Jilin Provincial Key Laboratory on Molecular and Chemical Genetic, The Second Hospital of Jilin University, Changchun, China; Hand Surgery Department, The Second Hospital of Jilin University, Changchun, Jilin Province, China.
Jilin Provincial Key Laboratory on Molecular and Chemical Genetic, The Second Hospital of Jilin University, Changchun, China; Hand Surgery Department, The Second Hospital of Jilin University, Changchun, Jilin Province, China.
Eur J Pharmacol. 2019 Dec 15;865:172775. doi: 10.1016/j.ejphar.2019.172775. Epub 2019 Nov 2.
Individuals with traumatic brain injury (TBI) manifest a high incidence of depression, which is associated with an impaired recovery from TBI and a lower quality of life. Several neurobiological changes in patients with TBI contribute a form of depression that is unique to that of general depression. This is evinced by the poor efficacy of antidepressants in treating post-TBI depression relative to general depression. In general, however, the treatment of post-TBI depression has received relatively scattered attention in the literature. The purpose of this review is thus to discuss about the possible pathology of depression following TBI and summarize the recent findings on the treatment of it in clinical studies. While both pharmacological and non-pharmacological approaches can reportedly attenuate depressive symptoms in patients with TBI to a moderate extent, the various limitations of such studies require that further well-powered, randomized controlled trials with larger sample sizes and longer follow-ups are warranted to investigate the exact pathophysiology underlying post-TBI depression, the mechanism underlying treatment efficacy, and the optimal pharmacological and non-pharmacological interventions for this population. A combination of different treatments in a comprehensive therapeutic regimen may be an optimal direction for future research.
颅脑损伤（TBI）患者抑郁发生率高，与 TBI 恢复不良和生活质量下降有关。TBI 患者存在多种神经生物学改变，导致其抑郁形式有别于一般抑郁。这表现在抗抑郁药治疗 TBI 后抑郁的疗效相对较差，而一般抑郁的疗效则较好。然而，一般来说，TBI 后抑郁的治疗在文献中受到的关注相对分散。因此，本综述旨在讨论 TBI 后抑郁的可能发病机制，并总结临床研究中关于其治疗的最新发现。虽然据报道，药物和非药物治疗均可在一定程度上减轻 TBI 患者的抑郁症状，但这些研究存在各种局限性，因此需要进一步进行更大样本量、更长随访时间的精心设计、随机对照试验，以探讨 TBI 后抑郁的确切病理生理学、治疗效果的机制以及针对该人群的最佳药物和非药物干预措施。综合治疗方案中不同治疗方法的联合可能是未来研究的一个最佳方向。
