Verbal learning ability after traumatic brain injury : roles of working memory and processing speed

Learning and memory impairments are among the most common and enduring cognitive consequences of traumatic brain injury (TBI). Researchers have yet to reach a consensus with regard to the basic cognitive mechanism underlying new learning and memory disturbances after TBI. The purpose of the present study was to investigate the current views regarding the cognitive processes thought to explain impairments in verbal learning and memory subsequent to brain injury. Specifically, this study sought to examine the roles of the central executive component of working memory and processing speed in verbal learning ability following TBI. Latent variable structural equation modeling (SEM) was used to analyze the data of 70 post-acute care TBI patients between the ages of 16 and 65, who completed a full neuropsychological evaluation. Results indicated that verbal learning and memory difficulties following TBI were explained primarily in terms of the central executive aspects of working memory, after accounting for the relative contributions of processing speed in the model. The direct effect of processing speed on verbal learning and memory was not significant when working memory was taken into account in the model. Rather, the effects of processing speed on verbal learning ability were largely indirect through the central executive component of working memory. Results highlight the importance of both working memory and processing speed in supporting verbal learning and memory processes after TBI. Practical implications for targeting remediation efforts and directing approaches to memory rehabilitation are discussed in light of the study’s findings.