Experimental Brain Research

, Volume 180, Issue 1, pp 59–67 | Cite as

Characterising error-awareness of attentional lapses and inhibitory control failures in patients with traumatic brain injury

  • F. M. O’Keeffe
  • P. M. Dockree
  • P. Moloney
  • S. Carton
  • I. H. Robertson
Research Article

Abstract

Awareness deficits are a significant problem following traumatic brain injury (TBI). This study examined error processing as candidate marker of awareness and compared the performance of 18 TBI participants and 18 controls using an online error-monitoring task while participants performed simple go/no-go tasks. Error-monitoring performance was compared where the no-go target was part of (a) a predictive sequence, (b) predictive sequence plus a dual-task element and (c) a random sequence. Results showed that the TBI participants, in contrast to control participants, were significantly impaired at monitoring their errors during both predictive sequence tasks but were not impaired on the random sequence task. These findings suggest that following TBI, when an error is more impulsive it may be more easily monitored, whereas when an error is characterised by attentional drift, subsequent error-processing mechanisms may fail to engage. Higher levels of online error-awareness were also associated with lower levels of anxiety, fewer symptoms of frontal dysfunction and greater competence in everyday functioning.

Keywords

Traumatic brain injury Errors Attention Response inhibition Frontal dysfunction 

References

  1. Anson K, Ponsford J (2006) Coping and emotional adjustment following traumatic brain injury. J Head Trauma Rehabil 21:248–259PubMedGoogle Scholar
  2. Barco PP, Crosson B, Bolesta MM, Werts D, Stout R (1991) Training awareness and compensation in postacute head injury rehabilation. In: Kreutzer J, Wehman P (eds) Cognitive Rehabilitation for Persons with Traumatic Brain Injury. Paul H. Brookes, Baltimore, pp 129–146Google Scholar
  3. Crosson C, Barco PP, Velozo C, Bolesta MM, Cooper PV, Werts D, Brobeck TC (1989) Awareness and compensation in postacute head injury rehabilitation. J Head Trauma Rehabil 4:46–54Google Scholar
  4. Dockree PM, Bellgrove MA, O’Keeffe F, Moloney P, Aimola L, Carton S, Robertson IH (2006) Sustained attention in traumatic brain injury (TBI) and healthy controls: enhanced sensitivity with dual-task load. Exp Brain Res 168:218–229PubMedCrossRefGoogle Scholar
  5. Dockree PM, Kelly SP, Roche RA, Hogan MJ, Reilly RB, Robertson IH (2004) Behavioural and physiological impairments of sustained attention after traumatic brain injury. Brain Res Cogn Brain Res 20:403–414PubMedCrossRefGoogle Scholar
  6. Dockree PM, Kellly SP, Robertson III, Reilly RB, Foxe JJ (2005) Neurophysiological markers of alert responding during goal directed behavior: A high density electrical mapping study. Neuroimage 27:587–601PubMedCrossRefGoogle Scholar
  7. Fassbender C, Murphy K, Foxe JJ, Wylie GR, Javitt DC, Robertson IH, Garavan H (2004) A topography of executive functions and their interactions revealed by functional magnetic resonance imaging. Brain Res Cogn Brain Res 20:132–143PubMedCrossRefGoogle Scholar
  8. Fleming JM, Strong J, Ashton R (1996) Self-awareness of deficits in adults with traumatic brain injury: how best to measure? Brain Inj 10:1–15PubMedCrossRefGoogle Scholar
  9. Fleming JM, Strong J, Ashton R (1998) Cluster analysis of self-awareness levels in adults with traumatic brain injury and relationship to outcome. J Head Trauma Rehabil 13:39–51PubMedGoogle Scholar
  10. Garavan H, Ross TJ, Murphy K, Roche RAP, Stein EA (2002) Dissociable executive functions in the dynamic control of behavior: inhibition, Error detection, and Correction. Neuroimage 17:1820–1829PubMedCrossRefGoogle Scholar
  11. Grace J, Malloy PF (2002) Frontal systems behavior scale. Professional ManualGoogle Scholar
  12. Hart T, Giovannetti T, Montgomery MW, Schwartz MF (1998) Awareness of errors in naturalistic action after traumatic brain injury. J Head Trauma Rehabil 13:16–28PubMedGoogle Scholar
  13. Manly T, Owen AM, McAvinue L, Datta A, Lewis GH, Scott SK, Rorden C, Pickard J, Robertson IH (2003) Enhancing the sensitivity of a sustained attention task to frontal damage: convergent clinical and functional imaging evidence. Neurocase 9:340–349PubMedCrossRefGoogle Scholar
  14. Markova IS, Berrios GE (2006) Approaches to the assessment of awareness: conceptual issues. Neuropsychol Rehabil 16:439–455PubMedCrossRefGoogle Scholar
  15. Mateer CA, Sira CS, O’Connell ME (2005) Putting humpty dumpty together again: the importance of integrating cognitive and emotional interventions. J Head Trauma Rehabil 20:62–75PubMedGoogle Scholar
  16. Mattson AJ, Levin HS (1990) Frontal lobe dysfunction following closed head injury: a review of the literature. J Nerv Ment Dis 178:282–291PubMedCrossRefGoogle Scholar
  17. McAvinue L, O’Keeffe F, McMackin D, Robertson IH (2005) Impaired sustained attention and error awareness in traumatic brain injury: implications for insight. Neuropsychol Rehabil 15:569–587Google Scholar
  18. McKinlay WW, Brooks DN, Bond MR, Martinage DP, Marshall MM (1981) The short-term outcome of severe blunt head injury as reported by relatives of the injured persons. J Neurol Neurosurg Psychiatry 44:527–533PubMedCrossRefGoogle Scholar
  19. O’Keeffe FM, Dockree PM, Robertson IH (2004) Poor insight in traumatic brain injury mediated by impaired error processing? Evidence from electrodermal activity. Brain Res Cogn Brain Res 22:101–112PubMedGoogle Scholar
  20. O’Keeffe F, Murray B, Coen R, Dockree PM, Bellgrove M, Hoerold D, et al (in press) Loss of insight in frontotemporal dementia, corticobasal degeneration and progressive supranuclear palsy. BrainGoogle Scholar
  21. Ownsworth TL, McFarland KM, Young RM (2000) Development and standardization of the self-regulation skills interview (SRSI): a new clinical assessment tool for acquired brain injury. Clin Neuropsychol 14:76–92PubMedGoogle Scholar
  22. Prigatano GP, Altman IM (1990) Impaired awareness of behavioral limitations after traumatic brain injury. Arch Phys Med Rehabil 71:1058–1064PubMedGoogle Scholar
  23. Prigatano GP, Altman IM, O’Brien KP (1990) Behavioral limitations that traumatic-brain-injured patients tend to underestimate. Clin Neuropsychol 4:163–176Google Scholar
  24. Prigatano GP, Borgaro S, Baker J, Wethe J (2005) Awareness and distress after traumatic brain injury: a relative’s perspective. J Head Trauma Rehabil 20:359–367PubMedCrossRefGoogle Scholar
  25. Richardson J (2000) Clinical and neuropsychological aspects of closed head injury. Psychology Press, UxbridgeGoogle Scholar
  26. Robertson IH, Garavan H (2004) Vigilant attention. In: Gazzaniga MS (ed) The cognitive neurosciences III, 3rd edn. MIT Press, Cambridge, pp 631–640Google Scholar
  27. Robertson IH, Manly T, Andrade J, Baddeley BT, Yiend J (1997) ‘Oops!’: performance correlates of everyday attentional failures in traumatic brain injured and normal subjects. Neuropsychologia 35:747–758PubMedCrossRefGoogle Scholar
  28. Sherer M, Boake C, Levin E, Silver B, Ringholz G, High WM Jr (1998) Characteristics of impaired awareness after traumatic brain injury. J Int Neuropsychol Soc 4:380–387PubMedGoogle Scholar
  29. Sturm W, Longoni F, Fimm B, Dietrich T, Weis S, Kemna S, Herzog H, Willmes K (2004) Network for auditory intrinsic alertness: a PET study. Neuropsychologia 42:563–568PubMedCrossRefGoogle Scholar
  30. Stuss DT (1998) Contribution of frontal lobe injury to cognitive impairment after closed head injury: methods and assessment and recent findings. In: Levin HS, Grafman J, Eisenberg HM (eds) Neurobehavioural recovery from head injury. Oxford University Press, New YorkGoogle Scholar
  31. Stuss DT, Gow GC (1992) Frontal Dysfunction after traumatic brain injury. Neuropsychiatry Neuropsychol Behav Neurol 5:272–282Google Scholar
  32. Toglia J, Kirk U (2000) Understanding awareness deficits following brain injury. NeuroRehabilitation 15:57–70PubMedGoogle Scholar
  33. Trudel TM, Tryone WW, Purdum CM (1998) Awareness of disability and long-term outcome after traumatic brain injury. Rehabil Psychol 43:267–281CrossRefGoogle Scholar
  34. Wise K, Ownsworth T, Fleming J (2005) Convergent validity of self-awareness measures and their association with employment outcome in adults following acquired brain injury. Brain Inj 19:765–775PubMedCrossRefGoogle Scholar
  35. Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–370PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • F. M. O’Keeffe
    • 1
    • 2
  • P. M. Dockree
    • 1
  • P. Moloney
    • 1
  • S. Carton
    • 2
  • I. H. Robertson
    • 1
  1. 1.Trinity College Institute of Neuroscience and Department of PsychologyTrinity College DublinDublin 2Ireland
  2. 2.Department of Clinical NeuropsychologyNational Rehabilitation HospitalCo. DublinIreland

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