepsy. This was due to the near absence of dedicated content validation studies relevant to this population and shortcomings in the methodology and scientific reporting of available studies of structural validity. Recommendations to support the advancement and psychometric validation of self-report memory questionnaires for people with epilepsy are provided.

Using EEG to investigate the influence of boredom on prospective memory in top-down and bottom-up processing mechanisms for intelligent interaction

We aimed to investigate the alpha (α) activity in operators experiencing boredom while performing prolonged monitoring and prospective memory tasks using different processing mechanisms. Fifty-four participants underwent electroencephalography (EEG) and were found to have poorer prospective memory performance under top-down conditions. Further, α power and synchronisation were higher during bottom-up than in top-down processes, revealing an inhibition effect of the former. Significant differences in brain regions and hemispheres were identified to distinguish different cognitive processes in both information-processing mechanisms. Thus, people are likely to cope with boredom differently in terms of top-down and bottom-up processes. Specifically, a higher attention level was reported during top-down processing, to mitigate the negative influences of boredom. Overall, this study provides EEG evidence which suggests that prospective memory can be enhanced in top-down processing during prolonged monitoring tasks by increasing the salience of cues.

Memory failure predicts belief regression after the correction of misinformation

After misinformation has been corrected, people initially update their belief extremely well. However, this change is rarely sustained over time, with belief returning towards pre-correction levels. This is called belief regression. The current study aimed to examine the association between memory for the correction and belief regression, and whether corrected misinformation suffers from belief regression more than affirmed facts. Participants from Prolific Academic (N = 612) rated the veracity of 16 misinformation and 16 factual items and were randomly assigned to a correction condition or test-retest control. Immediately after misinformation was corrected and facts affirmed, participants re-rated their belief and were asked whether they could remember the items' presented veracity. Participants repeated this post-test one month later. We found that belief and memory were highly associated, both immediately (⍴ = 0.51), and after one month (⍴ = 0.82), and that memory explained 66% of the variance in belief regression after correcting for measurement reliability. We found the rate of dissenting (accurately remembering that misinformation was presented as false but still believing it) remained stable between the immediate and delayed post-test, while the rate of forgetting quadrupled. After one month, 57% of participants who believed in the misinformation thought that the items were presented to them as true. Belief regression was more pronounced for misinformation than facts, but this was greatly attenuated once pre-test belief was equated. Together, these results clearly indicate that memory plays a fundamental role in belief regression, and that repeated corrections could be an effective method to counteract this phenomenon.

[Formula: see text]Systematic review of pediatric memory questionnaires

Memory disturbances are common in children with neurological and developmental conditions. One way to measure memory disturbances and their functional implications is via a memory questionnaire. Several pediatric memory questionnaires have been published but no systematic review has been conducted to establish their psychometric properties. This review evaluated currently available pediatric memory questionnaires using the Evidence-Based Assessment (EBA) criteria developed by the American Psychological Association Task force. A systematic search of CINAHL, EMBASE, Medline, and PsychINFO was completed on June 2019. The selection process was guided by pre-defined inclusion and exclusion criteria, followed by full manuscript reviews, and hand-search of reference lists of relevant papers. Selected questionnaires were evaluated by two independent raters against the EBA criteria and classified into "well established", "approaching well-established", and "promising" categories. The electronic searches yielded 9888 articles, 24 of which met the inclusion criteria. Hand searches identified additional 21 studies. The 45 identified studies reported on 24 versions of 10 memory questionnaires assessed working memory, everyday memory, prospective and retrospective memory, and self-awareness of memory functions. Based on EBA criteria, only one memory questionnaire (The Working Memory Rating Scale - 20 item version) was classified as "well-established", 3 as "approaching well-established", and 20 as "promising". Most (n = 19) had good reliability but lacked concurrent validity; had low or no correlations with objective memory tests, and low predictive power. In conclusion, this review highlights an urgent need for the development and validation of pediatric memory questionnaires to increase the evidence base and improve questionnaires' clinical utility.

Demographic Characteristics, Motivation and Perception of Change as Determinants of Memory Compensation Self-Reports After Acquired Brain Injury

INTRODUCTION

Individuals with brain injuries experience cognitive and emotional changes that have long-lasting impacts on everyday life. In the context of rehabilitation, surveys have stressed the importance of compensating for memory disturbances to ease the impact of disorders on day-to-day autonomy. Despite extensive research on the nature of neurocognitive impairments following brain injury, few studies have looked at patients' perceptions of these day-to-day compensations. This study examines these perceptions; in particular, what brain-injured people believe they do to compensate for memory deficiencies in everyday life. It also investigates the determinants of reported compensation strategies (age, gender, perceived stress, change awareness and motivation to succeed).

METHODS

Eighty patients and 80 controls completed the French Memory Compensation Questionnaire, a self-report measure of everyday memory compensation. Five forms of compensation were investigated: External and Internal strategies, Reliance on social help, and investments in Time and Effort, along with two general factors: the degree of importance attached to Success (motivation) and perceptions of Change. Participants also completed measures of demographic and emotional aspects that may affect everyday compensation perceptions.

RESULTS

The brain-injured group reported significantly more frequent use of memory compensation strategies than controls, with the exception of External aids. Large effects were observed for Reliance and Effort. Demographic, motivation and perception of change determinants were found to have different effects depending on the compensation strategy, and mediated the direct effect of brain injury on reported compensation.

CONCLUSION

Clinical and rehabilitation neuropsychologists often seek to have a better sense of how their patients perceive their compensatory behaviors. In practice, such an understanding is needed to help select appropriate methods and improve the long-term impact of rehabilitation programs: memory rehabilitation will fail if neuropsychologists do not deal, first and foremost, with the emotional and metacognitive issues surrounding traumatic brain injury (TBI), rather than focusing on cognitive efficiency.

Prospective memory assessment in acute mild traumatic brain injury

Objective: Prospective memory (PM) is the ability to remember to perform an intention at the appropriate time in the future. It is of primary importance for daily living, and its disruption may impact functional autonomy. To date, few studies have examined PM during the acute phase of mild traumatic brain injury (mTBI), despite the high prevalence of this neurological condition and its potential impact on cognition. Method: Twenty mTBI patients (time since injury ranged from 45 to 73 days) and 15 healthy control participants performed the Ecological Test of Prospective Memory (TEMP), a simulated errand task in which participants were required to execute 10 event-based (EB) and five time-based (TB) tasks. The TEMP separately evaluates PM phases as well as prospective and retrospective components in event- and time-based conditions. Participants also completed a neuropsychological test battery. Correlations were performed between cognitive composite scores and the TEMP. Results: mTBI patients experienced difficulty in learning the content of intentions, retrieving these intentions in the time-based condition (prospective component) and recalling the associated actions in the event- and time-based conditions (retrospective component). Retrospective memory composite score was correlated with the learning and retention phases of the TEMP, whereas attention/working memory and executive composite scores were correlated with the time-based condition and performance on the ongoing task. Conclusion: These results suggest the presence of global PM impairment during the acute phase of mTBI, as well as impairment of retrospective memory, attention/working memory, and executive functions, which are key components for PM performance.

Saccadic impairment in chronic traumatic brain injury: examining the influence of cognitive load and injury severity

OBJECTIVE

Previous research suggests that saccadic eye movements can be uniquely sensitive to impairment in chronic traumatic brain injury (TBI). This study was conducted to examine saccadic eye movements across varying levels of cognitive load and TBI history/severity. We hypothesized that saccadic impairment in chronic mild and moderate-severe TBI would be most pronounced under conditions of high cognitive load.

METHODS

In total, 61 participants (including n = 20 with chronic mild TBI, n = 15 with chronic moderate-severe TBI, and 26 uninjured controls) completed a battery of conventional neuropsychological tests and the Fusion n-Back Test, which measures manual and saccadic response time (RT) across varying cognitive load and cueing conditions.

RESULTS

Consistent with our hypotheses, chronic mild and moderate-severe TBI were associated with substantial saccadic impairment under conditions of high cognitive load. Participants with moderate-severe TBI also demonstrated saccadic impairment at low levels of cognitive load. TBI groups and uninjured controls did not differ significantly on manual metrics or conventional neuropsychological measures.

CONCLUSIONS

This study provides additional support for the value of eye tracking for enhanced assessment of TBI. Additionally, findings suggest that TBI is associated with greatest susceptibility to oculomotor interference under high levels of cognitive load.

Predicting Remembering: Judgments of Prospective Memory After Traumatic Brain Injury

PURPOSE

Adults with traumatic brain injuries (TBIs) often struggle with prospective memory (PM), the ability to remember to complete tasks in the future, such as taking medicines on a schedule. Metamemory judgments (or how well we think we will do at remembering) are linked to strategy use and are critical for managing demands of daily living. The current project used an Internet-based virtual reality tool to assess metamemory judgments of PM following TBI.

METHOD

Eighteen adults with moderate to severe TBI and 20 healthy controls (HCs) played Tying the String, a virtual reality game with PM items embedded across the course of a virtual work week. Participants studied PM items and made two judgments of learning about the likelihood of recognizing the CUE, that is, when the task should be done, and of recalling the TASK, that is, what needed to be done.

RESULTS

Participants with TBI adjusted their metamemory expectations downward, but not enough to account for poorer recall performance. Absolute difference scores of metamemory accuracy showed that healthy adults were underconfident across PM components, whereas adults with TBI were markedly overconfident about their ability to recall TASKs.

CONCLUSIONS

Adults with TBI appear to have a general knowledge that PM tasks will be difficult but are poor monitors of actual levels of success. Because metamemory monitoring is linked to strategy use, future work should examine using this link to direct PM intervention approaches.

A review of prospective memory in individuals with acquired brain injury

OBJECTIVE

Prospective memory (PM) deficits have emerged as an important predictor of difficulty in daily life for individuals with acquired brain injury (BI). This review examines the variables that have been found to influence PM performance in this population. In addition, current methods of assessment are reviewed with a focus on clinical measures. Finally, cognitive rehabilitation therapies are reviewed, including compensatory, restorative and metacognitive approaches.

METHOD

Preferred reporting items for systematic reviews and meta-analyses guidelines were used to identify studies. Studies were added that were identified from the reference lists of these.

RESULTS

Research has begun to elucidate the contributing variables to PM deficits after BI, such as attention, executive function and retrospective memory components. Imaging studies have identified prefrontal deficits, especially in the region of BA10 as contributing to these deficits. There are now several clinical measures available with good psychometric properties. Rehabilitation techniques have mostly focused on compensatory strategies, but, in addition, some restorative and metacognitive approaches have shown preliminary promise.

CONCLUSIONS

PM deficits are a common and important deficit after BI. Clinical evaluation is recommended and further understanding of rehabilitation techniques is needed.

An investigation of white matter integrity and attention deficits following traumatic brain injury

OBJECTIVE

This study aimed to investigate the association between white matter tracts and multiple aspects of attention and working memory deficits in a relatively acute traumatic brain injury (TBI) sample.

METHOD

Neuropsychological measures of attention and working memory were administered to 20 participants with complicated mild-to-very severe TBI and 20 control participants. Tract-based spatial statistics was used to assess fractional anisotropy (FA) and mean diffusivity (MD) of white matter tracts for 15 TBI participants and 20 controls.

RESULTS

When compared to controls, participants with TBI were found to have lower FA (p < 0.001) and higher MD (p < 0.001) values in the majority of white matter tracts. TBI participants were also slower to complete tasks including Trail Making Test, Hayling, computerized Selective Attention Task, n-back and Symbol Digit Modalities Test (p < 0.001), when compared to controls. When controlling for age and estimated premorbid intelligence, slowed information processing speed following TBI was found to be associated with FA values in the corpus callosum, superior longitudinal fasciculus, cingulum, inferior fronto-occipital fasciculi, corona radiata and cerebral white matter.

CONCLUSION

The results highlight the widespread damage associated with TBI, as well as the impact of these alterations on information processing speed.

Correlates of employment and postsecondary education enrolment in Afghanistan and Iraq veterans with traumatic brain injuries

PRIMARY OBJECTIVE

About 20% of Iraq and Afghanistan Veterans have sustained a traumatic brain injury (TBI), which can result in postconcussive symptoms and difficulty transitioning from the military to civilian employment and postsecondary education. To better inform programs help Veterans transition back into civilian life, we evaluated correlates of employment and postsecondary education enrolment among treatment-seeking Veterans with a history of TBI.

RESEARCH DESIGN

A cross-sectional design, using an archival database of VA medical records, was used to answer these research questions.

METHODS AND PROCEDURES

We examined demographic, TBI-related, postconcussive, psychiatric, and neuropsychological factors in 390 Veterans (86% with mild TBI) to determine what factors were associated with employment or enrolment in postsecondary education. Bivariate correlations and multivariate regression were used.

MAIN OUTCOMES AND RESULTS

age, minority status, and service connected disability ratings were significantly associated with employment and postsecondary education enrolment in a multivariate context, whereas TBI-related factors and neurocognitive, postconcussive, and psychiatric symptom severity were not associated with employment or postsecondary education outcomes.

CONCLUSIONS

Further research is needed to confirm these findings and to evaluate the contribution of age, minority status, and disability on successful return to work and/or school for Veterans with a history of TBI.

White matter integrity of the medial forebrain bundle and attention and working memory deficits following traumatic brain injury

BACKGROUND AND OBJECTIVE

The medial forebrain bundle (MFB) contains ascending catecholamine fibers that project to the prefrontal cortex (PFC). Damage to these fibers following traumatic brain injury (TBI) may alter extracellular catecholamine levels in the PFC and impede attention and working memory ability. This study investigated white matter microstructure of the medial MFB, specifically the supero-lateral branch (slMFB), following TBI, and its association with performance on attention and working memory tasks.

METHOD

Neuropsychological measures of attention and working memory were administered to 20 moderate-severe participants with TBI (posttraumatic amnesia M = 40.05 ± 37.10 days, median time since injury 10.48 months, range 3.72-87.49) and 20 healthy controls. Probabilistic tractography was used to obtain fractional anisotropy (FA) and mean diffusivity (MD) values for 17 participants with TBI and 20 healthy controls.

RESULTS

When compared to controls, participants with TBI were found to have significantly lower FA (p < .001) and higher MD (p < .001) slMFB values, and they were slower to complete tasks including Trail Making Task-A, Hayling, selective attention task, n-back, and Symbol Digit Modalities Test.

CONCLUSION

This study was the first to demonstrate microstructural white matter damage within the slMFB following TBI. However, no evidence was found for an association of alterations to this tract and performance on attentional tasks.

Prospective Memory Impairment in Children with Prenatal Alcohol Exposure

BACKGROUND

Prenatal alcohol exposure (PAE) is linked to impaired performance on tests of retrospective memory, but prospective memory (PM; the ability to remember and act on delayed intentions) has not been examined in alcohol-exposed children. We investigated event-based PM in children with heavy PAE and the degree to which associations between PAE and PM are influenced by IQ, executive functioning (EF), retrospective memory, and attention deficit/hyperactivity disorder (ADHD).

METHODS

We administered a computerized PM task to 89 children (Mage = 11.1 years) whose mothers were recruited prenatally: 29 with fetal alcohol syndrome (FAS) or partial FAS (PFAS), 32 nonsyndromal heavily exposed (HE), and 28 Controls. We examined effects of diagnostic group, cue focality, and task difficulty on PM performance. The association between a continuous measure of alcohol exposure and PM performance was also examined after controlling for sociodemographic confounders. Mediation of alcohol effects on PM by IQ, EF, and retrospective memory scores was assessed as was the effect of ADHD on PM performance.

RESULTS

Children with FAS/PFAS made more PM errors than either HE or Control children. PAE was negatively related to PM performance even after adjusting for sociodemographic confounders, EF, and retrospective memory. This relation was only partially mediated by IQ. PAE was related to ADHD, but ADHD was not related to PM performance.

CONCLUSIONS

Fetal alcohol-related impairment in event-based PM was seen in children with FAS/PFAS. The effect of PAE on PM was not attributable to impaired EF and retrospective memory and was not solely attributable to lower IQ. Consistent with previous studies, we found no effect of ADHD on event-based PM performance at this age. This is the first study documenting PM impairment in children with heavy PAE and identifies a new domain of impairment warranting attention in diagnosis and management of fetal alcohol spectrum disorders.

Concussion is confusing us all

It is time to stop using the term concussion as it has no clear definition and no pathological meaning. This confusion is increasingly problematic as the management of ‘concussed’ individuals is a pressing concern. Historically, it has been used to describe patients briefly disabled following a head injury, with the assumption that this was due to a transient disorder of brain function without long-term sequelae. However, the symptoms of concussion are highly variable in duration, and can persist for many years with no reliable early predictors of outcome. Using vague terminology for post-traumatic problems leads to misconceptions and biases in the diagnostic process, producing uninterpretable science, poor clinical guidelines and confused policy. We propose that the term concussion should be avoided. Instead neurologists and other healthcare professionals should classify the severity of traumatic brain injury and then attempt to precisely diagnose the underlying cause of post-traumatic symptoms.

Time-based prospective memory functioning in mild cognitive impairment associated with Parkinson's disease: relationship with autonomous management of daily living commitments

OBJECTIVE

Prospective memory (PM), that is, the ability to keep in memory and carry out intentions in the future, is reported to be impaired in individuals with Parkinson's disease (PD). PM failure may be also associated with reduced daily living functioning in these patients. Little is known, however, about the relationship between mild cognitive impairment (MCI) and time-based PM functioning in PD patients and the possible impact of PM deficits on patients' autonomy in daily living. Here we aimed to investigate whether MCI associated with PD affects time-based PM. We also wished to determine whether PM impairment accounts for reduced autonomous management of medication in these patients.

METHOD

The study included 48 PD patients with MCI, 33 PD patients without cognitive disorders (PDN) and 20 healthy controls. The time-based PM procedure required that subjects perform an action after a fixed time. The PM procedure was incorporated in the standard neuropsychological assessment. One score was computed for the ability to retrieve the intention (prospective component) and one for remembering the action to be executed (retrospective component). The Pill Questionnaire was administered to assess the ability to manage medication.

RESULTS

PD patients with MCI performed less accurately in the PM procedure than HC and tended to perform poorer than PDN. Moreover, in PD patients with MCI, accuracy on the prospective component of the PM task and performance on the Modified Card Sorting Test significantly predicted the ability to manage medication.

CONCLUSIONS

RESULTS document that reduced efficiency of time-based PM processes in PD is specifically related to the presence of MCI. The same data indicate that PM weakness may be associated with impaired daily living functioning and decreased autonomy.

Everyday-like memory and its cognitive correlates in healthy older adults and in young patients with traumatic brain injury: a pilot study based on virtual reality

PURPOSE STATE: A pilot-study with a comparison approach between aging and traumatic brain injury (TBI) is proposed to investigate everyday object memory patterns using a virtual HOMES test.

METHODS

Sixteen young controls, 15 older adults and 15 TBI patients underwent the HOMES test and traditional tests.

RESULTS

Older adults and TBI patients exhibited similar HOMES performances: poor recall, a greater recognition benefit, high false recognitions, but intact clustering and proactive interference effects. The age-related differences for HOMES measures were mainly mediated by executive functioning, while the HOMES performances in the TBI group were correlated with memory measures.

CONCLUSION

The differential cognitive mediating effects for a similar everyday-like memory pattern are discussed by highlighting the need for more cautious interpretations of cognitive mechanisms behind similar behavioral patterns in different populations especially in clinical and rehabilitation settings.

Comparing memory and meta-memory abilities between children with acquired brain injury and healthy peers

This study compared visual memory and meta-memory abilities of children with ABI to that of healthy peers. Participants included 16 children (aged 13.55 ± 3.29 years) with moderate or severe ABI and 16 healthy children (aged 12.44 ± 3.24 years) with typical development. Children completed the Contextual Memory Test for Children (CMT-CH). The study group showed significantly lower immediate and delayed recall abilities. While the controls used the context for better memorizing, most of the children with ABI used rehearsals. In both groups better delayed recall correlated with the use of a more efficient strategy. Meta-memory should be an integral part of the assessment for children with ABI. Therapists should enhance child's self-awareness to his/her abilities and encourage the use of strategies (e.g. context) for memorizing in daily life.

Relations among prospective memory, cognitive abilities, and brain structure in adolescents who vary in prenatal drug exposure

This investigation examined how prospective memory (PM) relates to cognitive abilities (i.e., executive function, attention, working memory, and retrospective memory) and brain structure in adolescents who vary in prenatal drug exposure (PDE). The sample consisted of 105 (55 female and 50 male) urban, primarily African American adolescents (mean age=15.5 years) from low socioeconomic status (SES) families. Approximately 56% (n=59) were prenatally exposed to drugs (heroin and/or cocaine) and 44% (n=46) were not prenatally exposed, but the adolescents were similar in age, gender, race, and SES. Executive functioning, attentional control, working memory, retrospective memory, and overall cognitive ability were assessed by validated performance measures. Executive functioning was also measured by caregiver report. A subset of 52 adolescents completed MRI (magnetic resonance imaging) scans, which provided measures of subcortical gray matter volumes and thickness of prefrontal, parietal, and temporal cortices. Results revealed no differences in PM performance by PDE status, even after adjusting for age and IQ. Executive function, retrospective memory, cortical thickness in frontal and parietal regions, and volume of subcortical regions (i.e., putamen and hippocampus) were related to PM performance in the sample overall, even after adjusting for age, IQ, and total gray matter volume. Findings suggest that variations in PM ability during adolescence are robustly related to individual differences in cognitive abilities, in particular executive function and retrospective memory, and brain structure, but do not vary by PDE status.

Prospective memory impairment and executive dysfunction in prefrontal lobe damaged patients: is there a causal relationship?

BACKGROUND

The prospective memory (PM) construct is aimed at capturing cognitive operations involved in the successful accomplishment of delayed intentions. It is generally agreed that PM impairment occurs in patients with prefrontal lobes damage.

OBJECTIVE

To evaluate if there is a causal role of a deficit of executive abilities (failures of planning, set-shifting, selective attention, or working memory) over the PM impairment.

METHODS

We report a detailed investigation of PM and executive abilities in two patients with posttraumatic damage to prefrontal lobes who complained from a reduced compliance with appointments and daily routines.

RESULTS

Laboratory tests confirmed a difficulty in fulfilling delayed intentions in response to the occurrence of critical events and elapsed time. In one patient, PM impairment was associated with poor performance on tests investigating planning, working memory, and mental shifting. The other patient performed in the normal range on all executive tests.

CONCLUSIONS

Despite the frequent claim of a dependence of PM deficits from executive dysfunction, the reported cases demonstrate that this is not necessarily the case. The results are discussed in the light of current hypotheses relating PM impairment to other deficits that commonly occur as a result of damage to the prefrontal lobes.

The relations among cognitive impairment, coping style, and emotional adjustment following traumatic brain injury

OBJECTIVE

To examine the direct, mediated, and moderated associations among cognition, coping, and emotional adjustment following traumatic brain injury (TBI).

DESIGN

Cross-sectional, single-group design.

PARTICIPANTS

Ninety-seven participants with mild to severe TBI recruited from their rehabilitation hospital and assessed on average 19 months postinjury.

MEASURES

The BIRT Memory and Information Processing Battery, Doors Test from the Doors and People Test, Hayling Sentence Completion Test, Controlled Oral Word Association Test, Trail Making Test, Digit Span, Symbol Digit Modalities Test-Oral Version, Hospital Anxiety and Depression Scale, and the Coping Scale for Adults.

RESULTS

Poorer performance on measures of memory, executive functions, and attention and information processing was associated with greater levels of self-reported depression and anxiety. No mediated relation was found between cognition and emotional adjustment. However, the use of adaptive coping strategies was found to moderate the relation between the Hayling A-a measure of information processing speed-and self-reported depression.

CONCLUSIONS

Greater impairments in cognition directly predicted higher levels of anxiety and depression following TBI. In addition, the results suggest that the use of adaptive coping strategies has a greater effect on levels of depression for individuals with poor information processing speed.

Frontal lobe function and structure in juvenile myoclonic epilepsy: a comprehensive review of neuropsychological and imaging data

Juvenile myoclonic epilepsy is the most common idiopathic epilepsy syndrome and is considered a benign seizure disorder that responds well to antiepileptic drug treatment, in particular sodium valproate. By definition, routine brain imaging shows no abnormalities, but advanced imaging studies have identified functional and structural abnormalities in the frontal cortex and thalamus. Neuropsychological studies revealed subtle cognitive deficits in patients with JME, mainly implicating the frontal lobes. These findings are in keeping with anecdotal reports of behavioral problems in JME. Cognitive dysfunction in otherwise healthy siblings of patients with JME and a high heritability support the concept of a genetically determined thalamo-frontocortical network dysfunction, accounting for the cognitive impairment and cognitively triggered "motor seizures."

Improving memory in outpatients with neurological disorders using a group-based training program

Memory problems are common in patients with a range of neurological conditions, but there have been few attempts to provide and evaluate the usefulness of memory training for groups of neurological outpatients. We used a waitlist-controlled trial design to assess the effectiveness of a newly created, 6-session intervention, which involved training in the use of compensatory strategies as well as education regarding memory function, neurological damage, sleep and lifestyle factors that have an impact on memory. Fifty-six patients with neurological conditions (e.g., stroke, epilepsy) and memory complaints completed the training and assessments. Outcomes were evaluated in terms of reported strategy use as well as objective and subjective measures of anterograde and prospective memory. Training resulted in significant improvements on number of strategies used, scores on the Rey Auditory Verbal Learning Test (total learning and delayed recall) and self-report on the Comprehensive Assessment of Prospective Memory. Improvements were stable at 3-month follow-up. Better individual outcomes were related to lower baseline memory scores, fewer symptoms of depression and greater self-awareness of memory function. Overall the study provides encouraging results to indicate that patients with neurological conditions such as stroke and epilepsy can show improvements in memory after a relatively short group-based intervention.

Use of Virtual Reality Tasks to Assess Prospective Memory: Applicability and Evidence

Virtual reality (VR) is a term used to describe computer-generated virtual environments that the patient can explore and interact with in real time. In this review, the use of VR to construct ecologically valid tasks for use in neuropsychological assessment and rehabilitation is discussed with particular reference to the measurement of prospective memory (PM) abilities. PM, the ability to act upon delayed intentions, is an example of an everyday ability requiring the coordination of a different cognitive processes that is ideally suited to research and rehabilitation using VR. Studies investigating PM and related abilities in patients with brain impairments are surveyed, and it is established that there is evidence for the utility of applying VR procedures to measure prospective remembering. Future research could usefully focus on the construction of a standardised testing procedure with credible psychometric characteristics. In particular, there needs to be evidence for the criterion validity of such tests. Another potential research avenue is the evaluation of VR platforms as tools to teach memory skills and awareness of impairments. It is concluded that difficulties in adapting programs to specific clinical needs, technical issues, and the reluctance of many clinicians to use computer-based technology need to be overcome before VR is likely to be widely used to measure PM.

Everyday Memory for Everyday Tasks: Prospective Memory as an Outcome Measure Following TBI in Older Adults

Traumatic brain injury in older adults is an increasing problem in our aging community. Traditional functional outcome measures, such as return to work or academic achievement, as used with younger samples following traumatic brain injury are of limited use for older people. Although challenging to assess reliably, evaluation of prospective memory is gradually being included in outcome assessments following traumatic brain injury in younger samples and may be a useful index of cognitive competence in everyday life when assessing older adults following traumatic brain injury.

Traumatic Brain Injury and Prospective Memory in a Virtual Shopping Trip Task: Does It Matter Who Generates the Prospective Memory Target?

The current study aimed to investigate prospective memory in traumatic brain injury by using a laboratory-based but naturalistic style assessment task. The objective was to determine if performance differed when the prospective memory targets were self-generated or experimenter-generated (a generation effect). Sixteen people who had sustained a traumatic brain injury and had received rehabilitation were compared to 16 healthy age-matched control participants on a naturalistic virtual measure of shopping and prospective memory. Results demonstrated that the traumatic brain group was less accurate in overall prospective remembering performance than the control group but there was a lack of difference between the self- and experimenter-generated prospective memory targets for both participant groups. Both retrospective memory and executive attention of working memory were associated with prospective memory performance in the naturalistic task. The findings of the study suggest that the generation effect commonly observed in retrospective memory performance may not impact performance in prospective memory.

Traumatic Brain Injury and Prospective Memory: An Examination of the Influences of Executive Functioning and Retrospective Memory

This study investigated the effect of severe traumatic brain injury (TBI) on prospective memory. It also sought to identify the relative contributions of executive functioning and retrospective memory to prospective memory. Thirteen patients with severe TBI and 13 matched control subjects were assessed on two novel, yet ecologically valid, experimental measures of prospective memory and standard tests of neuropsychological functioning. Participants with TBI performed significantly worse than did controls on neuropsychological tests and a time-based prospective memory task, indicating that TBI affected not only retrospective but also prospective memory functioning. Multiple regression analyses identified relationships between executive functioning and time-based prospective memory and between retrospective memory and event-based prospective memory. Implications of these findings for the assessment and rehabilitation of memory impairment in individuals with TBI are discussed.

Effect of Cognitive Demand on Prospective Memory in Individuals with Traumatic Brain Injury

This study aimed to evaluate the influence of cognitive demand on prospective-memory in individuals with traumatic brain injury (TBI) using a dual-task paradigm. Fourteen individuals with severe TBI and 14 matched controls were required to undertake two tasks. A lexical-decision task was used as an ongoing task and had two levels of cognitive demand (viz., low and high). The event-based prospective-memory task involved performing a specific action whenever a target stimulus appeared during the ongoing task. The Letter-Number Sequencing Test, the Tower of London and the Controlled Oral Word Association Test were also administered to assess the relationship between prefrontal lobe functions and prospective memory. As hypothesised, participants in the TBI group performed more poorly than participants in the control group on the prospective-memory task in the high but not in the low demand condition. There were significant correlations between prospective-memory task performance and scores on the Letter-Number Sequencing Test and the Controlled Oral Word Association Test. These findings help to clarify the nature of prospective-memory impairment in individuals with TBI and support the involvement of prefrontal processes in prospective remembering.

Prospective Memory and Traumatic Brain Injury: A Review

This article aimed to review the assessment and treatment of prospective memory impairment in individuals with traumatic brain injury. The three assessment techniques reviewed included questionnaires, psychological tests, and experimental procedures. Because interest in this area is relatively new, not many assessment techniques have been specifically developed to assess the various constructs of prospective memory. Of these, most lack a firm theoretical basis, adequate norms, and strong psychometric properties. Rehabilitative techniques, based on remedial and compensatory approaches, were then evaluated. Intervention methods that show promise include a prospective memory training approach, diary or memory notebook use, and electronic aids. Nevertheless, there is a need for further controlled trials with larger sample sizes to more thoroughly evaluate these methods. Self-awareness of memory impairment and generalisation of gains from treatment are another two issues identified as important for assessing and treating prospective memory impairment.

Monetary incentive effects on event-based prospective memory three months after traumatic brain injury in children

Information regarding the remediation of event-based prospective memory (EB-PM) impairments following pediatric traumatic brain injury (TBI) is scarce. Addressing this, two levels of monetary incentives were used to improve EB-PM in children ages 7 to 16 years with orthopedic injuries (OI, n = 51), or moderate (n = 25) and severe (n = 39) TBI at approximately 3 months postinjury. The EB-PM task consisted of the child giving a specific verbal response to a verbal cue from the examiner while performing a battery of neuropsychological measures (ongoing task). Significant effects were found for age-at-test, motivation condition, period, and group. Within-group analyses indicated that OI and moderate TBI groups performed significantly better under the high- than under the low-incentive condition, but the severe TBI group demonstrated no significant improvement. These results indicate that EB-PM can be significantly improved at 3 months postinjury in children with moderate, but not severe, TBI.

Prospective memory after moderate-to-severe traumatic brain injury: a multinomial modeling approach

OBJECTIVE

Prospective memory (PM), which can be understood as the processes involved in realizing a delayed intention, is consistently found to be impaired after a traumatic brain injury (TBI). Although PM can be empirically dissociated from retrospective memory, it inherently involves both a prospective component (i.e., remembering that an action needs to be carried out) and retrospective components (i.e., remembering what action needs to be executed and when). This study utilized a multinomial processing tree model to disentangle the prospective (that) and retrospective recognition (when) components underlying PM after moderate-to-severe TBI.

METHOD

Seventeen participants with moderate to severe TBI and 17 age- and education-matched control participants completed an event-based PM task that was embedded within an ongoing computer-based color-matching task.

RESULTS

The multinomial processing tree modeling approach revealed a significant group difference in the prospective component, indicating that the control participants allocated greater preparatory attentional resources to the PM task compared to the TBI participants. Participants in the TBI group were also found to be significantly more impaired than controls in the when aspect of the retrospective component.

CONCLUSIONS

These findings indicated that the TBI participants had greater difficulty allocating the necessary preparatory attentional resources to the PM task and greater difficulty discriminating between PM targets and nontargets during task execution, despite demonstrating intact posttest recall and/or recognition of the PM tasks and targets.

Effect of type of cue, type of response, time delay and two different ongoing tasks on prospective memory functioning after acquired brain injury

Failures of prospective memory (PM) are one of the most frequent, and least studied, sequelae of brain injury. PM, also referred to as memory for intentions, is the ability to remember to carry out a future task. Successful completion of a PM task requires the ability to monitor time, keep the action to be performed periodically in awareness, remember the task to be performed, and initiate the action. Although PM has been shown to be a common difficulty after brain injury, it remains unknown which aspects of performance are impaired. In this study, the performance of 25 individuals with brain injury and that of 25 healthy participants were measured separately on the following variables: time until completion of the task, difficulty of the ongoing task being performed while waiting, whether the task to be performed is an action or is verbal, and whether the cue to perform the task is the passing of a particular amount of time (e.g., 10 minutes) or is an external cue (e.g., an alarm sounding). Individuals with brain injury demonstrated impairment compared to healthy adults on virtually all variables. PM performance was also compared to a battery of standard neuropsychological measures of attention, memory, and executive functions, and to self-report measures of PM functioning, in order to determine the underlying cognitive deficits responsible for poor PM performance, if any. PM performance was correlated with measures of executive functioning but not to self-report measures of PM functioning. Implications are discussed in terms of cognitive rehabilitation recommendations.

Diffusion tensor imaging of incentive effects in prospective memory after pediatric traumatic brain injury

Few studies exist investigating the brain-behavior relations of event-based prospective memory (EB-PM) impairments following traumatic brain injury (TBI). To address this, children with moderate-to-severe TBI performed an EB-PM test with two motivational enhancement conditions and underwent concurrent diffusion tensor imaging (DTI) at 3 months post-injury. Children with orthopedic injuries (OI; n=37) or moderate-to-severe TBI (n=40) were contrasted. Significant group differences were found for fractional anisotropy (FA) and apparent diffusion coefficient for orbitofrontal white matter (WM), cingulum bundles, and uncinate fasciculi. The FA of these WM structures in children with TBI significantly correlated with EB-PM performance in the high, but not the low motivation condition. Regression analyses within the TBI group indicated that the FA of the left cingulum bundle (p=0.003), left orbitofrontal WM (p<0.02), and left (p<0.02) and right (p<0.008) uncinate fasciculi significantly predicted EB-PM performance in the high motivation condition. We infer that the cingulum bundles, orbitofrontal WM, and uncinate fasciculi are important WM structures mediating motivation-based EB-PM responses following moderate-to-severe TBI in children.