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Neurorehabilitation and Neural Repair
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*Traumatic Brain Injury
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The Predictive Brain State: Timing Deficiency in Traumatic Brain Injury?

Jamshid Ghajar, MD, PhD

Brain Trauma Foundation and the Department of Neurological Surgery, Weill Medical College of Cornell University, New York, New York, ghajar{at}braintrauma.org

Richard B. Ivry, PhD,

Department of Psychology, University of California, Berkeley

Attention and memory deficits observed in traumatic brain injury (TBI) are postulated to result from the shearing of white matter connections between the prefrontal cortex, parietal lobe, and cerebellum that are critical in the generation, maintenance, and precise timing of anticipatory neural activity. These fiber tracts are part of a neural network that generates predictions of future states and events, processes that are required for optimal performance on attention and working memory tasks. The authors discuss the role of this anticipatory neural system for understanding the varied symptoms and potential rehabilitation interventions for TBI. Preparatory neural activity normally allows the efficient integration of sensory information with goal-based representations. It is postulated that an impairment in the generation of this activity in traumatic brain injury (TBI) leads to performance variability as the brain shifts from a predictive to reactive mode. This dysfunction may constitute a fundamental defect in TBI as well as other attention disorders, causing working memory deficits, distractibility, a loss of goal-oriented behavior, and decreased awareness.

Key Words: Attention • mild traumatic brain injury • head injury • concussion • post-concussive symptoms • diffuse axonal injury • neuropsychological tests

References

Neurorehabilitation and Neural Repair, Vol. 22, No. 3, 217-227 (2008)
DOI: 10.1177/1545968308315600
SAGE Open article

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This Article
Immediate free access via SAGE Open
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Citing Articles
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Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Ghajar, J.
Right arrow Articles by Ivry, R. B.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ghajar, J.
Right arrow Articles by Ivry, R. B.
Right arrowPubmed/NCBI databases
Medline Plus Health Information
*Memory
*Traumatic Brain Injury
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Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati   Add to Twitter  
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