Neuropsychological assessment of executive functions in traumatic brain injury: hot and cold components

ABSTRACT

The present study compared decision-making processing between patients with traumatic brain injury (TBI) and healthy controls. The study also sought to identify dissociations in the frequency of deficits in executive functions (EF) tasks that mainly assess decision making (DM; hot component) and inhibition (cold component) following TBI. The sample was composed of 16 post-TBI adults aged between 18 and 68 years and 16 healthy controls matched by age and education. Decision-making was assessed with the Iowa Gambling Task (IGT), and inhibitory control was assessed with the Trail Making Task (TMT) and Hayling Test. No differences were found between groups in total scores and block scores on the IGT. However, TBI patients preferred the disadvantageous decks, with no evidence of learning during the task. Seven patients presented dissociations between deficient DM on the IGT and accurate inhibition on the Hayling Test and TMT. Conversely, five patients presented partial dissociations between deficits in the IGT and TMT and opposite performance in the Hayling Test. Only three patients exhibited deficits on all of the instruments. These results indicate that patients can maintain comparable performance on the IGT after TBI. Therefore we found dissociations in hot and cold executive components.