Brain activation during a social attribution task in adolescents with moderate to severe traumatic brain injury

Abstract

The ability to make accurate judgments about the mental states of others, sometimes referred to as theory of mind (ToM), is often impaired following traumatic brain injury (TBI), and this deficit may contribute to problems with interpersonal relationships. The present study used an animated social attribution task (SAT) with functional magnetic resonance imaging (fMRI) to examine structures mediating ToM in adolescents with moderate to severe TBI. The study design also included a comparison group of matched, typically developing (TD) adolescents. The TD group exhibited activation within a number of areas that are thought to be relevant to ToM, including the medial prefrontal and anterior cingulate cortex, fusiform gyrus, and posterior temporal and parietal areas. The TBI subjects had significant activation within many of these same areas, but their activation was generally more intense and excluded the medial prefrontal cortex. Exploratory regression analyses indicated a negative relation between ToM-related activation and measures of white matter integrity derived from diffusion tensor imaging, while there was also a positive relation between activation and lesion volume. These findings are consistent with alterations in the level and pattern of brain activation that may be due to the combined influence of diffuse axonal injury and focal lesions.

Keywords:

• Traumatic brain injury
• fMRI
• Social cognition
• Adolescents
• Diffusion tensor imaging

Acknowledgments

This research was supported by National Institutes of Health grant NS021889. We thank the adolescents and their families for their participation, Xiaoqi Li for statistical assistance, and Dr Sandra Chapman for advice regarding the design of this study. Recruitment and imaging of the subjects were facilitated by the General Clinical Research Center at Texas Children's Hospital and Ben Taub General Hospital in Houston, as well as the Children's Medical Center and Our Children's House at the Baylor Medical Center in Dallas and the Advanced Imaging Center at the University of Texas Southwestern Medical Center. The South Central Mental Illness Research, Education, and Clinical Center (MIRECC) and the Michael E. DeBakey Veteran's Affairs Medical Center provided access to laboratory facilities used for the analysis of the image data.