Disconnection after traumatic brain injury: impairments of cognitive control and their impact on learning.

头部受伤往往会导致严重的残疾。虽然患者的身体可能会恢复，但许多人发现很难重返工作岗位或继续他们的社交生活。造成这种情况的原因通常很难用常规测试来确定。一个常见的致残问题是，患者对自己身体和精神上的局限性的认识减少了。这种自我意识的缺乏使得康复的尝试变得困难。头部受伤是如何导致这个问题的尚不清楚。意识被认为依赖于不同大脑区域之间的远距离交流。这是通过大脑深处的连接发生的，这些连接被组织成束或“束”，很像交换机中的电缆。在头部损伤中，这些联系是脆弱的，而大脑成像的新进展为详细研究损伤提供了工具。我将调查参与控制行为的大脑区域之间的连接受损是否会导致自我意识的损害。由于自我意识的降低导致学习困难，我预测这种控制网络的破坏将是决定患者康复的关键因素。这项工作很重要，因为它将在大脑中确定一个目标，用于开发新的治疗策略，这将构成我研究的下一个阶段。

Head injuries often lead to profound disability. Although patients may recover physically, many find it difficult to return to work or continue their social life. The reasons for this are often difficult to determine using conventional tests. A common and disabling problem is that patients have reduced awareness of their own physical and mental limitations. This lack of self-awareness makes attempts at rehabilitation difficult. How head injuries cause this problem is unknown. Awareness is thought to depend on long distance communication between distinct brain regions. This occurs through connections deep within the brain that are organized into bundles or ‘tracts‘, rather like electrical cabling in a switchboard. These connections are vulnerable in head injury, and new advances in brain imaging have provided tools to study damage in detail. I will investigate whether damage to the connections between brain regions involved in controlling actions produce impairments of self-awareness. As reduced self-awareness leads to difficulty in learning, I predict damage to this control network will be a critical factor in determining patient recovery. This work is important as it will identify a target within the brain for the development of new treatment strategies, which will form the next stage of my research.