Effects of Depression and Antidepressant Use on Cognitive Deficits and Functional Cognition Following Severe Traumatic Brain Injury.
Effects of Depression and Antidepressant Use on Cognitive Deficits and Functional Cognition Following Severe Traumatic Brain Injury.
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DOI：
10.1097/htr.0000000000000214
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Wagner AK
中科院分区：
文献类型：
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作者：
Failla MD;Juengst SB;Graham KM;Arenth PM;Wagner AK
使用康复组学框架来评估 TBI 后抑郁症 (PTD) 与潜在相关因素（包括抗抑郁药物的使用）之间对严重 TBI 后认知恢复的关系。严重 TBI 幸存者 (n=154)，从 1 级创伤中心招募。前瞻性队列研究，在受伤后 6 个月和 12 个月进行评估。患者健康问卷 9（PTD 症状）；神经心理学评估组的认知综合评分（认知障碍）；和功能独立测量-认知（FIM-Cog，自我报告的功能认知）。患有和不患有 PTD 的个体在认知障碍方面没有差异。然而，无论 PTD 状态如何，抗抑郁药物的使用都与认知障碍相关。与没有 PTD 的个体相比，患有 PTD 的个体在两个时间点的 FIM-Cog 评分均较低。在事后纵向分析中，晚发性 PTD 患者的认知障碍更严重。这些结果表明，抗抑郁药物的使用会损害没有 PTD 的个体的认知能力。此外，PTD 不会直接影响认知障碍，但可能通过自我评价和冷漠/动机因素影响功能性认知限制。
To use a Rehabilomics framework to evaluate relations between post-TBI depression (PTD) and potential associated factors, including antidepressant use, on cognitive recovery following severe TBI. Severe TBI survivors (n=154), recruited from a level 1 trauma center. Prospective cohort study with assessments at 6 and 12 months post-injury. Patient Health Questionnaire-9 (PTD symptoms); cognitive composite score from a neuropsychological assessment battery (cognitive impairment); and Functional Independence Measure–Cognition (FIM-Cog, self-reported functional cognition). Individuals with and without PTD did not differ with respect to cognitive impairment. However, antidepressant use, regardless of PTD status, was associated with cognitive impairment. Individuals with PTD reported lower FIM-Cog scores at both time-points compared to those without PTD. In a post-hoc longitudinal analysis, individuals with late-onset PTD had worse cognitive impairment. These results suggest antidepressant use impairs cognition among individuals without PTD. Also, PTD does not directly affect cognitive impairment but may affect functional cognitive limitations through self-evaluation and apathy/motivation factors.