If you’ve ever gotten a concussion before–maybe during sports or even a car crash–you know it can be an incredibly disorienting experience. You might be dazed, feel nauseous, and even lose your memory temporarily. Luckily, there’s a good chance you’ll recover in just a few days or weeks. However, a significant amount of people don’t–suffering from long-lasting and unseen symptoms for the rest of their lives.
Depression is one of the issues. Studies have shown that incidence of the symptom emerges in half of patients within a year of a traumatic brain injury (TBI). Nearly 66 percent show signs of depression within seven years following the injury.
This can be for a variety of reasons, such as an emotional response to the trauma of a brain injury, or a patient’s genetic predisposition to depression. A new study indicates that this issue may be deeper.
A paper was published on Wednesday by an international research team in the journal Science Translational Medicine . The findings showed that depression brain circuits differed in patients who had TBI compared to those who did not. The findings suggest that depression caused by brain injury may be a different kind of mental disorder altogether than what follows from other causes such as genetics or PTSD.
This may lead to more effective, targeted treatment for people with TBI.
“Many doctors have suspected this disorder is clinically unique, with unique symptoms and treatment responses, such as a poor response to antidepressants,” Shan Siddiqi said, assistant professor of psychology at Harvard Medical School, and coauthor of the study. “But until now, we didn’t have clear physiological evidence to prove this.”
The study involved 273 adult patients with TBI from a variety of causes including car accidents and sports related injuries. The participants were given an MRI that analyzed 200,000 points of their brains at roughly 1,000 different times. This resulted in 200 million data points per patient. These results were compared to data collected from groups that had no TBI or depression. They also compared them with data obtained from a TBI group and a depression group without TBI.
According to the authors, the TBI group showed the same location as the non-TBI group in terms of depression, but the connectivity between this brain circuit and those with TBI was higher. The difference was so distinct that the researchers even proposed a new name for the malady: TBI affective syndrome.
“Our results help explain why physical trauma in specific brain circuits may lead to depression, Siddiqi said. “If we’re right, it means that we should be treating depression after TBI like a distinct disease.”
The authors are already using this method of brain mapping in order to help personalize new treatments for patients. Transcranial Magnetic Stimulation is one of these treatments. It involves zapping large magnets into the brain. In past studies, this process was shown to improve depression symptoms.
Siddiqui and one of his co-authors even used the method to treat 15 patients in a pilot trial–and saw great success with the treatment. The researchers hope to replicate this study and build on the success of their pilot trial in a military multicenter trial.
“I have always suspected that it’s not the same thing as major depression or any other mental conditions unrelated to traumatic head injury,” said co-author David Brody. Brody is a neurosurgeon at Uniformed Services University, Bethesda in Maryland. “There’s still a lot we don’t understand, but we’re starting to make progress.”
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