Neural correlates of working memory performance in mild traumatic brain injury

项目摘要 轻度创伤性脑损伤（mTBI）已被确定为伊拉克和阿富汗的标志性伤口 18 MTBI通常与慢性认知障碍有关，这与 工作记忆缺陷退伍军人认知主诉和工作记忆缺陷的评估 以下与战斗有关的mTBI提出了许多挑战，因为退伍军人群体代表了一个 具有相对独特的特征如损伤机制（例如，爆炸）19-21和战斗有关 精神病共病（即，创伤后应激障碍（PTSD）19，22，23功能性磁共振 功能磁共振成像（fMRI）提供了阐明mTBI中工作记忆表现的神经相关性的机会。 将神经激活与行为表现直接联系起来为异常神经激活提供了重要的背景。 脑损伤患者的反应。神经影像学的现代应用，如基于任务的功能性 连通性分析允许调查复杂的认知过程（即，工作记忆） 研究任务执行过程中分布式大脑区域的相互作用。研究审查功能 在mTBI的工作记忆任务期间，大脑区域的连接是有限的，据我们所知，没有研究 研究了有或没有mTBI的退伍军人基于工作记忆任务的神经连接。当前 因此，一项提案寻求使用先进的、非侵入性的fMRI方法来：（1）调查mTBI是否 退伍军人表现出比退伍军人控制更差的工作记忆表现;（2）检查大脑激活， 与退伍军人对照组相比，mTBI退伍军人的功能连接;（3）评估mTBI退伍军人与退伍军人之间的关联。 mTBI退伍军人和退伍军人的大脑激活、功能连接和工作记忆表现 （4）探讨临床损伤特征对神经功能损害的调节作用 激活或功能连接和工作记忆的表现。调查结果 该提案将加强我们对临床特征和相关脑连接模式的理解 mTBI后认知功能不佳此外，了解工作的神经相关性， 患有mTBI的退伍军人的记忆缺陷可以帮助提供干预策略的目标， 认知结果和生活质量的退伍军人谁持续头部创伤。

PROJECT ABSTRACT Mild traumatic brain injury (mTBI) has been identified as the signature wound of the Iraq and Afghanistan wars.18 MTBI is often associated with chronic cognitive complaints, which have been inconsistently linked to deficits in working memory. Assessments of cognitive complaints and working memory deficits in veterans following combat-related mTBI present numerous challenges because the veteran population represents a cohort with relatively unique characteristics such as mechanism of injury (e.g., blast)19-21 and combat-related psychiatric co-morbidity (i.e., post-traumatic stress disorder; PTSD).19, 22, 23 Functional magnetic resonance imaging (fMRI) provides the opportunity to elucidate neural correlates of working memory performance in mTBI. Directly relating neural activation to behavioral performance provides important context to abnormal neural responses in brain-injured individuals. Modern uses of neuroimaging, such as task-based functional connectivity analyses, permit the investigation of complex cognitive processes (i.e., working memory) by examining interactions of distributed brain regions during task performance. Studies examining the functional connectivity of brain regions during working memory tasks in mTBI are limited, and to our knowledge, no study has examined working memory task-based neural connectivity in veterans with or without mTBI. The current proposal therefore seeks to use advanced, non-invasive, fMRI methods to: (1) investigate whether mTBI veterans exhibit poorer working memory performance than veteran controls; (2) examine brain activation and functional connectivity in mTBI veterans compared to veteran controls; (3) evaluate the association between brain activation, functional connectivity, and working memory performance in mTBI veterans and veteran Controls; and (4) explore the moderation of clinical injury characteristics on the relationship between neural activation or functional connectivity and working memory performance in mTBI veterans. Findings of this proposal will enhance our understanding of clinical characteristics and brain connectivity patterns associated with poor cognitive outcomes following mTBI. Furthermore, understanding the neural correlates of working memory deficits in veterans with mTBI could help provide targets for intervention strategies to help improve cognitive outcomes and quality of life in veterans who have sustained head trauma.