A meta-analysis of working memory impairments in survivors of a moderate-to-severe traumatic brain injury

This is the author accepted manuscript. The final version is available from the American Psychological Association via the DOI in this record.Objectives: To establish the magnitude of deficits in working memory (WM) and short-term memory (STM) in those with moderate-to-severe traumatic brain injury (TBI) relative to age-matched, healthy controls and to explore the moderating effects of time since injury and age at injury on these impairments. Method: Twenty-one studies that compared the WM and/or STM abilities of individuals with at least a moderate TBI relative to healthy controls were included in a random effects meta-analysis. Measures used to examine memory performance were categorized by modality (visuospatial, verbal) and memory system (WM, STM). Results: Individuals with TBI had significant deficits in verbal STM (Cohen’s d = .41), visuospatial WM (Cohen’s d = .69), and verbal WM (Cohen’s d = .37) relative to controls. Greater decrements in verbal STM and verbal WM skills were associated with longer time postinjury. Larger deficits were observed in verbal WM abilities in individuals with older age at injury. Conclusion: Evidence for WM impairments following TBI is consistent with previous research. Larger verbal STM and verbal WM deficits were related to a longer time postinjury, suggesting that these aspects of memory do not “recover” over time and instead, individuals might show increased rates of cognitive decline. Age at injury was associated with the severity of verbal WM impairments, with larger deficits evident for injuries that occurred later in life. Further research needs to chart the long-term effects of TBI on WM and to compare the effects of injury on verbal relative to visuospatial memory.This project was supported by generous grants from the Henry Smith Charity and Action Medical Research

A meta-analysis of working memory impairments in survivors of a moderate-to-severe traumatic brain injury

This is the author accepted manuscript. The final version is available from the American Psychological Association via the DOI in this record.Objectives: To establish the magnitude of deficits in working memory (WM) and short-term memory (STM) in those with moderate-to-severe traumatic brain injury (TBI) relative to age-matched, healthy controls and to explore the moderating effects of time since injury and age at injury on these impairments. Method: Twenty-one studies that compared the WM and/or STM abilities of individuals with at least a moderate TBI relative to healthy controls were included in a random effects meta-analysis. Measures used to examine memory performance were categorized by modality (visuospatial, verbal) and memory system (WM, STM). Results: Individuals with TBI had significant deficits in verbal STM (Cohen’s d = .41), visuospatial WM (Cohen’s d = .69), and verbal WM (Cohen’s d = .37) relative to controls. Greater decrements in verbal STM and verbal WM skills were associated with longer time postinjury. Larger deficits were observed in verbal WM abilities in individuals with older age at injury. Conclusion: Evidence for WM impairments following TBI is consistent with previous research. Larger verbal STM and verbal WM deficits were related to a longer time postinjury, suggesting that these aspects of memory do not “recover” over time and instead, individuals might show increased rates of cognitive decline. Age at injury was associated with the severity of verbal WM impairments, with larger deficits evident for injuries that occurred later in life. Further research needs to chart the long-term effects of TBI on WM and to compare the effects of injury on verbal relative to visuospatial memory.This project was supported by generous grants from the Henry Smith Charity and Action Medical Research

A model for pediatric neurocognitive interventions: considering the role of development and maturation in rehabilitation planning.

PublishedJournal ArticleThe need for post-acute neurorehabilitation after childhood acquired brain injury is increasingly recognized but recent reviews highlight the limited evidence-base and lack of a neuropsychological treatment model. Evidence from different fields was reviewed to inform the development of a pediatric neurocognitive interventions (PNI) model. The review included literature from child neuropsychology, adult neuropsychology, cognitive neuroscience, learning disabilities, education, and mental health. The resulting PNI model provides a systematic approach to delivering and evaluating appropriate care while minimizing the obstacles to successful outcomes. The model emphasizes the role of development and cognitive maturation in the planning of rehabilitation. Areas that represent significant gaps in our knowledge are discussed and future research directions are suggested based on predictions generated by the proposed model

Children's CBT skills, metacognition, empathy, and theory of mind

Purpose Cognitive Behavioural Therapy (CBT) is an evidence-based treatment for common mental health problems that affect children, young people and adults. The suitability of CBT for children has been questioned because it requires children to think about their thoughts, feelings and behaviours. The purpose of this paper is to investigate which cognitive and affective capacities predict children’s ability to relate thoughts, feelings and behaviours. Design/methodology/approach A total of 59 typically developing children aged between 8 and 11 years took part in the study. CBT skills were assessed on a story task that required children to relate the character’s thoughts to their feelings and behaviours. Children also completed an assessment of IQ, a feeling-of-knowing metamemory task that assessed metacognition, and a higher-order theory of mind task. Furthermore, parents rated their child’s empathy on the children’s empathy quotient. Findings The findings suggest that CBT is developmentally appropriate for 8–11 year old children; however, young children and children with mental health problems may have impaired metacognition and CBT skills. Metacognition and empathy may moderate the efficacy of child CBT and warrant further investigation in clinical trials. Originality/value This study provides evidence for the cognitive and affective skills that might predict the outcome of CBT in children. Metacognition and empathy predict children’s ability to relate thoughts, feelings and behaviours, and therefore may moderate the efficacy of CBT

The Bangor Gambling Task: Characterising the performance of survivors of traumatic brain injury

The Bangor Gambling Task (BGT, Bowman & Turnbull, 2004) is a simple test of emotion-based decision-making, with contingencies varying across five blocks of 20 trials. This is the first study to characterise BGT performance in survivors of traumatic brain injury (TBI) relative to healthy controls. The study also aimed to explore sub-groups (cluster analysis), and identify predictors of task performance (multiple regression). Thirty survivors of TBI and 39 controls completed the BGT and measures of premorbid IQ, working memory, and executive function. Results showed that survivors of TBI made more gamble choices than controls (total BGT score), although the groups did not significantly differ when using a cut-off score for ‘impaired’ performance. Unexpectedly, the groups did not significantly differ in their performance across the blocks, however, the cluster analysis revealed three subgroups (with survivors of TBI and controls represented in each cluster). Findings also indicated that age and group were significant predictors of overall BGT performance, but not gender, premorbid IQ, or working memory and executive function. In conclusion, the study findings are consistent with an individual differences account of emotion-based decision-making, and a number of issues need to be addressed prior to recommending the clinical use of the BGT

Moral decision-making and moral development: Toward an integrative framework

How moral decision-making occurs, matures over time and relates to behaviour is complex. To develop a full picture of moral decision-making, moral development and moral behaviour it is necessary to understand: (a) how real-time moral decisions are made (including relevant social and contextual factors), (b) what processes are required to develop to enable mature moral decisions, (c) how these processes develop over time, and (d) how moral decisions relate to behaviour. In this paper, psychological and social neuroscience theories of moral decision-making and development are briefly reviewed, as is the development of relevant component processes. Various component processes and factors are seen as required for moral decision-making and development, yet there is no comprehensive framework incorporating these components into one explanation of how real-time moral decisions are made and mature. In this paper, we integrated these components into a new framework based on social information processing (SIP) theory. Situational factors, and how both cognitive and affective process guide moral decisions was incorporated into the Social Information Processing-Moral Decision-Making (SIP-MDM) framework, drawing upon theories and findings from developmental psychology and social neuroscience. How this framework goes beyond previous SIP models was outlined, followed by a discussion of how it can explai

Enhanced task-related brain activation and resting perfusion in healthy older adults after chronic blueberry supplementation

© 2017, Canadian Science Publishing. All rights reserved. Blueberries are rich in flavonoids, which possess antioxidant and anti-inflammatory properties. High flavonoid intakes attenuate age-related cognitive decline, but data from human intervention studies are sparse. We investigated whether 12 weeks of blueberry concentrate supplementation improved brain perfusion, task-related activation, and cognitive function in healthy older adults. Participants were randomised to consume either 30 mL blueberry concentrate providing 387 mg anthocyanidins (5 female, 7 male; age 67.5 ± 3.0 y; body mass index, 25.9 ± 3.3 kg·m−2) or isoenergetic placebo (8 female, 6 male; age 69.0 ± 3.3 y; body mass index, 27.1 ± 4.0 kg·m−2). Pre-and postsupplementation, participants undertook a battery of cognitive function tests and a numerical Stroop test within a 1.5T magnetic resonance imaging scanner while functional magnetic resonance images were continuously acquired. Quantitative resting brain perfusion was determined using an arterial spin labelling technique, and blood biomarkers of inflammation and oxidative stress were measured. Significant increases in brain activity were observed in response to blueberry supplementation relative to the placebo group within Brodmann areas 4/6/10/ 21/40/44/45, precuneus, anterior cingulate, and insula/thalamus (p < 0.001) as well as significant improvements in grey matter perfusion in the parietal (5.0 ± 1.8 vs-2.9 ± 2.4%, p = 0.013) and occipital (8.0 ± 2.6 vs-0.7 ± 3.2%, p = 0.031) lobes. There was also evidence suggesting improvement in working memory (2-back test) after blueberry versus placebo supplementation (p = 0.05). Supplementation with an anthocyanin-rich blueberry concentrate improved brain perfusion and activation in brain areas associated with cognitive function in healthy older adults

The neural correlates of working memory training in typically developing children.

Working memory training improves children's cognitive performance on untrained tasks; however, little is known about the underlying neural mechanisms. This was investigated in 32 typically developing children aged 10-14 years (19 girls and 13 boys) using a randomized controlled design and multi-modal magnetic resonance imaging (Devon, UK; 2015-2016). Training improved working memory performance and increased intrinsic functional connectivity between the bilateral intraparietal sulci. Furthermore, improvements in working memory were associated with greater recruitment of the left middle frontal gyrus on a complex span task. Repeated engagement of fronto-parietal regions during training may increase their activity and functional connectivity over time, affording greater working memory performance. The plausibility of generalizable cognitive benefits from a neurobiological perspective and implications for neurodevelopmental theory are discussed

Clinical and cost-effectiveness of teen online problem-solving for adolescents who have survived an acquired brain injury in the UK: protocol for a randomised, controlled feasibility study (TOPS-UK).

INTRODUCTION: Paediatric acquired brain injury is a leading cause of mortality in children in the UK. Improved treatment during the acute phase has led to increased survival rates, although with life-long morbidity in terms of social and emotional functioning. This is the protocol for a feasibility randomised controlled trial with an embedded qualitative study and feasibility economic evaluation. If feasible, a later definitive trial will test the effectiveness and cost-effectiveness of an online intervention to enhance problem solving ability versus treatment as usual. METHODS AND ANALYSIS: Twenty-five adolescents and their families identified by primary or secondary care clinicians at participating UK National Health Service Trusts will be recruited and individually randomised in a 1:1 ratio to receive the online intervention or treatment as usual. Participants will be followed up by online questionnaires 17 weeks after randomisation to capture acceptability of the study and intervention and resource use data. Qualitative interviews will capture participants' and clinicians' experiences of the study. ETHICS AND DISSEMINATION: This study has been granted ethical approval by the South West-Exeter Research Ethics Committee (ref 17/SW/0083). Results will be disseminated via peer-reviewed publications and will inform the design of a larger trial. TRIAL REGISTRATION NUMBER: ISRCTN10906069

Efficient Visual Object and Word Recognition Relies on High Spatial Frequency Coding in the Left Posterior Fusiform Gyrus: Evidence from a Case-Series of Patients with Ventral Occipito-Temporal Cortex Damage

Seeing a face in motion can improve face recognition in the general population, and studies of face matching indicate that people with face recognition difficulties (developmental prosopagnosia; DP) may be able to use movement cues as a supplementary strategy to help them process faces. However, the use of facial movement cues in DP has not been examined in the context of familiar face recognition. This study examined whether people with DP were better at recognizing famous faces presented in motion, compared to static. Methods: Nine participants with DP and 14 age-matched controls completed a famous face recognition task. Each face was presented twice across 2 blocks: once in motion and once as a still image. Discriminability (A) was calculated for each block. Results: Participants with DP showed a significant movement advantage overall. This was driven by a movement advantage in the first block, but not in the second block. Participants with DP were significantly worse than controls at identifying faces from static images, but there was no difference between those with DP and controls for moving images. Conclusions: Seeing a familiar face in motion can improve face recognition in people with DP, at least in some circumstances. The mechanisms behind this effect are unclear, but these results suggest that some people with DP are able to learn and recognize patterns of facial motion, and movement can act as a useful cue when face recognition is impaired