Patients with chronic depression may suffer from global cognitive defects. Here, we present a case with repetitive mild traumatic brain injuries (mTBI) that aggravated her depressive symptoms and exhibited atypical cognitive impairments. Her depressive symptoms had been resistant to a combination of SNRI and antipsychotics. The single-photon emission computed tomography scan showed asymmetric perfusion at medial temporal lobes - which has been found to be associated with somatic delusions in some other patients. Her cognitive impairment profile was also consistent with difficulty in inhibition and visual processing, as noted in medial temporal lobe dysfunction, but not commonly seen in chronic depression. After her depression was improved with antipsychotic medications, her specific cognitive impairments persisted. To conclude, repetitive mTBI might cause selective or atypical cognitive impairments that impact treatment responses in patients with depressive disorders.
Ping I Lin, Drew H Barzman