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Unique White Matter Injuries for Anxiety, Depression Post TBI

Findings in mild traumatic brain injury patients; no such pattern for irritability

WEDNESDAY, June 17, 2015 (HealthDay News) — Unique white matter injury patterns are seen for anxiety and depression after mild traumatic brain injury (mTBI), but not for irritability, according to a study published online June 16 in Radiology.

Lea M. Alhilali, M.D., from the University of Pittsburgh Medical Center, and colleagues used tract-based spatial statistics analysis of diffusion-tensor images to examine whether a central axonal injury underlies neuropsychiatric symptoms after mTBI. Forty-five patients with mTBI (38 with irritability, 32 with depression, and 18 with anxiety) underwent diffusion-tensor imaging and serial neurocognitive testing with the Immediate Post-Concussion Assessment and Cognitive Testing evaluation.

The researchers found that patients with mTBI and depression had decreased fractional anisotropy in the superior longitudinal fasciculus, white matter around the nucleus accumbens, and anterior limb of the internal capsule (P = 0.006, 0.03, and 0.02, respectively), compared with controls. Diminished fractional anisotropy in the vermis was seen for patients with anxiety (P = 0.04). Relative to controls, there were no regions of significantly decreased fractional anisotropy in patients with irritability. In patients with depression there was an inverse correlation between injury in the region of the nucleus accumbens and recovery time (P = 0.005).

“Detection of the central white matter injuries that underlie depression and anxiety but not irritability indicates that not all neuropsychiatric symptoms after mTBI are the result of discrete white matter injuries,” the authors write.

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