Major Depression Following Traumatic Brain Injury

Abstract

Major depression is a frequent complication of TBI that hinders a patient's recovery. It is associated with executive dysfunction, negative affect, and prominent anxiety symptoms. The neuropathological changes produced by TBI may lead to deactivation of lateral and dorsal prefrontal cortices and increased activation of ventral limbic and paralimbic structures including the amygdala.

Differences in Regional Brain Volumes Two Months and One Year after Mild Traumatic Brain Injury

“…It is thus suited for tracking structural volume changes in white/gray matter, long-term outcome prediction, and monitoring of disease/recovery progression in follow-up studies. 1 Although several studies have documented changes in brain structure and volume associated with moderate and severe TBI, 2 there have been very few studies addressing whether mild brain injury is associated with change in brain volume and if such changes are stable over time. This is of increasing interest given escalating concerns over potential long-term effects of even a single mild TBI.…”

Treatment for depression following mild traumatic brain injury in adults: A meta-analysis

“…In addition, it highlights the importance of controlled trials, as focusing solely on the studies using a pre-post design would suggest that treatments of depression post mild TBI are effective. Addressing depression post-TBI is important as there is an accumulation of evidence which suggests it is linked to poorer outcomes across a range of areas, including cognitive, psychosocial and functional outcomes (Jorge, Robinson et al 2004;Alderfer, Arciniegas et al 2005;Rapoport, Kiss et al 2006). Thus, there is a clear need for large randomised controlled trials of treatment for depression after mild TBI.…”

“…Development of depression post-TBI has been linked to poorer post-injury outcomes, including increased post-concussive symptoms and cognitive deficits (Rapoport, Kiss et al 2006), as well as poorer psychosocial and functional outcomes (Rapoport, McCullagh et al 2003;Jorge, Robinson et al 2004). Given this, treatment of depression post-TBI is clearly needed.…”

Trained innate immunity: a salient factor in the pathogenesis of neuroimmune psychiatric disorders

“…In humans, TBI is associated with microglial activation on positron emission tomography (PET) decades later, 51 and is a risk factor for depression. 52 Microglia isolated from mice that had been injected peripherally with LPS 1 month after TBI showed increased IL-1β and TNF-α mRNA expression relative to microglia from LPS exposed only mice. 53 This heightened microglial activity was accompanied by depressivelike behaviors in the mice.…”