BACKGROUND: Following concussion, adolescents may experience both poor inhibitory control and increased depressive symptoms. fMRI research suggests a physiological difference between patients with clinical depression and patients with depressive symptoms after concussion. The scarcity of information surrounding depression following concussion in youth makes it difficult to identify patients at risk of depression after injury. This is the first study to examine neural activity patterns in adolescents with post-concussive depressive symptoms.
PURPOSE: To explore the effect of depressive symptoms on inhibitory control in adolescents with concussion in the presence of emotional stimuli using fMRI.
METHODS: Using a prospective cohort design, 30 adolescents diagnosed with concussion between 10 and 17years were recruited. The Children's Depression Inventory questionnaire was used to divide participants into two groups: average or elevated levels of depressive symptoms. Participants completed an Emotional Go/No-Go task involving angry or neutral faces in a 3T MRI scanner.
RESULTS: Eleven participants had elevated depressive symptoms, of which 72% were hit in occipital region at the time of injury. fMRI results revealed activity patterns of the overall sample. Faces activated regions associated with both facial and cognitive processing. However, frontal regions that are usually associated with inhibitory control were not activated. Adolescents with elevated levels of depressive symptoms engaged more frontal lobe regions during the task than the average group.
CONCLUSIONS: Adolescents with elevated depressive symptoms were more likely to engage brain regions subserving evaluative processing of social interactions. This finding provides insight into the role the environment plays in contributing to the cognitive demands placed on adolescents recovering from concussion.