Analogical Reasoning in Chronic Traumatic Brain Injury: An Evaluation of Similarity Judgments, Eye-Tracking, and Clinical Sequelae

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2019-05

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Abstract

One of challenges of conditions like chronic mild-to-moderate traumatic brain injury (mTBI) is identifying and measuring cognitive deficits associated with the condition. It is not uncommon for individuals in the chronic phase of mTBI to report subjective complaints of cognitive deficits while their performance is within normal ranges on standard neuropsychological assessments. This suggests that these assessments may not be sufficiently challenging or otherwise are unable to detect performance differences in those with mTBI. Analogical reasoning is a cognitive function that is challenging, while being something familiar to many individuals. Analogical reasoning assessments have previously differentiated between individuals with clinical conditions like TBI. I co-created a visual task of analogical reasoning, called the Similar Situations Task (SST), to better identify and measure deficits in cognitive functioning. The development and design of the SST are explained in full. Successful performance on the SST required participants to encode a specific item in relational depictions of items interacting with each other in a source scene, and then identify an analogous object in a similar relationship in a target scene, with the possibility of no analogous item. Preliminary and pilot testing of the SST indicated that it is a reliable assessment and it is sufficiently challenging for a neuro-typical adult population. Because it is a visual task, eye-tracking was used in conjunction with the SST for the goal of providing additional cognitive performance measures by which to differentiate an mTBI group from a comparison non-TBI group. Scene relations were used as areas of interest for eye-tracking metrics that included measures of gaze, fixation, and saccades. Gaze was used to identify memory encoding, fixation to identify memorization and processing, and saccades to identify attention and additional effort. Measures of clinical symptoms, primarily those of depression and anxiety, were also measured, since there is a high rate of these symptoms in the chronic phase of mTBI and because these symptoms could be a source of additional deficits. Results indicated that while accuracy rates were not found to be significantly different between the mTBI group and the comparison group, the mTBI group did display differences in cognitive functioning as measured by increased fixation durations, counts, and saccadic fixation revisits. These results indicate differences in task efficiency and increased cognitive effort needed to complete this task. These results suggest that measuring eye-tracking on a test of analogical reasoning like the SST is able to capture differences in mTBI cognition that were not evident in static measures of accuracy or in simpler tests of performance and reaction time.

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