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TBI Affective Disorder May Be Distinct From Traditional Depression, MDD
A new study has found physiological evidence that depression following traumatic brain injury (TBI) may be clinically distinct from traditional major depressive disorder (MDD), manifesting with unique symptoms and consequently requiring unique treatment responses. Findings were published in Science Translational Medicine.
"Our findings help explain how the physical trauma to specific brain circuits can lead to development of depression. If we're right, it means that we should be treating depression after TBI like a distinct disease," said corresponding author Shan Siddiqi, MD, Department of Psychiatry and Center for Brain Circuit Therapeutics, Brigham and Women’s Hospital, Boston, Massachusetts.
The study utilized brain mapping techniques to evaluate 273 adults with TBI from a variety of causes, like sports injuries, military injuries, and car accidents. This cohort of patients was compared to other cohorts, including people without TBI or depression, people with depression without TBI, and people with post-traumatic stress disorder.
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Study participants underwent resting-state functional magnetic resonance imaging data, which provided thorough information about how oxygen moves through the brain. A machine learning algorithm was then utilized to translate the more than 200 million data points from each patient into an individualized brain map.
After comparing the brain maps between cohorts, the researchers discovered a “distinct brain connectivity profile” in TBI-associated depression. The location of the brain circuit involved in depression was the same in people with TBI as those without. The nature of the abnormalities, however, was different between the two groups. TBI-associated depression exhibited decreased dorsal attention network (DAN)-subgenual cingulate connectivity, increased DAN-default mode network (DMN) connectivity, and the combined effect of both these characteristics.
“Our results support the possibility of a physiologically distinct ‘TBI affective syndrome,’ which may benefit from individualized neuromodulation approaches to target its distinct neural circuitry,” the authors concluded.
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