A study led by Dr. Shan Siddiqi from Brigham and Women’s Hospital suggests that depression after a traumatic brain injury (TBI) could be a different disorder than traditional major depressive disorder.
This groundbreaking research could have major implications for how we treat patients with depression following a TBI.
The team of researchers, which also includes scientists from Washington University in St. Louis, Duke University School of Medicine, the University of Padua, and the Uniformed Services University of the Health Sciences, began this project seven years ago.
They initially started a small clinical trial to explore brain stimulation as a treatment for TBI patients with depression.
Over the course of their research, they noticed a specific pattern of abnormalities in the brain maps of these patients.
New Insights
Their most recent study included 273 adults who had experienced a TBI, often as a result of sports injuries, military injuries, or car accidents.
They compared this group to others who did not have a TBI or depression, people with depression without TBI, and people with post-traumatic stress disorder.
All participants underwent a resting-state functional connectivity MRI, which allowed the researchers to analyze brain activity based on oxygen movement.
The team found that the location of the brain circuit involved in depression was the same among people with TBI as people without TBI.
However, the nature of the abnormalities was different. People with depression and no TBI showed decreased connectivity in this circuit, while people with TBI-associated depression showed increased connectivity.
This discovery has led the researchers to suggest that TBI-associated depression could be a unique disease process, which they’ve proposed to name “TBI affective syndrome”.
Looking Forward
While the study is a significant step forward in understanding TBI-associated depression, there are limitations.
Given the vast amount of data collected, the researchers could not conduct in-depth assessments of each patient beyond brain mapping.
In the future, they hope to perform more detailed behavioral assessments and potentially define different types of TBI-associated neuropsychiatric syndromes.
Dr. Siddiqi and his team are also working on developing personalized treatments.
Their initial pilot study used brain mapping technology to target specific brain regions in people with TBI and depression using transcranial magnetic stimulation (TMS).
They enrolled 15 people in the pilot and have seen success with this treatment approach, which has led to further funding for a larger, multi-center military trial.
The team is optimistic about the potential of this research.
“We hope our discovery guides a precision medicine approach to managing depression and mild TBI, and perhaps even intervene in neuro-vulnerable trauma survivors before the onset of chronic symptoms,” said Dr. Rajendra Morey, a professor of psychiatry at Duke University School of Medicine and co-author on the study.
If you care about mental health, please read studies about 6 foods you can eat to improve mental health, and B vitamins could help prevent depression and anxiety.
For more information about mental health, please see recent studies about how dairy foods may influence depression risk, and results showing Omega-3 fats may help reduce depression.
The study was published in Science Translational Medicine.
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