Lee Bern, Bennett Lauren L, Bernick Charles, Shan Guogen, Banks Sarah J
University of Nevada, Las Vegas (Mr Lee); Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, Nevada (Drs Bennett and Bernick and Mr Lee); Department of Environmental and Occupational Health, School of Community Health Sciences, University of Nevada, Las Vegas (Dr Shan); and Multidisciplinary Memory Clinic, Department of Neurosciences, University of California San Diego, La Jolla (Dr Banks).
J Head Trauma Rehabil. 2019 Nov/Dec;34(6):E29-E39. doi: 10.1097/HTR.0000000000000495.
Depression, neuropathology, and cognitive decline are commonly observed with repetitive head injuries (RHIs). We examined whether in boxers (a) clinically significant depression is associated with structural brain changes and cognition; (b) minimal symptoms of depression moderate the relations among RHI and brain volumes and cognition; and (c) baseline depression is associated with longitudinal cognitive changes.
Clinical Research Center.
A total of 205 male professional boxers.
Cross-sectional and longitudinal (subsample: n = 45; first visit to follow-up range = 1-6 years; mean = 2.61 years).
Patient Health Questionnaire-9 depression; CNS Vital Signs cognitive battery; brain imaging.
Clinically significant depression was associated with smaller regional volumes in insula, cingulate, orbitofrontal cortex, thalami, and middle corpus-callosum subregions; and with poorer verbal memory and psychomotor speed performance. Depression symptoms moderated the relations between RHI and bilateral thalami, left hippocampus, left medial orbitofrontal cortex, and bilateral insula volumes; but not cognition. Baseline depression was associated with poorer psychomotor speed and reaction time longitudinally and improved verbal memory performance longitudinally.
Clinical depression is associated with volumetric and cognitive changes occasioning RHI exposure, and even minimal depressive symptoms may moderate the relations between exposure and brain volumes in key regions. Longitudinally, there is preliminary evidence that depression precedes cognitive changes.
重复性头部损伤（RHI）常伴有抑郁、神经病理学改变和认知功能下降。我们研究了拳击运动员中：（a）具有临床意义的抑郁症是否与脑结构改变和认知功能相关；（b）轻度抑郁症状是否会调节RHI与脑容量和认知功能之间的关系；（c）基线抑郁是否与认知功能的纵向变化相关。
临床研究中心。
共205名男性职业拳击运动员。
横断面研究和纵向研究（子样本：n = 45；首次就诊至随访时间范围 = 1 - 6年；平均 = 2.61年）。
患者健康问卷 - 9抑郁量表；CNS生命体征认知测试组；脑成像。
具有临床意义的抑郁症与岛叶、扣带回、眶额皮质、丘脑和胼胝体中部亚区的区域体积较小有关；与较差的言语记忆和精神运动速度表现有关。抑郁症状调节了RHI与双侧丘脑、左侧海马体、左侧眶额内侧皮质和双侧岛叶体积之间的关系；但未调节与认知功能的关系。基线抑郁与纵向较差的精神运动速度和反应时间有关，与纵向言语记忆表现改善有关。
临床抑郁症与RHI暴露引起的体积和认知变化有关，即使是轻微的抑郁症状也可能调节暴露与关键区域脑容量之间的关系。纵向来看，有初步证据表明抑郁先于认知变化出现。
