Journal of the International Neuropsychological Society

Working memory after severe traumatic brain injury

CLAIRE  VALLAT-AZOUVI  a1 a2 a4 , THOMAS  WEBER  a1 a3 , LUDOVIC  LEGRAND  a1 a3 and PHILIPPE  AZOUVI  a2 a3 a4 c1
a1 Antenne UEROS-UGECAM Hôpital Raymond Poincaré, Garches, France
a2 INSERM U 731, Paris, France
a3 Service de Médecine Physique et de Réadaptation, Université de Versailles Saint Quentin; AP-HP, Hôpital Raymond Poincaré, Garches, France
a4 Université Paris 6, Faculté de Médecine, Laboratoire de Physiologie et Physiopathologie de la Motricité, Paris

Article author query
vallat-azouvi c   [PubMed][Google Scholar] 
weber t   [PubMed][Google Scholar] 
legrand l   [PubMed][Google Scholar] 
azouvi p   [PubMed][Google Scholar] 


The aim of the present study was to assess the functioning of the different subsystems of working memory after severe traumatic brain injury (TBI). A total of 30 patients with severe chronic TBI and 28 controls received a comprehensive assessment of working memory addressing the phonological loop (forward and backward digit span; word length and phonological similarity effects), the visuospatial sketchpad (forward and backward visual spans), and the central executive (tasks requiring simultaneous storage and processing of information, dual-task processing, working memory updating). Results showed that there were only marginal group differences regarding the functioning of the two slave systems, whereas patients with severe TBI performed significantly poorer than controls on most central executive tasks, particularly on those requiring a high level of controlled processing. These results suggest that severe TBI is associated with an impairment of executive aspects of working memory. The anatomic substrate of this impairment remains to be elucidated. It might be related to a defective activation of a distributed network, including the dorsolateral prefrontal cortex. (JINS, 2007, 13, 770–780.)

(Received September 13 2006)
(Revised March 6 2007)
(Accepted March 6 2007)

Key Words: Head injury; Executive functions; Attention; Divided attention; Central executive; Short-term memory.

c1 Correspondence and reprint requests to: Philippe Azouvi, Service de Médecine Physique et de Réadaptation, Hôpital Raymond Poincaré, Garches, 92380 France. E-mail: