Citation

Lima Santos JP, Kontos AP, Holland CL, Suss SJJ, Stiffler RS, Bitzer HB, Colorito AT, Shaffer M, Skeba A, Iyengar S, Manelis A, Brent D, Shirtcliff EA, Ladouceur CD, Phillips ML, Collins MW, Versace A. Biol. Psychiatry Cogn. Neurosci. Neuroimaging 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, Society of Biological Psychiatry, Publisher Elsevier Publishing)

DOI

10.1016/j.bpsc.2022.09.013

PMID

36517369

Abstract

BACKGROUND: Adolescence represents a window of vulnerability for developing psychological symptoms following concussion, especially in girls. Concussion-related lesions in emotion regulation circuits may help explain these symptoms. However, the contribution of sex and pubertal maturation remains unclear. Using the neurite density index (NDI) in emotion regulation tracts (left/right cingulum bundle [CB], forceps minor [FMIN], and left/right uncinate fasciculus), we sought to elucidate these relationships.

METHODS: No adolescent had a history of anxiety and/or depression. The Screen for Child Anxiety Related Emotional Disorders and Children's Depression Rating Scale were used at scan to assess anxiety and depressive symptoms in 55 concussed adolescents (41.8% girls) and 50 control adolescents with no current/history of concussion (44% girls). We evaluated if a mediation-moderation model including the NDI (mediation) and sex or pubertal status (moderation) could help explain this relationship.

RESULTS: Relative to control adolescents, concussed adolescents showed higher anxiety (p =.003) and lower NDI, with those at more advanced pubertal maturation showing greater abnormalities in 4 clusters: the left CB frontal (p =.002), right CB frontal (p =.011), FMIN left-sided (p =.003), and FMIN right-sided (p =.003). Across all concussed adolescents, lower NDI in the left CB frontal and FMIN left-sided clusters partially mediated the association between concussion and anxiety, with the CB being specific to female adolescents. These effects did not explain depressive symptoms.

CONCLUSIONS: Our findings indicate that lower NDI in the CB and FMIN may help explain anxiety following concussion and that adolescents at more advanced (vs less advanced) status of pubertal maturation may be more vulnerable to concussion-related injuries, especially in girls.

Language: en

Keywords

Concussion; Anxiety; Adolescence; Diffusion MRI; NODDI; Sex and pubertal developmental status