The neural correlates of cognitive fatigue in traumatic brain injury using functional MRI

A. D. Kohl, Glenn R. Wylie, H. M. Genova, F. G. Hillary, J. DeLuca

Research output: Contribution to journalArticlepeer-review

120 Scopus citations


Primary objective: The present study used fMRI (functional magnetic resonance imaging) to objectively assess cognitive fatigue in persons with traumatic brain injury (TBI). It was hypothesized that while performing a cognitive task, TBI participants would show increased brain activity over time, indicative of increased cerebral 'effort' which might manifest as the subjective feeling of cognitive fatigue. Methods and procedures: Functional MRI was used to track brain activity across time while 11 TBI patients with moderate-severe injury and 11 age-matched healthy controls (HCs) performed a modified Symbol Digit Modalities Task (mSDMT). Cognitive fatigue was operationally defined as a relative increase in cerebral activation across time compared to that seen in HCs. ROIs were derived from the Chauduri and Behan model of cognitive fatigue. Main outcomes and results: While performing the mSDMT, participants with a TBI showed increased activity, while HCs subsequently showed decreased activity in several regions including the middle frontal gyrus, superior parietal cortex, basal ganglia and anterior cingulate. Conclusions: Increased brain activity exhibited by participants with a TBI might represent increased cerebral effort which may be manifested as cognitive fatigue. Functional MRI appears to be a potentially useful tool for understanding the neural mechanisms associated with cognitive fatigue in TBI.

Original languageEnglish (US)
Pages (from-to)420-432
Number of pages13
JournalBrain Injury
Issue number5
StatePublished - May 2009

All Science Journal Classification (ASJC) codes

  • Neuroscience (miscellaneous)
  • Developmental and Educational Psychology
  • Clinical Neurology


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