Temporal lobe activation during episodic memory encoding following traumatic brain injury.

The temporal lobes are critical for encoding and retrieving episodic memories. The temporal lobes are preferentially disrupted following a traumatic brain injury (TBI), likely contributing to the difficulties observed in episodic memory. However, the underlying neural changes that precipitate or maintain these difficulties in individuals with TBI remains poorly understood. Here, we use functional magnetic resonance imaging (fMRI) to interrogate the relationship between temporal lobe activation and encoding of episodic stimuli. Participants encoded face, scene, and animal stimuli during an fMRI run. In an out-of-scanner task, participants were required to correctly identify previously displayed stimuli over two presentation runs (each in-scanner stimuli presented twice). Forty-three patients with moderate-severe TBI were recruited and compared with 38 demographically similar healthy controls. The pattern of behavioural performance between groups depended on the stimuli presentation run. The TBI group demonstrated poorer episodic memory for faces and scenes during the first presentation, but not the second presentation. When episodic memory was analysed across all presentation runs, behavioural deficits were only apparent for faces. Interestingly, processing of faces emerged as the only between group-difference on fMRI, whereby TBI participants had an increased signal in the middle temporal gyrus extending to the superior temporal sulcus. These findings provide evidence to suggest that following TBI: (a) episodic memory is preferentially impaired for complex stimuli such as faces, and (b) robust behavioural inefficiencies are reflected in increased activation in specific temporal lobe structures during encoding.