T F Münte1, H J Heinze. 1. Department of Neurology, Medical School of Hanover, Germany.
Abstract
OBJECTIVE: To delineate deficits in language processing after closed head injury with use of behavioral measures and event-related brain potentials. DESIGN: Case-control design. All subjects participated in three verbal event-related brain potential experiments, and the resulting measures were compared both within and between groups. PATIENTS/CONTROLS: Eleven patients at least 2 years after severe closed head injury (Glasgow Coma Scale score < 8 at admission and duration of posttraumatic amnesia > 48 hours) were compared with a control group matched for age and educational level. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Reaction times and percentage correct as behavioral measures in the three experiments (sentence verification, semantic and repetition priming with lexical decision task, and continuous word recognition). Event-related brain potentials were quantified by area measures in successive time windows for the different experimental conditions and for different experiments. RESULTS: The reaction times of the patient group were significantly longer than those of the controls (P < .005). Similarly, the patients' accuracy was significantly worse in all experiments (P < .03). The event-related brain potentials of the controls showed a clear and significant reduction of a negative component (N400) to terminal words of true sentences (sentence verification experiment), semantically primed words and repeated words (lexical decision experiment), and recognized words (continuous word recognition). For the patients, a clear N400 effect was seen only in the sentence verification task (delayed by about 100 milliseconds), while only later event-related brain potential modulations were seen in the other tasks. CONCLUSION: Language functions are disturbed after closed head injury. The electrophysiologic data suggest difficulties in the integration of incoming linguistic stimuli with the previous context as a possible underlying cause.
OBJECTIVE: To delineate deficits in language processing after closed head injury with use of behavioral measures and event-related brain potentials. DESIGN: Case-control design. All subjects participated in three verbal event-related brain potential experiments, and the resulting measures were compared both within and between groups. PATIENTS/CONTROLS: Eleven patients at least 2 years after severe closed head injury (Glasgow Coma Scale score < 8 at admission and duration of posttraumatic amnesia > 48 hours) were compared with a control group matched for age and educational level. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Reaction times and percentage correct as behavioral measures in the three experiments (sentence verification, semantic and repetition priming with lexical decision task, and continuous word recognition). Event-related brain potentials were quantified by area measures in successive time windows for the different experimental conditions and for different experiments. RESULTS: The reaction times of the patient group were significantly longer than those of the controls (P < .005). Similarly, the patients' accuracy was significantly worse in all experiments (P < .03). The event-related brain potentials of the controls showed a clear and significant reduction of a negative component (N400) to terminal words of true sentences (sentence verification experiment), semantically primed words and repeated words (lexical decision experiment), and recognized words (continuous word recognition). For the patients, a clear N400 effect was seen only in the sentence verification task (delayed by about 100 milliseconds), while only later event-related brain potential modulations were seen in the other tasks. CONCLUSION: Language functions are disturbed after closed head injury. The electrophysiologic data suggest difficulties in the integration of incoming linguistic stimuli with the previous context as a possible underlying cause.
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