2008 Brain Star Award Recipient - Jen-Kai Chen
Recipient
Jen-Kai Chen - Biosketch
PhD
McGill University
Article
Chen JK, Johnston KM, Petrides M, Ptito A. Neural substrates of symptoms of depression following concussion in male athletes with persisting postconcussion symptoms. Arch Gen Psychiatry. 2008;65(1):81-9.
Significance of the paper
Emotional complaints, together with other somatic symptoms and cognitive deficits are common following mild head injury and concussion, and this cluster of clinical signs have been referred to as pos-concussive symptoms (PCS). Existing investigations in traumatic brain injury have focused mainly on the cognitive and somatic aspects of PCS; the affective dimension of PCS remains largely unexplored. Symptoms of depression may be particularly relevant in sport concussion as they have readily been attributed to external factors such as the loss of position on the team, lack of team support environment, and the lack of a defined timeline to recovery.
This study was the first designed to examine the nature of symptoms of depression reported by individuals after a sport-related concussion. We demonstrated that while all concussed athletes showed reduced brain activity in the dorsolateral prefrontal cortex, the difference between those with and without symptoms of depression lay in the cortico-striato-thalamic system, in a manner consistent with functional neuroimaging findings in major depression. Moreover, our voxel-based morphological study confirmed gray matter loss in those brain areas where abnormal activations were observed. These findings point to a pathophysiological basis to symptoms of depression following concussion, and have important implications for the clinical care of these patients. For instance, early identification of the nature of depression symptoms following head trauma (psychological versus pathological) could help health care providers design more effective rehabilitation programs centered on the alleviation of emotional disturbances. Results from this study also suggest that anti-depressant medication in conjunction with the rehabilitation program could be an effective treatment approach for these patients.