Executive Dysfunction Predicts Treatment Response to Neuroplasticity-Based Computerized Cognitive Remediation (nCCR-GD) in Elderly Patients with Major Depression

Objectives Executive dysfunction (ED) is a predictor of poor treatment response of late-life depression to pharmacotherapy. In response to the consistency of these findings, we designed neuroplasticity-based computerized cognitive remediation (nCCR-GD) intervention to target and improve ED in patien...

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Bibliographic Details
Published in:The American journal of geriatric psychiatry 2016-10, Vol.24 (10), p.816-820
Main Authors: Morimoto, Sarah Shizuko, Psy.D, Gunning, Faith M., Ph.D, Wexler, Bruce E., M.D, Hu, Willie, B.S, Ilieva, Irena, Ph.D, Liu, Jiacheng, M.D., Ph.D, Nitis, Juliana, Alexopoulos, George S., M.D
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Antidepressive Agents - therapeutic use
Cognitive Remediation
Computerized cognitive remediation
depression
Depressive Disorder, Major - physiopathology
Depressive Disorder, Major - psychology
Depressive Disorder, Major - rehabilitation
Depressive Disorder, Treatment-Resistant - physiopathology
Depressive Disorder, Treatment-Resistant - psychology
Depressive Disorder, Treatment-Resistant - rehabilitation
executive dysfunction
Executive Function - physiology
Female
geriatric
Humans
Internal Medicine
Male
Middle Aged
Neuronal Plasticity
Neuropsychological Tests
Treatment Outcome
treatment resistant
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Summary:Objectives Executive dysfunction (ED) is a predictor of poor treatment response of late-life depression to pharmacotherapy. In response to the consistency of these findings, we designed neuroplasticity-based computerized cognitive remediation (nCCR-GD) intervention to target and improve ED in patients who failed to remit with antidepressant treatment. This study tests the hypothesis that ED at baseline will predict favorable treatment response to nCCR-GD. Methods 11 elderly patients with treatment-resistant major depression were treated with a 30-hour, 4-week, unblinded, nCCR-GD treatment trial. Neuropsychological performance was assessed at baseline and after treatment ceased. Results ED at baseline was associated with greater reduction in Montgomery-Asberg Depression Rating Scale score over the 4-week treatment β = −0.74, F(2,8)  = 10.85, p = 0.009, R2  = 0.55. Conclusions ED predicts favorable treatment response to nCCR-GD in older adults suffering from major depression resistant to antidepressants. This finding is opposed to studies testing pharmacotherapy where ED predicts poorer treatment response.
ISSN:1064-7481
1545-7214
DOI:10.1016/j.jagp.2016.06.010