[ARTICLE] Cognitive fatigue in individuals with traumatic brain injury is associated with caudate activation – Full Text


We investigated differences in brain activation associated with cognitive fatigue between persons with traumatic brain injury (TBI) and healthy controls (HCs). Twenty-two participants with moderate-severe TBI and 20 HCs performed four blocks of a difficult working memory task and four blocks of a control task during fMRI imaging. Cognitive fatigue, assessed before and after each block, was used as a covariate to assess fatigue-related brain activation. The TBI group reported more fatigue than the HCs, though their performance was comparable. Regarding brain activation, the TBI group showed a Task X Fatigue interaction in the caudate tail resulting from a positive correlation between fatigue and brain activation for the difficult task and a negative relationship for the control task. The HC group showed the same Task X Fatigue interaction in the caudate head. Because we had prior hypotheses about the caudate, we performed a confirmatory analysis of a separate dataset in which the same subjects performed a processing speed task. A relationship between Fatigue and brain activation was evident in the caudate for this task as well. These results underscore the importance of the caudate nucleus in relation to cognitive fatigue.

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The interaction of Group, Task and Fatigue in Experiment 1 in the caudate head (indicated by blue arrow). The plots on the left are included only to show the slopes of the regression lines. For the HC group, there was a negative correlation between fatigue and activation for the 0-back task (top left), and a positive correlation for the 2-back task (top right). For the TBI group, the correlations between fatigue and activation in both tasks were very weak (lower plots). In all cases, the vertical axis is the percent signal change in the caudate head and the horizontal axis is the normalized fatigue score. On the right is a 3-dimensional rendering of the activation in the caudate head for Experiment 1.

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