TY - JOUR
PY - 2023//
TI - Factors perpetuating functional cognitive symptoms after mild traumatic brain injury
JO - Journal of clinical and experimental neuropsychology
A1 - Picon, Edwina L.
A1 - Wardell, Victoria
A1 - Palombo, Daniela J.
A1 - Todd, Rebecca M.
A1 - Aziz, Bilal
A1 - Bedi, Sanjana
A1 - Silverberg, Noah D.
SP - ePub
EP - ePub
VL - ePub
IS - ePub
N2 - INTRODUCTION: Self-reported memory difficulties (forgetting familiar names, misplacing objects) often persist long after a mild traumatic brain injury (mTBI), despite normal neuropsychological test performance. This clinical presentation may be a manifestation of a functional cognitive disorder (FCD). Several mechanisms underlying FCD have been proposed, including metacognitive impairment, memory perfectionism, and misdirected attention, as well as depression or anxiety-related explanations. This study aims to explore these candidate perpetuating factors in mTBI, to advance our understanding of why memory symptoms frequently persist following mTBI.
METHODS: A cross-sectional study of 67 adults (n = 39 with mTBI mean = 25 months ago and n = 28 healthy controls). Participants completed standardized questionnaires (including the Functional Memory Disorder Inventory), a metacognitive task (to quantify discrepancies between their trial-by-trial accuracy and confidence), and a brief neuropsychological test battery. We assessed candidate mechanisms in two ways: (1) between-groups, comparing participants with mTBI to healthy controls, and (2) within-group, examining their associations with functional memory symptom severity (FMDI) in the mTBI group.
RESULTS: Participants with mTBI performed similarly to controls on objective measures of memory ability but reported experiencing much more frequent memory lapses in daily life. Contrary to expectations, metacognitive efficiency did not differentiate the mTBI and control groups and was not associated with functional memory symptoms. Memory perfectionism was strongly associated with greater functional memory symptoms among participants with mTBI but did not differ between groups when accounting for age. Depression and checking behaviors produced consistent results across between-groups and within-group analyses: these factors were greater in the mTBI group compared to the control group and were associated with greater functional memory symptoms within the mTBI group.
CONCLUSIONS: This study highlights promising (e.g., depression, checking behaviors) and unlikely (e.g., metacognitive impairment) mechanisms underlying functional memory symptoms after mTBI, to guide future research and treatment.
Language: en
LA - en SN - 1380-3395 UR - http://dx.doi.org/10.1080/13803395.2023.2247601 ID - ref1 ER -