Altered Relationship between Working Memory and Brain Microstructure after Mild Traumatic Brain Injury
Open accessAbstract
BACKGROUND AND PURPOSE: Working memory impairment is one of the most troubling and persistent symptoms after mild traumatic brain injury (MTBI). Here we investigate how working memory deficits relate to detectable WM microstructural injuries to discover robust biomarkers that allow early identification of patients with MTBI at the highest risk of working memory impairment. MATERIALS AND METHODS: Multi-shell diffusion MR imaging was performed on a 3T scanner with 5 b-values. Diffusion metrics of fractional anisotropy, diffusivity and kurtosis (mean, radial, axial), and WM tract integrity were calculated. Auditory-verbal working memory was assessed using the Wechsler Adult Intelligence Scale, 4th ed, subtests: 1) Digit Span including Forward, Backward, and Sequencing; and 2) Letter-Number Sequencing. We studied 19 patients with MTBI within 4 weeks of injury and 20 healthy controls. Tract-Based Spatial Statistics and ROI analyses were performed to reveal possible correlations between diffusion metrics and working memory performance, with age and sex as covariates. RESULTS: = .04), mainly present in the right superior longitudinal fasciculus, which was not observed in healthy controls. Patients with MTBI also appeared to lose the normal associations typically seen in fractional anisotropy and axonal water fraction with Letter-Number Sequencing. Tract-Based Spatial Statistics results also support our findings. CONCLUSIONS: Differences between patients with MTBI and healthy controls with regard to the relationship between microstructure measures and working memory performance may relate to known axonal perturbations occurring after injury.
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Abnormal coherence and working memory impairments have been linked to diffuse axonal injury, highlighting a relationship between neurophysiology and cognition.
“Abnormal coherence (Sponheim et al., 2011) and working memory impairments (Chung et al., 2019) have been linked to DAI, highlighting the relationship between neurophysiology and cognition.”
From Investigation of neurobiological responses to theta burst stimulation during recovery from mild traumatic brain injury (mTBI) (2023) · cites this paper as Chung et al., 2019
The Discussion reports poorer working-memory performance alongside a microstructural measure associated with axon injury in patients with mild traumatic brain injury. It does not establish that these patients had diffuse axonal injury specifically. The separate abnormal-coherence claim is attributed to Sponheim et al., not to Chung et al. (LLM, conf=0.84)
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- Authors
- Chung, S., Wang, X., Fieremans, E., Rath, J. F., Amorapanth, P., Foo, F.-Y. A., Morton, C. J., Novikov, D. S., Flanagan, S. R., & Lui, Y. W.
- Affiliations
- Center for Advanced Imaging Innovation and Research (US)
- New York University (US)
- NYU Langone Health (US)
- Corresponding author
- Chung, S.
- ORCID
- Venue
- American Journal of Neuroradiology
- Published
- 2019-08-01
- Volume
- 40
- Issue
- 9
- Pages
- 1438-1444
- ISSN
- 0195-6108 (ISSN-L)
- 1936-959X
- PMC
- PMC6728186
- OpenAlex
- W2966508983
- Cited by
- 31
- References
- 55
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 8 · 2023: 4 · 2022: 8 · 2021: 2 · 2020: 3 · 2019: 1
- FWCI
- 2.66
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- American Journal of Neuroradiology (publishedVersion, cc-by)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (P41 EB017183, R01 NS039135–11, R21 NS090349)
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Automotive and Human Injury Biomechanics
- Keywords
- mild traumatic brain injury, working memory, white matter microstructure, diffusion MRI, fractional anisotropy, kurtosis, superior longitudinal fasciculus, axonal injury, letter-number sequencing, digit span, biomarkers
- MeSH terms
- Adolescent, Adult, Aged, Axons, Body Water, Brain, Brain Concussion, Educational Status, Female, Humans, Male, Memory, Short-Term, Middle Aged, Nerve Net, Neuropsychological Tests, Prospective Studies, Wechsler Scales, Biomarkers, Diffusion Magnetic Resonance Imaging, Young Adult, White Matter
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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