Dual Task Performance after Severe Diffuse Traumatic Brain Injury or Vascular Prefrontal Damage

The ability to perform two tasks simultaneously is a key function of the central executive of working memory (Baddeley, 1986). This study addressed dual-task performance after diffuse very severe traumatic brain injury (TBI) (mean coma duration = 21 days, mean post-traumatic amnesia = 70 days) or prefrontal damage due to a ruptured aneurysm of the anterior communicating artery (AACA). Mean time since injury was 8 and 16 months in the TBI and the AACA group respectively. A simple visual reaction time and random number generation were used as single and dual tasks. Randomization was self-paced, to control for individual differences in speed. Both patient groups had greater reaction time decrements than controls under the dual-task condition, suggesting a divided attention deficit. In addition, patients with AACA performed significantly poorer in random generation. These results suggest that patients with AACA and with severe TBI suffer from an impairment of the central executive system.

[1]  E. Niedermeyer,et al.  Clinical neuropsychology of attention , 1994 .

[2]  D. Norman,et al.  Attention to action: Willed and automatic control , 1980 .

[3]  Mark D'Esposito,et al.  Working memory impairments in traumatic brain injury: evidence from a dual-task paradigm , 1997, Neuropsychologia.

[4]  M Freedman,et al.  Amnesia after anterior communicating artery aneurysm rupture , 1984, Neurology.

[5]  A D Baddeley,et al.  The Capacity for Generating Information by Randomization , 1966, The Quarterly journal of experimental psychology.

[6]  O. Godefroy,et al.  Non-spatial attention disorders in patients with frontal or posterior brain damage. , 1996, Brain : a journal of neurology.

[7]  F. J. Evans,et al.  Monitoring attention deployment by random number generation: An index to measure subjective randomness , 1978 .

[8]  W. Brouwer,et al.  Central executive aspects of attention in subacute severe and very severe closed head injury patients: Planning, inhibition, flexibility, and divided attention , 1996 .

[9]  F. J. Evans,et al.  Random number generation, psychopathology and therapeutic change. , 1982, Archives of general psychiatry.

[10]  B. Wilson,et al.  Is there a central executive deficit after severe head injury? , 1992 .

[11]  J. Vilkki,et al.  Dual task performance after focal cerebral lesions and closed head injuries , 1996, Neuropsychologia.

[12]  H. Levin,et al.  Serial MRI and neurobehavioural findings after mild to moderate closed head injury. , 1992, Journal of neurology, neurosurgery, and psychiatry.

[13]  A. V. Zomeren,et al.  Residual complaints of patients two years after severe head injury. , 1985, Journal of neurology, neurosurgery, and psychiatry.

[14]  Alan C. Evans,et al.  Dissociation of human mid-dorsolateral from posterior dorsolateral frontal cortex in memory processing. , 1993, Proceedings of the National Academy of Sciences of the United States of America.

[15]  E. Capitani,et al.  Neuropsychological Follow-Up Of Patients Operated For Aneurysms Of Anterior Communicating Artery , 1989, Cortex.

[16]  M C Ridding,et al.  The effects of transcranial magnetic stimulation over the dorsolateral prefrontal cortex on suppression of habitual counting during random number generation. , 1998, Brain : a journal of neurology.

[17]  M. D’Esposito,et al.  The neural basis of the central executive system of working memory , 1995, Nature.

[18]  D. Norman,et al.  Attention to Action: Willed and Automatic Control of Behavior Technical Report No. 8006. , 1980 .

[19]  A. Baddeley,et al.  Working memory and executive control. , 1996, Philosophical transactions of the Royal Society of London. Series B, Biological sciences.

[20]  H S Levin,et al.  The Galveston Orientation and Amnesia Test: A Practical Scale to Assess Cognition after Head Injury , 1979, The Journal of nervous and mental disease.

[21]  T Shallice,et al.  The domain of supervisory processes and temporal organization of behaviour. , 1996, Philosophical transactions of the Royal Society of London. Series B, Biological sciences.

[22]  B. Bussel,et al.  Working memory and supervisory control after severe closed-head injury. A study of dual task performance and random generation. , 1996, Journal of clinical and experimental neuropsychology.

[23]  Tim Shallice,et al.  Supervisory control of action and thought selection. , 1993 .

[24]  R. Hazlewood,et al.  The effects of Parkinson's disease on the capacity to generate information randomly , 1996, Neuropsychologia.

[25]  P W Burgess,et al.  Unilateral frontal lobectomy can produce strategy application disorder. , 1993, Journal of neurology, neurosurgery, and psychiatry.

[26]  P. Brugger,et al.  Random number generation in dementia of the Alzheimer type: A test of frontal executive functions , 1996, Neuropsychologia.

[27]  G. Goldenberg,et al.  Components of Random Generation by Normal Subjects and Patients with Dysexecutive Syndrome , 1993, Brain and Cognition.

[28]  Marc Rousseaux,et al.  Divided and Focused Attention in Patients with Lesion of the Prefrontal Cortex , 1996, Brain and Cognition.

[29]  Kirsty Grieve.  Attentional deficits following severe closed head injury and in chronic pain : a comparative study , 1997 .

[30]  R. Knight,et al.  Long-term cognitive deficits in patients after surgery on aneurysms of the anterior communicating artery. , 1991, Journal of neurology, neurosurgery, and psychiatry.

[31]  G. Goldenberg,et al.  Cerebral correlates of disturbed executive function and memory in survivors of severe closed head injury: a SPECT study. , 1992, Journal of neurology, neurosurgery, and psychiatry.

[32]  Peter C. Van Wolffelaar,et al.  Divided Attention 5 to 10 Years after Severe Closed Head Injury , 1989, Cortex.

[33]  F Duval,et al.  Random number generation by normal, alcoholic and schizophrenic subjects , 1990, Psychological Medicine.

[34]  Michaela Swales,et al.  Frontal Lobe Deficits after Head Injury: Unity and Diversity of Function , 1997 .

[35]  B. Bussel,et al.  Functional anatomy of neuropsychological deficits after severe traumatic brain injury , 1999, Neurology.

[36]  Marc Rousseaux,et al.  Control Functions of the Frontal Lobes. Modularity of the Central-Supervisory System? , 1999, Cortex.

[37]  Alan C. Evans,et al.  Functional activation of the human frontal cortex during the performance of verbal working memory tasks. , 1993, Proceedings of the National Academy of Sciences of the United States of America.

[38]  A. Baddeley,et al.  Attention : selection, awareness, and control : a tribute to Donald Broadbent , 1996 .

[39]  C. Umilta,et al.  Attention and Control Deficits Following Closed Head Injury , 1994, Cortex.

[40]  A. Baddeley,et al.  Dual-task performance in dysexecutive and nondysexecutive patients with a frontal lesion. , 1997, Neuropsychology.