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.
Keywords
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Article info
Publication history
Published online: October 12, 2022
Accepted:
September 13,
2022
Received in revised form:
September 8,
2022
Received:
March 2,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
