Identifying Depression Utilizing the Quick Inventory of Depressive Symptomatology- self Report, Tumor Necrosis Factor- alpha, and Endothelial Function in Spinal Cord Injury

Research Objectives: To investigate the association between depression symptomology, biomarker derangement of tumor necrosis factor-alpha (TNF-alpha) and endothelial function in people with spinal cord injury (SCI).

Design: This was an observational study.

Setting: This study was conducted in a laboratory setting.

Participants: Twenty-four adults with chronic SCI (n=12) and their age- and body mass index (BMI)-matched controls (MC) (n=12).

Interventions: N/A

Main Outcome Measures: The primary outcome measure for depression was the QIDS-SR total score; the biomarker outcome measure was TNF-; and the outcome measures for endothelial function were two variables derived from SBF: normalized plateau, and time to plateau SBF.

Results: The SCI group had significantly higher mean QIDS-SR total scores than the MC group. Time to plateau measurements at the forearm and heel were significantly shorter in SCI than in the MC. There was no significant difference between groups in the normalized plateau at both sites. TNF- levels were significantly higher in the SCI group than in the MC group. No significant correlation was found among any of the variables.

Conclusions: SCI participants showed higher levels of depression, TNF- value, and shorter time to reach maximum level of nitric-oxide (NO) dependent vasodilation. Although these alterations co-exist, no direct correlation among these changes were observed. As a result, these objective measurements may not be useful markers for identifying depression in the SCI population. Future studies that aim at examining the effect of depression on pressure injury risk may consider etiological pathways other than TNF-α-induced inflammation or NO-dependent endothelial impairments.

Author(s) Disclosures: The authors have no disclosures to declare.