Depressive symptoms and white matter dysfunction in retired NFL players with concussion history

MedicalResearch.com eInterview with:

John Hart, M.D. Medical Science Director at the Center for BrainHealth Jane and Bud Smith Distinguished Chair Cecil Green Distinguished Chair The University of Texas at DallasJohn Hart, M.D.
Medical Science Director at the Center for BrainHealth
Jane and Bud Smith Distinguished Chair
Cecil Green Distinguished Chair
The University of Texas at Dallas

MedicalResearch.com: What are the main findings of the study?

Dr. Hart: Football players often sustain numerous concussive and subconcussive impacts—head impacts that do not elicit neurologic symptoms that may lead to white matter damage. We evaluated a population of retired NFL players in order to study the relationship between white matter integrity and the manifestation of depressive symptoms. We identified, for the first time, a correlation between depression and white matter abnormalities in former players with a remote history of concussion using diffusion tensor imaging (DTI).

Our data demonstrated a significant association between white matter integrity, as measured by DTI Fractional Anisotropy (FA), and the presence as well as severity of depressive symptoms in retired NFL athletes with a history of concussive or subconcussive impacts. We also found that dysfunction of the anterior aspect of the corpus callosum (forceps minor) and its projections to the frontal lobe can identify those with depression with 100% sensitivity and 95% specificity.

MedicalResearch.com: Were any of the findings unexpected?

Dr. Hart: Dr. Hart: The unexpected findings were that the depressive symptoms in these players had a specific profile. The depressed players had predominance of the cognitive and somatic symptoms of depression more so than mood. Also, the diagnostic accuracy of the DTI measures was surprising.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Hart: Football players often sustain numerous concussive and subconcussive head injuries. With these imaging findings, we may be able to develop markers that may one day be able to predict who is at risk for developing depression after a concussion. Depression can develop years after a head injury in these players and at times go undiagnosed.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Hart: We need further investigation into both short-term and long-term assessment of these measures immediately after a concussion has occurred.

Citation:

Depressive symptoms and white matter dysfunction in retired NFL players with concussion history

Strain J, Didehbani N, Cullum CM, Mansinghani S, Conover H,
Kraut MA, Hart J Jr, Womack KB.

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, M

Neurology. 2013 May 24. [Epub ahead of print]

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