Brain activations in errorless and errorful learning in patients with diffuse axonal injury: a functional MRI study.

PRIMARY OBJECTIVE Errorless learning has been reported to be effective in the rehabilitation of patients with impaired cognitive functions following brain injury. This study compared brain activations in errorless learning (EL) and errorful learning (EF) in patients with diffuse axonal injury (DAI) using a functional magnetic resonance imaging (fMRI). METHODS AND PROCEDURES The participants were 13 patients with DAI. Thirteen healthy individuals were evaluated as a control group. The participants learned words under the EL and EF conditions in advance and performed the recognition task during fMRI scanning. MAIN OUTCOMES AND RESULTS EL in the control group was significantly faster than EF (p = 0.005), but not in the DAI group. EL in the DAI group scored significantly higher than EF (p = 0.026). An fMRI showed significant activations in the posterior cingulate gyrus (BA 31) and precuneus (BA 7) in the control group when EF > EL, but in the precuneus (BA 7, 31) and bilateral inferior parietal lobules (BA 39, 40) in the DAI group. CONCLUSIONS These results indicate the disadvantage of EF and advantage of EL to DAI patients. The findings also reflect brain plasticity in patients with DAI in the chronic phase.