@article{ref1,
title="Impaired visual integration in children with traumatic brain injury: an observational study",
journal="PLoS one",
year="2015",
author="Königs, Marsh and Weeda, Wouter D. and van Heurn, L. W. Ernest and Vermeulen, R. Jeroen and Goslings, J. Carel and Luitse, Jan S. K. and Poll-Thé, Bwee Tien and Beelen, Anita and van der Wees, Marleen and Kemps, Rachèl J. J. K. and Catsman-Berrevoets, Coriene E. and Oosterlaan, Jaap",
volume="10",
number="12",
pages="e0144395-e0144395",
abstract="BACKGROUND: Axonal injury after traumatic brain injury (TBI) may cause impaired sensory integration. We aim to determine the effects of childhood TBI on visual integration in relation to general neurocognitive functioning. <br><br>METHODS: We compared children aged 6-13 diagnosed with TBI (n = 103; M = 1.7 years post-injury) to children with traumatic control (TC) injury (n = 44). Three TBI severity groups were distinguished: mild TBI without risk factors for complicated TBI (mildRF- TBI, n = 22), mild TBI with ≥1 risk factor (mildRF+ TBI, n = 46) or moderate/severe TBI (n = 35). An experimental paradigm measured speed and accuracy of goal-directed behavior depending on: (1) visual identification; (2) visual localization; or (3) both, measuring visual integration. Group-differences on reaction time (RT) or accuracy were tracked down to task strategy, visual processing efficiency and extra-decisional processes (e.g. response execution) using diffusion model analysis. General neurocognitive functioning was measured by a Wechsler Intelligence Scale short form. <br><br>RESULTS: The TBI group had poorer accuracy of visual identification and visual integration than the TC group (Ps ≤.03; ds ≤ -0.40). Analyses differentiating TBI severity revealed that visual identification accuracy was impaired in the moderate/severe TBI group (P =.05, d = -0.50) and that visual integration accuracy was impaired in the mildRF+ TBI group and moderate/severe TBI group (Ps <.02, ds ≤ -0.56). Diffusion model analyses tracked impaired visual integration accuracy down to lower visual integration efficiency in the mildRF+ TBI group and moderate/severe TBI group (Ps <.001, ds ≤ -0.73). Importantly, intelligence impairments observed in the TBI group (P =.009, d = -0.48) were statistically explained by visual integration efficiency (P =.002). <br><br>CONCLUSIONS: Children with mildRF+ TBI or moderate/severe TBI have impaired visual integration efficiency, which may contribute to poorer general neurocognitive functioning.<p /> <p>Language: en</p>",
language="en",
issn="1932-6203",
doi="10.1371/journal.pone.0144395",
url="http://dx.doi.org/10.1371/journal.pone.0144395"
}