OBJECTIVE:Mild traumatic brain injuries (mTBIs) have frequently been associated with the emergence and persistence of depressive symptoms. However, the factors which contribute to the increased risk for depression after these head injuries remain unclear. Accordingly, we examined the relationship between frequency of self-reported mTBIs and current symptoms of depression and the mediating role of rumination and cognitive flexibility. We also examined whether these relations were moderated by sex differences and the presence of the Val66Met polymorphism in a gene coding for brain-derived neurotrophic factor (BDNF). DESIGN:Retrospective, cross-sectional. SETTING:Carleton University. PARTICIPANTS:Two hundred nineteen Carleton University undergraduate students. MAIN OUTCOME MEASURES:Cognitive flexibility as assessed by the Wisconsin Card Sorting Task (WCST); subtypes of rumination (Ruminative Response Scale; Treynor, Gonzalez, and Nolen-Hoeksema, 2003); depressive symptoms (Beck Depression Inventory; Beck, Ward, and Mendelson, 1961). RESULTS:Greater frequency of self-reported mTBIs was associated with more frequent depressive rumination among women, but not men, which was accompanied by elevated current depressive symptoms. In addition, among Met allele carriers of the BDNF polymorphism, but not those who were Val homozygotes, greater frequency of mTBIs was related to higher levels of brooding, which was accompanied by heightened depressive symptoms. Brain-derived neurotrophic factor genotype also moderated the relationship between self-reported mTBIs and cognitive flexibility in that more frequent mTBIs were associated with more perseverative errors on the WCST among Met carriers, but not Val homozygotes. CONCLUSIONS:The present findings raise the possibility that the evolution of depression after mTBIs may be dependant on a BDNF polymorphism and sex differences.

译文

目的:轻度创伤性脑损伤(mTBI)经常与抑郁症状的出现和持续存在有关。但是,尚不清楚导致这些颅脑损伤后抑郁风险增加的因素。因此,我们检查了自我报告的mTBI的频率与当前抑郁症症状以及反刍和认知柔韧性的中介作用之间的关系。我们还检查了这些关系是否通过性别差异和在编码脑源性神经营养因子(BDNF)的基因中存在Val66Met多态性而得到缓解。
设计:回顾性横截面。
地点:卡尔顿大学。
参加者:219名卡尔顿大学的本科生。
主要观察指标:通过威斯康星卡片分类任务(WCST)评估的认知灵活性;反刍的亚型(反刍反应量表; Treynor,Gonzalez和Nolen-Hoeksema,2003年);抑郁症状(贝克抑郁量表;贝克,沃德和门德尔森,1961年)。
结果:自我报告的mTBIs发生频率越高,女性(而非男性)抑郁症反刍的频率就越高,这伴随着当前抑郁症症状的加剧。此外,在BDNF多态性的Met等位基因携带者中,但不是Val纯合子的携带者中,mTBI的频率增加与育卵水平升高有关,伴有抑郁症状的加剧。脑源性神经营养因子基因型还缓解了自我报告的mTBI与认知灵活性之间的关系,因为更频繁的mTBI与Met携带者的WCST持久性错误相关,而与Val纯合子无关。
结论:本研究结果提出了mTBI后抑郁症的发展可能取决于BDNF多态性和性别差异的可能性。

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