Neuroplasticity-based computerized cognitive remediation for treatment-resistant geriatric depression

Nat Commun. 2014 Aug 5:5:4579. doi: 10.1038/ncomms5579.

Abstract

Executive dysfunction (ED) in geriatric depression (GD) is common, predicts poor clinical outcomes and often persists despite remission of symptoms. Here we develop a neuroplasticity-based computerized cognitive remediation-geriatric depression treatment (nCCR-GD) to target ED in GD. Our assumption is that remediation of these deficits may modulate the underlying brain network abnormalities shared by ED and depression. We compare nCCR-GD to a gold-standard treatment (escitalopram: 20 mg per 12 weeks) in 11 treatment-resistant older adults with major depression; and 33 matched historical controls. We find that 91% of participants complete nCCR-GD. nCCR-GD is equally as effective at reducing depressive symptoms as escitalopram but does so in 4 weeks instead of 12. In addition, nCCR-GD improves measures of executive function more than the escitalopram. We conclude that nCCR-GD may be equally effective as escitalopram in treating GD. In addition, nCCR-GD participants showed greater improvement in executive functions than historical controls treated with escitalopram.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antidepressive Agents, Second-Generation / therapeutic use
  • Case-Control Studies
  • Citalopram / therapeutic use
  • Cognition
  • Cognitive Behavioral Therapy / methods*
  • Depression / therapy*
  • Executive Function
  • Female
  • Geriatrics / methods
  • Humans
  • Major Depressive Disorder / therapy*
  • Male
  • Middle Aged
  • Neuronal Plasticity*
  • Software
  • Treatment Outcome

Substances

  • Antidepressive Agents, Second-Generation
  • Citalopram