Rehabilitation Science, McMaster University, 1400 Main Street West, Hamilton, Ontario L8S 1C7, Canada.
Psychology, Neuroscience & Behaviour, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4L8, Canada.
Int J Psychophysiol. 2018 Oct;132(Pt A):62-73. doi: 10.1016/j.ijpsycho.2017.09.021. Epub 2017 Oct 3.
Following concussion, adolescents may experience both poor inhibitory control and increased depressive symptoms. fMRI research suggests that adolescents with major depressive disorder have abnormal physiological responses in the frontostriatal pathway, and exhibit poorer inhibitory control in the presence of negatively-aroused images. The scarcity of information surrounding depression following concussion in adolescents makes it difficult to identify patients at risk of depression after injury. This is the first study to examine neural activity patterns in adolescents with post-concussive depressive symptoms.
To explore the effect of depressive symptoms on inhibitory control in adolescents with concussion in the presence of emotional stimuli using fMRI.
Using a prospective cohort design, 30 adolescents diagnosed with concussion between 10 and 17years were recruited. The Children's Depression Inventory questionnaire was used to divide participants into two groups: average or elevated levels of depressive symptoms. Participants completed an Emotional Go/No-Go task involving angry or neutral faces in a 3Telsa MRI scanner.
Eleven participants had elevated depressive symptoms, of which 72% were hit in the occipital region of the head at the time of injury. fMRI results from the Emotional Go/No-Go task revealed activity patterns in the overall sample. Faces activated regions associated with both facial and cognitive processing. However, frontal regions that are usually associated with inhibitory control were not activated. Adolescents with elevated levels of depressive symptoms engaged more frontal lobe regions during the task than the average group. They also showed a trend towards worse symptoms following MRI scanning.
Adolescents with elevated depressive symptoms engaged brain regions subserving evaluative processing of social interactions. This finding provides insight into the role the environment plays in contributing to the cognitive demands placed on adolescents recovering from concussion.
脑震荡后，青少年可能同时出现抑制控制能力差和抑郁症状增加的情况。功能磁共振成像研究表明，患有重度抑郁症的青少年在前脑-纹状体通路中存在异常的生理反应，并且在呈现负性唤起的图像时表现出较差的抑制控制能力。青少年脑震荡后抑郁相关信息的缺乏使得难以识别受伤后有抑郁风险的患者。这是第一项研究青少年脑震荡后抑郁症状的神经活动模式的研究。
使用 fMRI 研究抑郁症状对伴有情绪刺激的青少年脑震荡后抑制控制的影响。
采用前瞻性队列设计，招募了 30 名年龄在 10 至 17 岁之间被诊断为脑震荡的青少年。使用儿童抑郁量表问卷将参与者分为两组：抑郁症状平均水平或升高水平。参与者在 3Telsa 磁共振成像扫描仪中完成了一项涉及愤怒或中性面孔的情绪 Go/No-Go 任务。
11 名参与者有较高的抑郁症状，其中 72%在受伤时头部的枕叶区域被击中。情绪 Go/No-Go 任务的 fMRI 结果显示了整个样本的活动模式。面孔激活了与面部和认知处理都相关的区域。然而，通常与抑制控制相关的额区没有被激活。与平均组相比，抑郁症状升高的青少年在任务中更多地参与了额区。他们在 MRI 扫描后也表现出症状恶化的趋势。
抑郁症状升高的青少年参与了处理社会互动的评价处理的脑区。这一发现为环境在为从脑震荡中恢复的青少年提供认知需求方面所起的作用提供了深入了解。
