This is a part of the Hot Topic podcast series from the Model Systems Knowledge Translation Center on Changes in Memory After TBI. Dr. David Arciniegas discusses Make Sure It Is a Memory Problem.

When people present to clinicians complaining of memory problems after TBI, one of the most important things we need to do right out of the gate is make sure that, in fact, the problem is a memory problem. Many things get talked about as memory problems after brain injury that actually have better explanations. So for example, word-finding difficulties.

This is really probably a language problem rather than a memory problem and entails different treatments than a memory disorder would. Sometimes people do have significant troubles with attention after brain injury. Not surprisingly, most of us can understand that if you can't pay attention, you probably won't remember the thing you weren't paying attention to.

So if indeed the problem is attention, that, too, has different treatments involved than memory treatments. Sometimes the problem is speed of information processing has slowed down. There's a whole anatomy to that as well. But it's a really common problem for people after injuries that they're not able to keep up with information at the same rate that they used to.

And as a result, if people are moving too quickly around them, if the information they're given is being presented faster than they can keep up with, they will appear to have a memory problem. It's not that they can't remember. It's that they can't remember when the information is presented too quickly.

Similarly, when people have significant emotional disturbances and distress after brain injury, they will interfere with memory, as well as other cognitive abilities. Depression is perhaps one of the biggest treatable, reversible causes of memory problems after brain injury. So when we see somebody who is complaining of memory but actually looks quite depressed or quite anxious, getting at those problems may actually eliminate the need to go after the memory problems specifically, or at least reduce the kinds of treatments that we need to offer to get memory in better shape.

Similarly, substance use – it's a really common problem in our society in general, and it turns out to be an even more common problem among some persons who had brain injuries. It's a cause of injury in some contexts, and it can be a response as well. When people are actively using alcohol or marijuana or other drugs that interfere with memory, it's very hard to treat those memory problems while those drugs are still being used.

So looking for, hearing and eliminating those things so that we can really see what the memory problem is after brain injury – the brain injury part of it, if you will – can help us organize our treatments and get to the right problem in the right way as quickly as we can.

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