Depressive symptoms and white matter dysfunction in retired NFL players with concussion history
Open accessAbstract
OBJECTIVE: To determine whether correlates of white matter integrity can provide general as well as specific insight into the chronic effects of head injury coupled with depression symptom expression in professional football players. METHOD: We studied 26 retired National Football League (NFL) athletes who underwent diffusion tensor imaging (DTI) scanning. Depressive symptom severity was measured using the Beck Depression Inventory II (BDI-II) including affective, cognitive, and somatic subfactor scores (Buckley 3-factor model). Fractional anisotropy (FA) maps were processed using tract-based spatial statistics from FSL. Correlations between FA and BDI-II scores were assessed using both voxel-wise and region of interest (ROI) techniques, with ROIs that corresponded to white matter tracts. Tracts demonstrating significant correlations were further evaluated using a receiver operating characteristic curve that utilized the mean FA to distinguish depressed from nondepressed subjects. RESULTS: Voxel-wise analysis identified widely distributed voxels that negatively correlated with total BDI-II and cognitive and somatic subfactors, with voxels correlating with the affective component (p < 0.05 corrected) localized to frontal regions. Four tract ROIs negatively correlated (p < 0.01) with total BDI-II: forceps minor, right frontal aslant tract, right uncinate fasciculus, and left superior longitudinal fasciculus. FA of the forceps minor differentiated depressed from nondepressed athletes with 100% sensitivity and 95% specificity. CONCLUSION: Depressive symptoms in retired NFL athletes correlate negatively with FA using either an unbiased voxel-wise or an ROI-based, tract-wise approach. DTI is a promising biomarker for depression in this population.
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Depression in former professional football players is also associated with increased fractional anisotropy on DTI, as well as white matter abnormalities on structural imaging.
“Depression in these athletes is also associated with increased fractional anisotropy on DTI, as well as white matter abnormalities on structural imaging [87, 176].”
From The neuropathology of sport (2014) · cites this paper as [176]
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- Authors
- Strain, J., Didehbani, N., Cullum, C. M., Mansinghani, S., Conover, H., Kraut, M. A., Hart, J., & Womack, K. B.
- Affiliations
- Johns Hopkins University (US)
- ORCID
- Venue
- Neurology
- Published
- 2013-07-02
- Volume
- 81
- Issue
- 1
- Pages
- 25-32
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- PMC
- PMC3770203
- OpenAlex
- W1965139263
- Cited by
- 155
- References
- 35
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 5 · 2023: 5 · 2022: 9 · 2021: 14 · 2020: 9 · 2019: 16 · 2018: 20 · 2017: 15 · 2016: 21 · 2015: 23 · 2014: 10 · 2013: 3
- FWCI
- 13.84
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Neurology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Centre d'Imagerie BioMédicale
- Weill Cornell Medical College
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- depressive symptoms, white matter integrity, concussion, chronic traumatic brain injury, professional football, fractional anisotropy, forceps minor, uncinate fasciculus, superior longitudinal fasciculus, frontal aslant tract, depression biomarkers, diffusion tensor imaging
- MeSH terms
- Brain Concussion, Brain Diseases, Cognition Disorders, Depression, Football, Humans, Magnetic Resonance Imaging, Retirement, Diffusion Tensor Imaging
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