Concussion Patients With Anxiety or Depression Show Unique Brain Injury Patterns

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New research published in the journal Radiology found individuals who experienced anxiety or depression after a concussion have distinct injury patterns, which in some cases resembled those of mental illness not traditionally associated with head trauma.


Brain CTE
“Mild traumatic brain injury, referred to as ‘concussion,’ affects nearly 3.8 million people in the United States annually,” Lea M. Alhilali, MD, of the University of Pittsburgh, and colleagues wrote. “While awareness of the cognitive consequences of concussive injuries has grown, the association with psychiatric disorders has failed to garner the attention given to associated neurodegenerative syndromes, such as Alzheimer dementia and chronic traumatic encephalopathy.”

For the study, the researchers conducted diffusion-tensor imaging and serial neurocognitive testing with 45 patients with mild TBI and depression, anxiety, or both, as well as 29 patients with mild TBI and no neuropsychiatric symptoms. The mean age of participants was 18 years and the median time from injury to clinical examination was 20 days.

The most common cause of brain injury within the study was sports-related injuries, followed by motor vehicle accidents.

Of the patients with mild TBI and neuropsychiatric symptoms, 38 reported irritability, 32 reported depression, and 18 reported anxiety.

The researchers noted patients with TBI and depression showed significantly lower activity in several regions of the brain, while those with anxiety had significantly lower activity in the cerebellar vermis. However, the patients without psychiatric symptoms showed no difference from healthy individuals.

“In summary, detection of the central white matter injuries that underlie depression and anxiety but not irritability indicates that not all neuropsychiatric symptoms after mild TBI are the result of discrete white matter injuries, but in those with corresponding injuries, the injured regions provide insight into the underlying pathophysiology and prognosis,” Alhilali and colleagues wrote.

The researchers say the study findings could have significant implications for future clinical research.

“First, it gives us insight into how abnormalities in the brain occur after trauma, and second, it shows that treatments for non-trauma patients with neuropsychological symptoms may be applicable to some concussion patients,” she said in a press release

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