Closed head injury (CHI) is a significant public health issue in the US and is associated with impairments in cognitive functioning, particularly in the domain of """"""""executive"""""""" control. The primary aim of this exploratory grant is to examine the componential nature and neural bases of cognitive control dysfunction in CHI.
The specific aims are to: 1) Identify the most critical components of cognitive control dysfunction across the continuum of CHI severity; 2) identify the neural bases of this dysfunction; and 3) determine relationships among cognitive control dysfunction, its neural bases, and manifest symptomatology in CHI. The specific hypotheses motivating the proposed research are that: 1) Patients with acute CHI exhibit severity dependent impairments in at least one of several components of cognitive control (i.e., implementation of cognitive control, detecting processing conflicts, performance monitoring); 2) regions of the frontal cortex mediate this impairment; and 3) aspects of these impairments and associated neural dysfunction are related to patient symptomatic experience. Study methods will examine adult mild, moderate and severe acute CHI patients while performing a novel cognitive task designed to temporally dissociate components of cognitive control in combination with measures of task-related neural activity. High-density event-related potentials will be used to dissociate strategic processes supporting the implementation of cognitive control, and evaluative processes supporting the detection of processing conflicts and performance monitoring. Functional magnetic resonance imaging will be used to identify the neural systems supporting these processes in healthy individuals, and those exhibiting dysfunction in patients with CHI. Self- and other-reported measures of symptom experience will provide information in the domains of cognitive, behavioral and affective expression, which will then be examined for relationships with measures of cognitive control and task-related brain activity. Accomplishing the aims outlined in this proposal will provide the foundation for future longitudinal studies to examine the temporal course of cognitive recovery, the mechanisms of successful intervention, and the design and evaluation of behavioral and pharmacological intervention strategies. ? ?
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