Functional MRI of working memory in paediatric head injury

A case study

Zach Holladay

Introduction• Subject: 8 year old boy

• Injury: Hit by a car

• Condition (fMRI): Subdural haematoma and contusion

• Transferred to a Rehabilitation Unit for 16 days

Methods• Two assessments 15 months apart

• Assessment measures: Wechsler Intelligence scale, Woodcock-Johnson Test of Achievement, Child Behavioral Checklist

• Visuospatial working memory tasks during fMRI; 1-back and 2-back tests

Results• Time 1: Lesions and atrophy in left

parietal-occipital region

• Time 2: Atrophy in left parietal-occipital region and right parietal region

• Less diffuse activation in time 2 than in time 1 for 1-back tests

• Increased activation in time 2 for 2-back tests

Structural Imaging

• Increase in correct responses for 1-back tests (78-92%)

• Decrease in false alarm in 1-back tests (16-6%)

• Increase in correct responses for 2-back tests (64-79%)

• Decrease in false alarm in 2-back tests (25-8%)

Changes from time 1 to time 2

Discussion• Cognitive performance consistent with or

better than expected

• Differences between recovery of working memory function between developed and developing brain