Sustained attention following mild closed-head injury

Abstract

The sustained-attention performance of patients with mild closed-head injury (CHI) was examined within one month of injury using a high-event rate, digit-discrimination vigilance task with two levels of stimulus degradation (undegraded, highly degraded). Under undegraded stimulus conditions, vigilance performance for mild CHI subjects, uninjured case-matched control subjects, and college students was highly accurate and remained so across the entire task period. When stimuli were presented in degraded fashion, however, all three groups showed a similar decline over time (i.e., vigilance decrement) in hit rates and d' scores. Although mild CHI did not lead to a greater rate of deterioration in vigilance performance in the degraded stimulus condition, it did produce lower overall levels of sensitivity (d') in target detection. These results suggest that, during the first month after mild CHI, vigilance performance is unimpaired under normal task conditions, but may fall short under task conditions that require sustained effortful processing. These findings join a growing body of evidence showing that mild CHI can lead to measurable deficits in cognitive functioning.