Research Reports - The use of diffusion tensor imaging to investigate depression after traumatic brain injury

Hum Brain Mapp. 2012 Sep 24

Maller JJ, Thomson RH, Pannek K, Rose SE, Bailey N, Lewis PM, Fitzgerald PB

Background: Many people with a traumatic brain injury (TBI), even mild to
moderate, will develop major depression (MD). Recent studies of patients with MD
suggest reduced fractional anisotropy (FA) in dorsolateral prefrontal cortex
(DLPFC), temporal lobe tracts, midline, and capsule regions. Some of these
pathways have also been found to have reduced FA in patients with TBI. It is
unknown whether the pathways implicated in MD after TBI are similar to those with
MD without TBI. This study sought to investigate whether there were specific
pathways unique to TBI patients who develop MD. Methods: A sample of TBI-MD
subjects (N = 14), TBI-no-MD subjects (N = 12), MD-no-TBI (N = 26), and control
subjects (no TBI or MD, N = 23), using a strict measurement protocol underwent
psychiatric assessments and diffusion tensor brain Magnetic Resonance Imaging
(MRI). Results: The findings of this study indicate that (1) TBI patients who
develop MD have reduced axial diffusivity in DLPFC, corpus callosum (CC), and
nucleus accumbens white matter tracts compared to TBI patients who do not develop
MD and (2) MD patients without a history of TBI have reduced FA along the CC. We
also found that more severe MD relates to altered radial diffusivity.
Conclusions: These findings suggest that compromise to specific white matter
pathways, including both axonal and myelination aspects, after a mild TBI
underlie the susceptibility of these patients developing MD.
 

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