Non-pharmacological interventions for depression in adults and children with traumatic brain injury

Gertler, Paul; Tate, Robyn; Cameron, Ian D.

doi:10.1002/14651858.cd009871

Cited by 13 publications

(19 citation statements)

References 23 publications

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“…The TBI‐plus‐depressive symptoms group showed reduced BDI‐II scores over time relative to the controls (Figure a), consistent with previous studies in the remediation of depression following training in individuals after TBI (Ashman et al, ; D'Antonio et al, ; Fann et al, ; Ponsford et al, ; Tiersky et al, ; Topolovec‐Vranic et al, ). A weakness of several prior studies has been the lack of control groups (Fann et al, ; Gertler et al, ). We utilized an active control group (i.e., the TBI‐only group) who underwent the same intervention programs and assessed group‐by‐time interaction effects—the gold standard for training‐induced changes.…”

Section: Discussionmentioning

confidence: 99%

“…Psychological intervention (Clark & Beck, ) is one of the promising options to treat depression in individuals with TBI, though more research is needed to provide stronger evidence for its efficacy (Fann, Hart, & Schomer, ; Gertler, Tate, & Cameron, ). Cognitive behavioral therapy (CBT) is a popular psychological intervention for depression.…”

Section: Introductionmentioning

confidence: 99%

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Neural correlates of reduced depressive symptoms following cognitive training for chronic traumatic brain injury

Han

Martínez

Chapman

et al. 2018

Human Brain Mapping

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Depression is the most frequent comorbid psychiatric condition among individuals with traumatic brain injury (TBI). Yet, little is known about changes in the brain associated with reduced depressive symptoms following rehabilitation for TBI. We identified whether cognitive training alleviates comorbid depressive symptoms in chronic TBI (>6 months post‐injury) as a secondary effect. Further, we elucidated neural correlates of alleviated depressive symptoms following cognitive training. A total of seventy‐nine individuals with chronic TBI (53 depressed and 26 non‐depressed individuals, measured using the Beck Depressive Inventory [BDI]), underwent either strategy‐ or information‐based cognitive training in a small group for 8 weeks. We measured psychological functioning scores, cortical thickness, and resting‐state functional connectivity (rsFC) for these individuals before training, immediately post‐training, and 3 months post‐training. After confirming that changes in BDI scores were independent of training group affiliation, we identified that the depressive‐symptoms group showed reductions in BDI scores over time relative to the non‐depressed TBI controls (p < .01). Within the depressive‐symptoms group, reduced BDI scores was associated with improvements in scores for post‐traumatic stress disorder, TBI symptom awareness, and functional status (p < .00625), increases in cortical thickness in four regions within the right prefrontal cortex (p vertex < .01, p cluster<.05), and decreases in rsFC with each of these four prefrontal regions (p vertex < .01, p cluster < .0125). Overall, these findings suggest that cognitive training can reduce depressive symptoms in TBI even when the training does not directly target psychiatric symptoms. Importantly, cortical thickness and brain connectivity may offer promising neuroimaging markers of training‐induced improvement in mental health status in TBI.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Neural correlates of reduced depressive symptoms following cognitive training for chronic traumatic brain injury

Han

Martínez

Chapman

et al. 2018

Human Brain Mapping

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“…Studies investigating its use in stroke, cerebral palsy, neurodegenerative disease, chronic pain, addictions, and anxiety have also shown much promise. TMS was FDA cleared for prevention and acute treatment in migraine with aura (sTMS) in 2014 through use of a handheld, patient administered device, and for treatment‐resistant depression (rTMS) in 2011 …”

Section: Introductionmentioning

confidence: 99%

Transcranial Magnetic and Direct Current Stimulation (TMS/tDCS) for the Treatment of Headache: A Systematic Review

et al. 2019

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Background Headache is among the most prevalent causes of disability worldwide. Non‐pharmacologic interventions, including neuromodulation therapies, have been proposed in patients who are treatment resistant or intolerant to medications. Objective To perform a systematic review on the use of transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) for the treatment of specific headache disorders (ie, migraine, tension, cluster, posttraumatic). Methods Data sources: Ovid MEDLINE, Cochrane Central Register of Clinical Trials, Embase, Scopus, PsycINFO. Data extraction: All references were reviewed by 2 independent researchers (3039 abstracts, duplicates removed). Records were selected by inclusion criteria for participants (adults 18‐65 with primary or secondary headaches), interventions (TMS and tDCS applied as headache treatment), comparators (sham or alternative standard of care), and study type (cohort, case‐control, and randomized controlled trials [RCT]). Studies were assessed using the Cochrane Risk of Bias Tool and overall quality determined through the GRADE Tool. A structured synthesis was performed due to heterogeneity of participants and methods. Results Thirty‐four studies were included: 16 rTMS, 6 TMS (excluding rTMS), and 12 tDCS. The majority investigated treatment for migraine (19/22 TMS, 8/12 tDCS). Quality of evidence ranged from very low to high. Conclusion Of all TMS and tDCS modalities, rTMS is most promising with moderate evidence that it contributes to reductions in headache frequency, duration, intensity, abortive medication use, depression, and functional impairment. However, only few studies reported changes greater than sham treatment. Further high‐quality RCTs with standardized protocols are required for each specific headache disorder to validate a treatment effect. Registration Number: PROSPERO 2017 CRD42017076232.

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“…Studies that are included in reviews and often cited as treatment outcome studies for depression that occurs after TBI lack the methodological rigor required to develop treatment guidelines. A more recent systematic review on behavioral interventions for depression after TBI by Gertler et al 37 resulted in 19 studies, [38][39][40][41][42][43][44][45][46][47][48] reporting outcomes on a depression measure; only 4 of the studies involved a behavioral intervention specifically designed to target depression. Only 2 studies met criteria for inclusion in the review, both of which involved pharmacological interventions.…”

mentioning

confidence: 99%

Comparison of Cognitive Behavioral Therapy and Supportive Psychotherapy for the Treatment of Depression Following Traumatic Brain Injury

Ashman¹,

Cantor²,

Tsaousides³

et al. 2014

Journal of Head Trauma Rehabilitation

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Both forms of psychotherapy were efficacious in improving diagnoses of depression and anxiety and reducing depressive symptoms. These findings suggest that in this sample of individuals with TBI, CBT was not more effective in treating depression than SPT, though further research is needed with larger sample sizes to identify different components of these interventions that may be effective with different TBI populations. ClinicalTrials.gov Identifier: NCT00211835.

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Non-pharmacological interventions for depression in adults and children with traumatic brain injury

Cited by 13 publications

References 23 publications

Neural correlates of reduced depressive symptoms following cognitive training for chronic traumatic brain injury

Neural correlates of reduced depressive symptoms following cognitive training for chronic traumatic brain injury

Transcranial Magnetic and Direct Current Stimulation (TMS/tDCS) for the Treatment of Headache: A Systematic Review

Comparison of Cognitive Behavioral Therapy and Supportive Psychotherapy for the Treatment of Depression Following Traumatic Brain Injury

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