Capture by misleading information and its false acceptance in patients with traumatic brain injury

Exposure to misleading information, presented after a critical episode, can alter or impair memory reports about that episode. Here, we examine vulnerability to misleading information in patients with traumatic brain injury (TBI). The ability to initiate an effective retrieval strategy and inhibit irrelevant or interfering information requires participation from the prefrontal cortices, which are susceptible to damage following brain injury. We report that TBI patients are more prone to interference effects produced by misleading information during a cued-recall task and are more likely to accept this information as the product of 'remembering' compared with healthy controls. The results are consistent with a model proposing that patients are captured by highly accessible responses eliminating their opportunity to engage in recollection. Correlations between the cued-recall interference task and other executive measures helped elucidate the processes underlying 'capture'. In TBI patients, reduced recollection produced by a misleading prime was associated with impaired prospective remembering when engaged in a background task. A common functional deficit that may underlie poor performance on both tasks is the failure to inhibit previously relevant but currently irrelevant information. Subjective reports pertaining to the subject's cued-recall response were indexed by electrodermal activity. In control subjects, larger skin conductance responses (SCRs) were associated with a greater frequency of guess reports, suggesting that SCRs provide a marker for uncertainty regarding the candidacy of a selected response. TBI patients did not show this relationship, suggesting that impairments of post-retrieval evaluation might also underlie greater false acceptance of misinformation. Discussion focuses on the role of the prefrontal cortex and cognitive processes that mediate the selection and evaluation of memories.