Citation

Lee B, Bennett LL, Bernick C, Shan G, Banks SJ. J. Head Trauma Rehabil. 2019; ePub(ePub): ePub.

Affiliation

University of Nevada, Las Vegas (Mr Lee); Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, Nevada (Drs Bennett and Bernick and Mr Lee); Department of Environmental and Occupational Health, School of Community Health Sciences, University of Nevada, Las Vegas (Dr Shan); and Multidisciplinary Memory Clinic, Department of Neurosciences, University of California San Diego, La Jolla (Dr Banks).

Copyright

(Copyright © 2019, Lippincott Williams and Wilkins)

DOI

10.1097/HTR.0000000000000495

PMID

31033751

Abstract

OBJECTIVE: Depression, neuropathology, and cognitive decline are commonly observed with repetitive head injuries (RHIs). We examined whether in boxers (a) clinically significant depression is associated with structural brain changes and cognition; (b) minimal symptoms of depression moderate the relations among RHI and brain volumes and cognition; and (c) baseline depression is associated with longitudinal cognitive changes. SETTING: Clinical Research Center. PARTICIPANTS: A total of 205 male professional boxers.

DESIGN: Cross-sectional and longitudinal (subsample: n = 45; first visit to follow-up range = 1-6 years; mean = 2.61 years). MAIN MEASURES: Patient Health Questionnaire-9 depression; CNS Vital Signs cognitive battery; brain imaging.

RESULTS: Clinically significant depression was associated with smaller regional volumes in insula, cingulate, orbitofrontal cortex, thalami, and middle corpus-callosum subregions; and with poorer verbal memory and psychomotor speed performance. Depression symptoms moderated the relations between RHI and bilateral thalami, left hippocampus, left medial orbitofrontal cortex, and bilateral insula volumes; but not cognition. Baseline depression was associated with poorer psychomotor speed and reaction time longitudinally and improved verbal memory performance longitudinally.

CONCLUSION: Clinical depression is associated with volumetric and cognitive changes occasioning RHI exposure, and even minimal depressive symptoms may moderate the relations between exposure and brain volumes in key regions. Longitudinally, there is preliminary evidence that depression precedes cognitive changes.

Language: en