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

Physical Medicine and Rehabilitation Alliance of Baylor College of Medicine, Houston, TX 77030, USA.
Journal of Clinical and Experimental Neuropsychology (Impact Factor: 2.08). 02/2011; 33(6):639-46. DOI: 10.1080/13803395.2010.547844
Source: PubMed


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.

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    ABSTRACT: 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.
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