Cognitive Improvement With Treatment of Depression Following Mild Traumatic Brain Injury

Fann, Jesse R.; Uomoto, Jay M.; Katon, Wayne

doi:10.1176/appi.psy.42.1.48

Cited by 207 publications

(135 citation statements)

References 32 publications

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“…For instance, successful treatment of depression might ameliorate some aspects of cognitive dysfunction, as it has been reported in patients with traumatic brain injury. 36,38 Nevertheless, the clinicians must be aware of the burden secondary to cognitive impairment and depression in MS subjects providing prompt diagnosis and treatment, considering both pharmacological and nonpharmacological (rehabilitation, psychotherapy) approaches.…”

Section: 2mentioning

confidence: 99%

Differential diagnosis, discerning depression from cognition

Portaccio

2016

Acta Neurol Scand

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Cognitive impairment is common in multiple sclerosis (MS), affecting up to 70% of patients. One of the most important possible confounders to cognitive assessment is the occurrence of depression, a common consequence of MS. Cognition and depression have been linked in recent neuropsychiatric research that proposed a number of neurocognitive models of mood disorders. According to these models, primary failure of key brain regions of emotional processing and regulation or abnormal connectivity between them contributes to the adoption of maladaptive cognitive strategies and the development of mood disorders. In MS, a similar interplay between cognitive function and depression has been reported. In particular, depression seems to alter attentional capacity in terms of deficits in working memory and, more specifically, deficits in the executive control. However, cognitive impairment in MS does exist also in the absence of depression and it is more likely that depression exacerbates existing cognitive difficulties rather than cause them per se. On the other hand, it is possible that a dysexecutive syndrome secondary to MS might in turn precipitate depression.

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Section: 2mentioning

confidence: 99%

Differential diagnosis, discerning depression from cognition

Portaccio

2016

Acta Neurol Scand

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“…Fann et al reported an 87 percent response rate in an 8-week, singleblind placebo run-in trial of sertraline 25 to 200 mg/d in 15 subjects with major depression 3 to 24 months follow-ing mild TBI [99]. They further reported improved psychomotor speed, recent verbal and visual memory, and cognitive efficiency with sertraline treatment, associated with significant improvement in depression scores [100].…”

Section: Ssrismentioning

confidence: 99%

Pharmacological management of neurobehavioral disorders following traumatic brain injuryA state-of the-art review

Chew

Zafonte²

2009

JRRD

163

103

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Abstract-Pharmacological management of neurobehavioral disorders following traumatic brain injury (TBI) is common practice. However, the evidence available to guide this practice remains sparse. This review summarizes, in brief, the state of knowledge, organized via a time continuum from injury as well as by symptom complex. The areas of neuroprotection, hypoarousal, attention and memory deficits, aggression, agitation, depression, and mania are reviewed. The literature was searched with PubMed on the terms "traumatic brain injury" or "brain injury" with "pharmacology" (and the symptoms according to which this review is arranged). Additional searches were conducted with the specific symptoms as search terms, crossed with the therapeutic agents or drug classes discussed. Where a paucity of prospective data exists, case reports and retrospective studies are included. Studies to date have yielded minimal positive evidence for enhancing function, memory, and behavior after TBI. No single agent likely will become sentinel in the recovery process, and combination therapy in the acute and postacute settings are required. A need exists to further define the role of psychopharmacology in postacute TBI medicine and the specific characteristics of subpopulations who might benefit.

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“…One study with a pre-post design (Fann, Uomoto et al 2001) found a large positive effect, however the effects were less favourable in the controlled trials with one study suggesting that sertraline was less effective than placebo ) and the other showed the effect to be no greater than zero (Lee, Kim et al 2005) The most obvious difference between these studies is that Fann et al, (2001) used a pre-post design and only evaluated the effect of the placebo treatment over 1 week rather than a period equivalent to active treatment. Furthermore, there were differences in time since injury across the three studies from approximately 1 month post-injury (Lee, Kim et al 2005), 3-24 months post injury (Fann, Uomoto et al 2001) and 17 years (on average) post-injury ). In both controlled trials, however, the placebo group also showed a significant improvement over the treatment period, suggesting that the other factors (e.g., contact with clinic staff) rather than the active treatment may be responsible for the improvement in symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…As can be seen in Figure 2, when examining the pharmacological treatments, the greatest positive effect was found for the selective serotonin reuptake inhibitor (SSRI) sertraline (Fann, Uomoto et al 2001). Two similar sized trials of sertraline (Lee, Kim et ) while the third had a maximum dose of 100 mg/week (Lee, Kim et al 2005).…”

Section: Insert Table 2 and Figure 2 Around Herementioning

confidence: 99%

Treatment for depression following mild traumatic brain injury in adults: A meta-analysis

2013

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Primary Objective: Development of depression after TBI is linked to poorer outcomes. The aim of this manuscript is to review evidence for the effectiveness of current treatments.Research Design: Two meta-analyses were undertaken to examine the effectiveness of both pharmacological and non-pharmacological interventions for depression after mild -TBI Method and Procedures: PubMed, Medline, PsychInfo, Web of Science, and Digital Dissertations were searched and 13 studies located. Meta Analyst Beta 3.13 was used to conduct analyses of pre versus post effects then to examine treatment group versus control group effects. Main Outcomes and Results:Studies using a pre-post design produced an overall effect size of 1.89 (95% CI 1.20-2.58, p<.001), suggesting that treatments were effective, however the overall effect for controlled trials was 0.46 (95%CI -0.44-1.36, p<.001), which favoured the control rather than treatment groups. Conclusions:This study highlights the need for additional large well controlled trials of effective treatments for depression post-TBI.

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Cognitive Improvement With Treatment of Depression Following Mild Traumatic Brain Injury

Cited by 207 publications

References 32 publications

Differential diagnosis, discerning depression from cognition

Differential diagnosis, discerning depression from cognition

Pharmacological management of neurobehavioral disorders following traumatic brain injuryA state-of the-art review

Treatment for depression following mild traumatic brain injury in adults: A meta-analysis

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