Impaired skill learning in patients with severe closed-head injury as demonstrated by the serial reaction time (SRT) task.

A group of 20 patients who sustained closed-head injury (CHI) and a matched control group of 20 individuals were tested on the serial reaction time (SRT) task. Three different sequence-learning measures were generated from the task: two implicit and one explicit. The two implicit sequence-learning measures include: (1) the learning rate on the first five blocks of the repeated sequence, assumed to reflect primarily general reaction time learning, and (2) the difference between the fifth block of the repeated sequence and the sixth block, a random sequence that reflects implicit sequence-specific learning. In addition, an explicit measure of sequence learning was generated. The results indicate that the CHI group was impaired on the explicit measure of sequence learning. The groups did not differ on general reaction time learning, one of the implicit measures of sequence learning. However, the control group was superior to the CHI group in learning the specific sequence repeated in the SRT task. This pattern of results is unique to the CHI group, corresponding with neither that of amnesic patients nor with that of patients with dysfunction of the basal ganglia (i.e., Parkinson's diseases).