抑郁症症状与创伤性脑损伤后的临床症状,残疾和功能连接相关
Joshitha Arora1, Alexandra Ossowski1, Abigail Patchell1
1Department of Radiology (Arora, Patchell, Jamison, Kuceyeski, Singh, Garetti, Cappillo, Hamill, Shah), Department of Psychiatry (Ossowski, Liston, Jaywant), Department of Rehabilitation Medicine (Ossowski, Jaywant), Brain and Mind Research Institute (Liston, Shah), Department of Neurology (Kaunzner, Schiff), and Department of Surgery (Winchell, Yee-Oleksy), Weill Cornell Medicine, New York City; Department of Computational Biology, Cornell University, Ithaca, N.Y. (Jamison, Kuceyeski); Icahn School of Medicine at Mount Sinai, New York City (Blunt, Dams-O'Connor); Department of Surgery, New York-Presbyterian Queens Hospital, Flushing, N.Y. (Yee-Oleksy, Khedr).
创伤性脑损伤 (TBI) 后的抑郁症呈现为不同的症状集群,而不是单一的综合征. 这些集群与TBI严重程度,功能结果和大脑连接有不同的相关性,这表明存在不同的潜在机制.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 临床心理学 临床心理学
背景情况:
- 抑郁症是一种异质的疾病,具有明显的症状集群.
- 创伤性脑损伤 (TBI) 后抑郁症异质性及其相关的性质在很大程度上仍未知.
研究的目的:
- 在亚急性TBI后调查抑郁症症状集群.
- 评估这些抑郁症集群的临床,功能和神经相关性.
主要方法:
- 在社区居住的参与者 (N=53) 患有复杂的轻度至重度TBI,在受伤后大约5个月被评估.
- 进行了标准化计量表 (HDRS,Rivermead脑震荡后症状问卷,GOS-E) 和神经心理测试.
- 休息状态功能性核磁共振扫描 (MRI) 在一小部分参与者身上进行.
主要成果:
- 汉密尔顿抑郁症评分尺度 (HDRS) 的主要组件分析确定了两个症状集群.
- 集群2 (焦虑,失眠,身体症状) 与较高的TBI症状负担,残疾和较差的执行功能相关.
- 集群1 (情绪,影响,激动) 没有显示与TBI负担或功能有显著的关联,但趋势将负面影响与改变的大脑网络连接联系起来.
结论:
- 创伤后的抑郁症可能不是一个单一的综合征.
- 不同的症状集群与TBI负担,功能结果和神经生物学措施有不同的关联.
- 这些发现凸显了为管理创伤后抑郁症需要量身定制的方法.
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