Depressive symptoms following traumatic brain injury are associated with resting-state functional connectivity.

Lizhu Luo,Emmanuel A Stamatakis,Laura Moreno-Lopez,Christelle Langley,Barbara J Sahakian,Keith Kendrick,David K Menon

doi:10.1017/s0033291721004724

Abstract

To determine whether depressive symptoms in traumatic brain injury (TBI) patients were associated with altered resting-state functional connectivity (rs-fc) or voxel-based morphology in brain regions involved in emotional regulation and associated with depression. In the present study, we examined 79 patients (57 males; age range = 17-70 years, M ± s.d. = 38 ± 16.13; BDI-II, M ± s.d. = 9.84 ± 8.67) with TBI. We used structural MRI and resting-state fMRI to examine whether there was a relationship between depression, as measured with the Beck Depression Inventory (BDI-II), and the voxel-based morphology or functional connectivity in regions previously identified as involved in emotional regulation in patients following TBI. Patients were at least 4 months post-TBI (M ± s.d. = 15.13 ± 11.67 months) and the severity of the injury included mild to severe cases [Glasgow Coma Scale (GCS), M ± s.d. = 6.87 ± 3.31]. Our results showed that BDI-II scores were unrelated to voxel-based morphology in the examined regions. We found a positive association between depression scores and rs-fc between limbic regions and cognitive control regions. Conversely, there was a negative association between depression scores and rs-fc between limbic and frontal regions involved in emotion regulation. These findings lead to a better understanding of the exact mechanisms that contribute to depression following TBI and better inform treatment decisions.

Highlights

Traumatic brain injury (TBI) is a highly prevalent complex condition, affecting men and women of all ages and socioeconomic backgrounds worldwide (Nguyen et al, 2016)
In the present study, we aimed to determine whether depressive symptoms in traumatic brain injury (TBI) patients were associated with altered rs-fc or voxel-based morphology in brain regions involved in emotional regulation and associated with depression
We examined a large sample of patients with TBI, with a range of depressive symptoms, to determine whether depressive symptoms in TBI patients were associated with altered rs-fc patterns or voxel-based morphology in brain regions involved in emotional regulation and associated with depression

Summary

Introduction

Traumatic brain injury (TBI) is a highly prevalent complex condition, affecting men and women of all ages and socioeconomic backgrounds worldwide (Nguyen et al, 2016). There is a spectrum of severity associated with TBI, which is clinically assessed by the Glasgow Coma Scale (GCS) (Teasdale & Jennett, 1974). To determine whether depressive symptoms in traumatic brain injury (TBI) patients were associated with altered resting-state functional connectivity (rs-fc) or voxelbased morphology in brain regions involved in emotional regulation and associated with depression. We used structural MRI and resting-state fMRI to examine whether there was a relationship between depression, as measured with the Beck Depression Inventory (BDI-II), and the voxel-based morphology or functional connectivity in regions previously identified as involved in emotional regulation in patients following TBI. Our results showed that BDI-II scores were unrelated to voxel-based morphology in the examined regions. There was a negative association between depression scores and rs-fc between limbic and frontal regions involved in emotion regulation. These findings lead to a better understanding of the exact mechanisms that contribute to depression following TBI and better inform treatment decisions

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Conclusion