Neuropsychological performance relative to sense of effort following traumatic brain injury

Every year, over three million people sustain traumatic brain injuries (TBI). Traumatic brain injury refers to any injury to the brain resulting from force to the skull that can cause concussion, contusion, and diffuse injury to neurons, which can further cause severe neurological problems (World Health Organization, 2010). Specifically, TBI often compromises the normal allocation of centralized attention and effort resources. With the return of combat veterans who sustained brain injuries while serving in Iraq and Afghanistan, it is becoming increasingly important to test the relationship between effort and cognitive functioning in this unique TBI sample. Evidence supporting this relationship would have significant clinical implications for prognosis and cognitive rehabilitation. The relationships among sense of effort and cognitive processing were tested within a sample of veterans who had sustained mild TBI. The measures were indices of sense of effort and neuropsychological performance scores. Multivariate regression was used to determine the predictive validity of sense of effort variables for neurocognitive scores. Subjects with mild TBI (MTBI) perceived increased sense of effort compared to normative data. Effort variables were in fact predictive of attention and working memory scores. Cognitive deficits experienced by subjects with MTBI may now be perceived differently by clinicians. Large scale research should provide further evidence of the relationship between sense of effort and neuropsychological performance, so that the aims of cognitive rehabilitation for subjects with chronic brain injury may shift to effort and performance feedback.