Citation

Strain J, Didehbani N, Cullum CM, Mansinghani S, Conover H, Kraut MA, Hart J, Womack KB. Neurology 2013; 81(1): 25-32.

Affiliation

From the Berman Laboratory for Learning and Memory (J.S., N.D., S.M., H.C., M.A.K., J.H.), Center for Brain Health, Dallas; School of Behavioral and Brain Sciences (C.M.C., K.B.W.), Department of Psychiatry, The University of Texas at Dallas; Department of Neurology and Neurotherapeutics (C.M.C., J.H., K.B.W.), University of Texas Southwestern Medical Center, Dallas; and Department of Radiology (M.A.K.), The Johns Hopkins School of Medicine, Baltimore, MD.

Copyright

(Copyright © 2013, Lippincott Williams and Wilkins)

DOI

10.1212/WNL.0b013e318299ccf8

PMID

23709590

Abstract

OBJECTIVE: To determine whether correlates of white matter integrity can provide general as well as specific insight into the chronic effects of head injury coupled with depression symptom expression in professional football players. METHOD: We studied 26 retired National Football League (NFL) athletes who underwent diffusion tensor imaging (DTI) scanning. Depressive symptom severity was measured using the Beck Depression Inventory II (BDI-II) including affective, cognitive, and somatic subfactor scores (Buckley 3-factor model). Fractional anisotropy (FA) maps were processed using tract-based spatial statistics from FSL. Correlations between FA and BDI-II scores were assessed using both voxel-wise and region of interest (ROI) techniques, with ROIs that corresponded to white matter tracts. Tracts demonstrating significant correlations were further evaluated using a receiver operating characteristic curve that utilized the mean FA to distinguish depressed from nondepressed subjects. RESULTS: Voxel-wise analysis identified widely distributed voxels that negatively correlated with total BDI-II and cognitive and somatic subfactors, with voxels correlating with the affective component (p < 0.05 corrected) localized to frontal regions. Four tract ROIs negatively correlated (p < 0.01) with total BDI-II: forceps minor, right frontal aslant tract, right uncinate fasciculus, and left superior longitudinal fasciculus. FA of the forceps minor differentiated depressed from nondepressed athletes with 100% sensitivity and 95% specificity. CONCLUSION: Depressive symptoms in retired NFL athletes correlate negatively with FA using either an unbiased voxel-wise or an ROI-based, tract-wise approach. DTI is a promising biomarker for depression in this population.

Keywords: American football;

Language: en