Spirou Angela, Chiaravalloti Nancy D, Dobryakova Ekaterina
Traumatic Brain Injury Research, Kessler Foundation, West Orange, New Jersey (Ms Spirou and Drs Chiaravalloti and Dobryakova); and Department of Physical Medicine and Rehabilitation, Rutgers, New Jersey Medical School, Newark (Drs Chiaravalloti and Dobryakova).
J Head Trauma Rehabil. 2019 Nov/Dec;34(6):E19-E28. doi: 10.1097/HTR.0000000000000482.
To examine the impact of depression on neural mechanisms associated with outcome processing (rewarding and punishing outcomes) in persons with traumatic brain injury (TBI).
Kessler Foundation's Rocco Ortenzio Neuroimaging Center.
A total of 16 adults with moderate to severe TBI.
Chicago Multiscale Depression Inventory (CMDI); Behavioral Inhibition/Behavioral Activation Scale (BIS/BAS); functional MRI of the head while performing a gambling task, with a reward (+$1.00) and punishment (-$0.50).
Individuals with TBI reporting high depressive symptomatology exhibited increased activation in the ventromedial prefrontal cortex (VMPFC) and striatum during presentation of rewarding outcomes compared with individuals with TBI reporting low depressive symptomatology. Punishing outcome presentation was not associated with any change in brain activation. No differences in volume of the striatum and VMPFC were observed between groups.
Current findings provide the first evidence of differences in neural mechanisms underlying outcome processing between individuals with TBI with and without depression. The results suggest that depressive symptomatology might have a different effect on individuals with TBI than what is typically observed in individuals without TBI reporting with depression, with the possibility of rewards becoming more reinforcing as depressive symptomatology increases. Future studies should explore the potential implications of behavioral responses to rewards and punishments in TBI and how they can affect rehabilitation approaches and activities of daily living.
研究抑郁症对创伤性脑损伤（TBI）患者与结果处理（奖励性和惩罚性结果）相关神经机制的影响。
凯斯勒基金会的罗科·奥滕齐奥神经影像中心。
共16名中重度TBI成年患者。
芝加哥多维度抑郁量表（CMDI）；行为抑制/行为激活量表（BIS/BAS）；在执行赌博任务（奖励1美元、惩罚0.5美元）时进行头部功能磁共振成像。
与报告低抑郁症状的TBI患者相比，报告高抑郁症状的TBI患者在呈现奖励性结果时腹内侧前额叶皮质（VMPFC）和纹状体激活增加。惩罚性结果呈现与大脑激活的任何变化均无关联。两组之间纹状体和VMPFC的体积无差异。
目前的研究结果首次证明了有抑郁症和无抑郁症的TBI患者在结果处理潜在神经机制上存在差异。结果表明，抑郁症状对TBI患者的影响可能与无TBI的抑郁症患者通常观察到的情况不同，随着抑郁症状的增加，奖励可能会变得更具强化作用。未来的研究应探讨TBI患者对奖励和惩罚的行为反应的潜在影响，以及它们如何影响康复方法和日常生活活动。
