Skip to main content

Neural Correlates of Interference Control in Adolescents with Traumatic Brain Injury: Functional Magnetic Resonance Imaging Study of the Counting Stroop Task

  • Sarah J. Tlustos (a1), C.-Y. Peter Chiu (a1) (a2), Nicolay Chertkoff Walz (a3) (a4), Scott K. Holland (a4) (a5), Lori Bernard (a6) and Shari L. Wade (a4) (a6)...

Difficulty in inhibition or cognitive control is a common and significant sequela of pediatric traumatic brain injury (TBI). The present study used functional MRI to examine one specific inhibitory function, interference control, in 11 adolescents, aged 12–16 years, (mean age, 15.7 years) with TBI who were at least 1 year postinjury and 11 age-matched typically developing control participants (TC) (mean age, 15.2 years). Participants completed a Counting Stroop task with 2 main conditions: (1) a neutral condition requiring the counting of animal words and (2) an interference condition in which mismatched number words were counted. Both TBI and TC adolescents activated similar networks of brain regions relevant to interference control, but the TBI group showed higher levels of activation relative to the TC group in multiple brain areas within this network, including predominantly right frontal and parietal regions. Findings of greater activation of the relevant neural network in the TBI group are consistent with recent fMRI findings using other interference control paradigms with individuals with a history of TBI. (JINS, 2011, 17, 000–000.)

Corresponding author
Correspondence and reprint requests to: Peter Chiu, Department of Psychology, University of Cincinnati, 101A Dyer Hall, ML 0376, Cincinnati, OH 45221-0376. E-mail:
Hide All
Aarts E., Roelofs A., van Turennout M. (2008). Anticipatory activity in anterior cingulate cortex can be independent of conflict and error likelihood. The Journal of Neuroscience, 28, 46714678. doi:10.1523/JNEUROSCI.4400-07.2008
Anderson V., Catroppa C., Morse S., Haritou F., Rosenfeld J. (2005). Attentional and processing skills following traumatic brain injury in early childhood. Brain Injury, 19, 699710. doi:10.1080/02699050400025281
Anderson V., Fenwick T., Manly T., Robertson I. (1998). Attentional skills following traumatic brain injury in childhood: A componential analysis. Brain Injury, 12, 937949. doi:10.1080/026990598121990
Bush G., Frazier J.A., Rauch S.L., Seidman L.J., Whalen P.J., Jenike M.A., Biederman J. (1999). Anterior cingulate cortex dysfunction in attention-deficit/hyperactivity disorder revealed by fMRI and the counting stroop. Biological Psychiatry, 45, 15421552.
Bush G., Shin L.M., Holmes J., Rosen B.R., Vogt B.A. (2003). The multi-source interference task: A validation study with fMRI in individual subjects. Molecular Psychiatry, 8, 6070. doi:10.1038/
Bush G., Whalen P.J., Rosen B.R., Jenike M.A., McInerney S.C., Rauch S.L. (1998). The counting stroop: An interference task specialized for functional neuroimaging – validation study with functional MRI. Human Brain Mapping, 6, 270282. doi:10.1002/(SICI)1097-0193(1998)6:4<270::AID-HBM6>3.0.CO;2-0
Casey B.J., Tottenham N., Liston C., Durston S. (2005). Imaging the developing brain: What have we learned about cognitive development? Trends in Cognitive Sciences, 9, 104110. doi:10.1016/j.tics.2005.01.011
Catroppa C., Anderson V. (2003). Children’s attentional skills 2 years post-traumatic brain injury. Developmental Neuropsychology, 23, 359373. doi:10.1207/S15326942DN2303_3
Catroppa C., Anderson V. (2005). A prospective study of the recovery of attention from acute to 2 years following pediatric traumatic brain injury. Journal of the International Neuropsychological Society, 11, 8498. doi:10.1017/S1355617705050101
Chen J.K., Johnston K.M., Collie A., McCroy P., Ptito A. (2007). A validation of the post concussion symptom scale in the assessment of complex concussion using cognitive testing and functional MRI. Journal of Neurology, Neurosurgery, and Psychiatry, 78, 12311238. doi:10.1136/jnnp.2006.110395
Chen J.K., Johnston K.M., Frey S., Petrides M., Worsley K., Ptito A. (2004). Functional abnormalities in symptomatic concussed athletes: an fMRI study. Neuroimage, 22, 6882. doi:10.1016/j.neuroimage.2003.12.032
Crosnoe R., Trinitapoli J. (2008). Shared family activities and the transition from childhood into adolescence. Journal of Research on Adolescence, 18, 2348. doi:10.1111/j.1532-7795.2008.00549.x
Delis D.C., Kaplan E., Kramer J.H. (2001). Delis Kaplan Executive Function System (D-KEFS). San Antonio, TX: Psychological Corporation.
Dunn L.M., Dunn D.M. (2007). Peabody Picture Vocabulary Test (PPVT4) (4th ed.). Minneapolis, MN: NCS Pearson, Inc.
E-Prime [Computer software]. Sharpsburg, PA: Psychological Software Tools, Inc.
Ewing-Cobbs L., Prasad M., Fletcher J.M., Levin H.S., Miner M.E., Eisenberg H.M. (1998). Attention after pediatric traumatic brain injury: A multidimensional assessment. Child Neuropsychology, 4, 3548. doi:10.1076/chin.
Ewing-Cobbs L., Prasad M.R., Landry S.H., Kramer L., DeLeon R. (2004). Executive functions following traumatic brain injury in young children: A preliminary analysis. Developmental Neuropsychology, 26, 487512. doi:10.1207/s15326942dn2601_7
Fan J., Flombaum J.I., McCandliss B.D., Thomas K.M., Posner M.I. (2003). Cognitive and brain consequences of conflict. Neuroimage, 18, 4257. doi:10.1006/nimg.2002.1319
Gioia G.A., Isquith P.K., Guy S.C. (2000). Behavior rating of executive function (BRIEF). Child Neuropsychology, 6, 235238.
Guy S.C., Isquith P.K., Gioia G.A. (2004). BRIEF-SR: Behavior rating inventory of executive function--Self-report version. Lutz, FL: Psychological Assessment Resources.
Hu X., Le T.H., Parrish T., Erhard P. (1995). Retrospective estimation and correction of physiological fluctuation in functional MRI. Magnetic Resonance in Medicine, 34, 201212. doi:10.1002/mrm.1910340211
Keenan H.T., Bratton S.L. (2006). Epidemiology and outcomes of pediatric traumatic brain injury. Developmental Neuroscience, 28, 256263. doi:10.1159/000094152
Kramer M.E., Chiu C.Y., Shear P.K., Wade S.L. (2009). Neural correlates of verbal associative memory and mnemonic strategy use following childhood traumatic brain injury. Journal of Pediatric Rehabilitation Medicine, 2, 255271. doi:10.3233/PRM-2009-0091
Kramer M.E., Chiu C.Y., Walz N.C., Holland S.K., Yuan W., Karunanayaka P., Wade S.L. (2008). Long-term neural processing of attention following early childhood traumatic brain injury: fMRI and neurobehavioral outcomes. Journal of the International Neuropsychological Society, 14, 424435. doi:10.1017/S1355617708080545
Langlois J.A., Rutland-Brown W., Thomas K.E. (2006). Traumatic brain injury in the United States: Emergency department visits, hospitalizations, and deaths. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Retrieved from CDC website:
Le T.H., Hu X. (1996). Retrospective estimation and correction of physiological artifacts in fMRI by direct extraction of physiological activity from MR data. Magnetic Resonance in Medicine, 35, 290298.
Ledberg A., Akerman S., Roland P.E. (1998). Estimation of the probabilities of 3D clusters in functional brain images. Neuroimage, 8, 113128. doi:10.1006/nimg.1998.0336
Levin H.S., Hanten G. (2005). Executive functions after traumatic brain injury in children. Pediatric Neurology, 33, 7993. doi:10.1016/j.pediatrneurol.2005.02.002
Levin H.S., Hanten G., Li X. (2009). The relation of cognitive control to social outcome after paediatric TBI: Implications for intervention. Developmental Neurorehabilitation, 12, 320329. doi:10.3109/17518420903087673
Max J.E., Manes F.F., Robertson B.A.M., Mathews K., Fox P.T., Lancaster J. (2005). Prefrontal and executive attention network lesions and the development of attention-deficit/hyperactivity symptomatology. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 443450. doi:10.1097/01.chi.0000156661.38576.0f
Max J.E., Schachar R.J., Levin H.S., Ewing-Cobbs L., Chapman S.B., Dennis M., Landis J. (2005a). Predictors of attention-deficit/hyperactivity disorder within 6 months after pediatric traumatic brain injury. Journal of the American Academy of Child & Adolescent Psychiatry, 44, 10321040. doi:10.1097/01.chi.0000173293. 05817.b1
Max J.E., Schachar R.J., Levin H.S., Ewing-Cobbs L., Chapman S.B., Dennis M., Landis J. (2005b). Predictors of secondary attention-deficit/hyperactivity disorder in children and adolescents 6 to 24 months after traumatic brain injury. Journal of the American Academy of Child & Adolescent Psychiatry, 44, 10411049. doi:10.1097/01.chi.0000173292.05817.f8
Mayer A.R., Mannell M.V., Ling J., Elgie R., Gasparovic C., Phillips J.P., Yeo R.A. (2009). Auditory orienting and inhibition of return in mild traumatic brain injury: A fMRI study. Human Brain Mapping, 30, 41524166. doi:10.1002/hbm.20836
McAllister T.W., Saykin A.J., Flashman L.A., Sparling M.B., Johnson S.C., Guerin S.J., Yanofsky N. (1999). Brain activation during working memory 1 month after mild traumatic brain injury: A functional MRI study. Neurology, 53, 13001308.
McAllister T.W., Sparling M.B., Flashman L.A., Guerin S.J., Mamourian A.C., Saykin A.J. (2001). Differential working memory load effects after mild traumatic brain injury. Neuroimage, 14, 10041012. doi:10.1006/nimg.2001.0899
Muzik O., Chugani D.C. (2000). Statistical parametric mapping: Assessment of application in children. Neuroimage, 12, 538549. doi:10.1006/nimg.2000.0651
Newsome M.R., Scheibel R.S., Hunter J.V., Wang Z.J., Chu Z., Li X., Levin H.S. (2007). Brain activation during working memory after traumatic brain injury in children. Neurocase, 13, 1624. doi:10.1080/13554790601186629
Newsome M.R., Scheibel R.S., Steinberg J.L., Troyanskaya M., Sharma R.G., Rauch R.A., Levin H.S. (2007). Working memory brain activation following severe traumatic brain injury. Cortex, 43, 95111. doi:10.1016/S0010-9452(08)70448-9
Newsome M.R., Steinberg J.L., Scheibel R.S., Troyanskaya M., Chu Z., Hanten G., Levin H.S. (2008). Effects of traumatic brain injury on working memory-related brain activation in adolescents. Neuropsychology, 22, 419425. doi:10.1037/0894-4105.22.4.419
Orme D.R., Johnstone B., Hanks R., Novack T. (2004). The WRAT-3 reading subtest as a measure of premorbid intelligence among persons with brain injury. Rehabilitation Psychology, 49, 250253.
Pennington B.F. (1994). The working memory function of the prefrontal cortices: Implications for developmental and individual differences in cognition. In M.M. Haith, J. Benson, R.J. Roberts, & B.F. Pennington (Eds.), Future oriented processes in development (pp. 243289). Chicago: University of Chicago Press.
Posner M.I., Rothbart M.K. (2007). Research on attention networks as a model for the integration of psychological science. Annual Review of Psychology, 58, 123. doi:10.1146/annurev.psych.58.110405.085516
Ridderinkhof K.R., van den Wildenberg W.P.M., Segalowitz S.J., Carter C.S. (2004). Neurocognitive mechanisms of cognitive control: The role of the prefrontal cortex in action selection, response inhibition, performance monitoring, and reward-based learning. Brain and Cognition, 56, 129140. doi:10.1016/j.bandc.2004.09.016
Sanchez-Carrion R., Fernandez-Espejo D., Junque C., Falcon C., Bargallo N., Roig T., Vendrell P. (2008). A longitudinal fMRI study of working memory in severe TBI patients with diffuse axonal injury. Neuroimage, 43, 421429. doi:10.1016/j.neuroimage.2008.08.003
Schachar R., Levin H.S., Max J.E., Purvis K., Chen S. (2004). Attention deficit hyperactivity disorder symptoms and response inhibition after closed head injury in children: Do preinjury behavior and injury severity predict outcome? Developmental Neuropsychology, 25, 179198. doi:10.1207/s15326942dn2501&2_10
Scheibel R.S., Newsome M.R., Steinberg J.L., Pearson D.A., Rauch R.A., Mao H., Levin H.S. (2007). Altered brain activation during cognitive control in patients with moderate to severe traumatic brain injury. Neurorehabilitation and Neural Repair, 21, 3645. doi:10.1177/1545968306294730
Scheibel R.S., Newsome M.R., Troyanskaya M., Steinberg J.L., Goldstein F.C., Mao H., Levin H.S. (2009). Effects of severity of traumatic brain injury and brain reserve on cognitive-control related brain activation. Journal of Neurotrauma, 26, 14471461. doi:10.1089/neu.2008.0736
Schmithorst V.J., Holland S.K. (2007). Sex differences in the development of neuroanatomical functional connectivity underlying intelligence found using Bayesian connectivity analysis. Neuroimage, 35, 406419. doi:10.1016/j.neuroimage.2006.11.046
Smits M., Dippel D.W., Houston G.C., Wielopolski P.A., Koudstaal P.J., Hunink M.G., van der Lugt A. (2009). Postconcussion syndrome after minor head injury: Brain activation of working memory and attention. Human Brain Mapping, 30, 27892803. doi:10.1002/hbm.20709
Talairach J., Tournoux P. (1988). Coplanar stereotactic atlas of the human brain. New York, NY: Thieme.
Thevenaz P., Ruttimann U.E., Unser M. (1998). A pyramid approach to subpixel registration based on intensity. IEEE Transactions in Image Processing, 7, 2741. doi:10.1109/83.650848
Wechsler D. (2003). Wechsler Intelligence Test for Children (WISC-IV) (4th ed.). San Antonio, TX: Psychological Corporation.
Wigfield A., Eccles J. (1994). Middle grades schooling and early adolescent development: An introduction. Journal of Early Adolescence, 14, 102106. doi:0.1177/027243169401400202
Wilke M., Schmithorst V.J., Holland S.K. (2002). Assessment of spatial normalization of whole-brain magnetic resonance images in children. Human Brain Mapping, 17, 4860. doi:10.1002/hbm.10053
Wilkinson G.S., Robertson G.J. (2006). Wide range achievement test (WRAT-4) (4th ed.). Lutz, FL: Psychological Assessment Resources, Inc.
Worsley K.J., Friston K.J. (1995). Analysis of fMRI time-series revisited – Again. Neuroimage, 2, 173181. doi:10.1006/nimg.1995.1023
Xiong J., Gao J.H., Lancaster J.L., Fox P.T. (1995). Clustered pixels analysis for functional MRI activation studies of the human brain. Human Brain Mapping, 3, 287301. doi:10.1002/hbm.460030404
Yeates K.O., Armstrong K., Janusz J., Taylor H.G., Wade S., Stancin T., Drotar D. (2005). Long-term attention problems in children with traumatic brain injury. Journal of the American Academy of Child & Adolescent Psychiatry, 44, 574584. doi:10.1097/01.chi.0000159947.50523.64
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Journal of the International Neuropsychological Society
  • ISSN: 1355-6177
  • EISSN: 1469-7661
  • URL: /core/journals/journal-of-the-international-neuropsychological-society
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 3
Total number of PDF views: 29 *
Loading metrics...

Abstract views

Total abstract views: 146 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 23rd November 2017. This data will be updated every 24 hours.