Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States.
Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States; Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States.
Neuroimage Clin. 2018 May 9;19:434-442. doi: 10.1016/j.nicl.2018.05.011. eCollection 2018.
Acute mood disturbance following sport-related concussion is common and is known to adversely affect post-concussion symptoms and recovery. The physiological underpinnings of depressive symptoms following concussion, however, are relatively understudied. We hypothesized that functional connectivity of the emotional processing network would be altered in concussed athletes and associated with the severity of depressive symptoms following concussion. Forty-three concussed collegiate athletes were assessed at approximately one day ( = 34), one week ( = 34), and one month post-concussion ( = 30). Fifty-one healthy contact-sport athletes served as controls and completed a single visit. The Hamilton Rating Scale for Depression (HAM-D) was used to measure depressive symptoms. Resting state fMRI data was collected on a 3 T scanner (TR = 2 s) and functional connectivity was calculated in a meta-analytically derived network of regions associated with emotional processing. Concussed athletes had elevated depressive symptoms across the first month post-concussion relative to control athletes, but showed partial recovery by one month relative to more acute visits (s < 0.05). Concussed athletes had significantly different connectivity in regions associated with emotional processing at one month post-concussion relative to one day post-concussion ( = 0.002) and relative to controls ( = 0.003), with higher connectivity between default mode and attention regions being common across analyses. Additionally, depressive symptoms in concussed athletes at one day ( = 0.003) and one week post-concussion ( = 7 × 10) were inversely correlated with connectivity between attention (e.g., right anterior insula) and default mode regions (e.g., medial prefrontal cortex). Finally, the relationships with HAM-D scores were not driven by a general increase in somatic complaints captured by the HAM-D, but were strongly associated with mood-specific HAM-D items. These results suggest that connectivity of emotional processing regions is associated with acute mood disturbance following sport-related concussion. Increased connectivity between attention and default mode regions may reflect compensatory mechanisms.
运动相关性脑震荡后急性情绪障碍很常见，已知会对脑震荡后症状和恢复产生不利影响。然而，脑震荡后抑郁症状的生理基础相对研究较少。我们假设，脑震荡运动员的情绪处理网络功能连接会发生改变，并与脑震荡后抑郁症状的严重程度相关。43 名患有脑震荡的大学生运动员在大约一天（n=34）、一周（n=34）和一个月（n=30）后接受评估。51 名健康的接触性运动运动员作为对照组，仅接受一次检查。汉密尔顿抑郁量表（HAM-D）用于测量抑郁症状。静息态 fMRI 数据在 3T 扫描仪上采集（TR=2s），并在元分析确定的与情绪处理相关的区域网络中计算功能连接。与对照组相比，脑震荡运动员在脑震荡后第一个月的抑郁症状明显升高，但与更急性的就诊相比，在一个月时有所恢复（s<0.05）。与脑震荡后一天相比，脑震荡运动员在一个月时与情绪处理相关的区域的连接有显著差异（p=0.002），与对照组相比（p=0.003），默认模式和注意力区域之间的连接更高，在所有分析中都很常见。此外，脑震荡运动员在脑震荡后一天（p=0.003）和一周（p=7×10）的抑郁症状与注意力（如右前岛叶）和默认模式区域（如内侧前额叶皮质）之间的连接呈负相关。最后，与 HAM-D 评分的关系不是由 HAM-D 中捕获的一般躯体抱怨增加驱动的，而是与情绪特异性 HAM-D 项目密切相关。这些结果表明，情绪处理区域的连接与运动相关性脑震荡后急性情绪障碍有关。注意力和默认模式区域之间连接的增加可能反映了代偿机制。
