Concussions impact the cognitive abilities and emotional wellbeing of adolescents. More specifically, adolescents exhibit signs of executive dysfunction and depressive symptoms following concussion. Evidence suggests a link between cognitive performance and depressive symptoms in concussed populations; however, concussion research has focused mostly on cognitive deficits and emotional dysregulation in singularity, rather than as an integrated system. Therefore, the purpose of this thesis is to explore the clinical and biological relationship between depressive symptoms and executive dysfunction following mild traumatic brain injury (mTBI) or concussion in pediatric populations.
Chapter 1 provides an overview of the literature surrounding children and youth with concussive injury as it pertains to executive dysfunction and depressive symptoms. Chapter 2 describes the clinical nature of the relationship between depressive symptoms and executive dysfunction. The results demonstrate that individuals with elevated depressive symptoms had comparable performance to individuals with normal levels of depressive symptoms on executive function scores. This included their performance on an inhibitory control task in which emotional distractors were presented. Regardless of levels of depressive symptoms, adolescents with concussive injury displayed impaired executive functioning compared to normative data, which emphasizes the importance of evaluating executive function following concussion.
Chapter 3 involves the use of functional brain imaging to explore the physiological differences between adolescents with average and elevated depressive symptoms on emotion-mediated inhibitory control processes. The group as whole did not display activity in the frontostriatal regions that are associated with inhibitory control, which suggests a potential impairment in this network. Adolescents with elevated depressive symptoms displayed fewer areas of activity compared to adolescents with average levels of depressive symptoms. As a number of individuals (particularly those with elevated depressive symptoms) were injured in the occipital region of the skull, the coup-contrecoup impact may have resulted in frontal lobe injury.
Faces were used to evoke emotional processing throughout the inhibitory control task. The results revealed that adolescents with elevated depressive symptoms were more likely to engage in brain regions subserving evaluative processing of social interactions. This might suggest that depressive symptoms display differences in physiology when emotional stimuli are present. These findings provide insight into the role the environment plays in contributing to the cognitive demands placed on adolescents recovering from concussion.
Chapter 4 reviews the key messages derived from these results and describes their clinical relevance. This exploration may lead to a more holistic understanding of concussion and a better approach to injury management, particularly for adolescents who express higher levels of depressive symptoms following concussion. / Thesis / Master of Science (MSc)
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/20634 |
| Date | January 2016 |
| Creators | Ho, Rachelle A. |
| Contributors | DeMatteo, Carol, Rehabilitation Science |
| Source Sets | McMaster University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis |
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