Working memory capacity links cognitive reserve with long-term memory in moderate to severe TBI: a translational approach

Traumatic brain injury (TBI) can have devastating negative consequences on an individuals’ ability to remember information; however, there is variability among memory impairment resulting from TBI. Some individuals exhibit long-term memory (LTM) impairment while others do not. This variability has been explained, at least in part, by the theory of cognitive reserve (CR). The theory suggests that individuals who have spent significant time engaged in intellectually enriching activities (higher CR) are better able to withstand LTM impairment despite neurological injury. The cognitive mechanisms that underlie this relationship are not well-specified. Recent evidence suggests that working memory (WM) capacity may be one mediating variable that can help explain how/why cognitive reserve (CR) protects against LTM impairment. The present research tested this hypothesis in a sample of fifty moderate to severe TBI patients. Specific neuropsychological tests were administered to estimate CR, LTM and WM. The results were congruent with a recent theoretical model that implicates WM capacity as a mediating variable in the relationship between CR and LTM (Sobel’s Z = 2.62, p = 0.009). These data corroborate recent findings in an alternate neurological population and suggest that WM is an underlying mechanism of CR. Additional research is necessary to establish whether (1) WM is an important individual difference variable to include in memory rehabilitation trials and (2) to determine whether rehabilitation and treatment strategies that specifically target WM may also lead to complimentary improvements on diagnostic tests of delayed LTM in TBI and other memory impaired populations.