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Randomized Controlled Trial
. 2017 Jun;34(6):508-517.
doi: 10.1002/da.22588. Epub 2017 Jan 3.

Improving Late Life Depression and Cognitive Control Through the Use of Therapeutic Video Game Technology: A Proof-Of-Concept Randomized Trial

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Free PMC article
Randomized Controlled Trial

Improving Late Life Depression and Cognitive Control Through the Use of Therapeutic Video Game Technology: A Proof-Of-Concept Randomized Trial

Joaquin A Anguera et al. Depress Anxiety. .
Free PMC article

Abstract

Background: Existing treatments for depression are known to have only modest effects, are insufficiently targeted, and are inconsistently utilized, particularly in older adults. Indeed, older adults with impaired cognitive control networks tend to demonstrate poor response to a majority of existing depression interventions. Cognitive control interventions delivered using entertainment software have the potential to not only target the underlying cerebral dysfunction associated with depression, but to do so in a manner that is engaging and engenders adherence to treatment protocol.

Methods: In this proof-of-concept trial (Clinicaltrials.gov #: NCT02229188), individuals with late life depression (LLD) (22; 60+ years old) were randomized to either problem solving therapy (PST, n = 10) or a neurobiologically inspired digital platform designed to enhance cognitive control faculties (Project: EVO™, n = 12). Given the overlapping functional neuroanatomy of mood disturbances and executive dysfunction, we explored the impact of an intervention targeting cognitive control abilities, functional disability, and mood in older adults suffering from LLD, and how those outcomes compare to a therapeutic gold standard.

Results: EVO participants demonstrated similar improvements in mood and self-reported function after 4 weeks of treatment to PST participants. The EVO participants also showed generalization to untrained measures of working memory and attention, as well as negativity bias, a finding not evident in the PST condition. Individuals assigned to EVO demonstrated 100% adherence.

Conclusions: This study provides preliminary findings that this therapeutic video game targeting cognitive control deficits may be an efficacious LLD intervention. Future research is needed to confirm these findings.

Keywords: behavioral therapy; cognitive control; depression; problem solving therapy; video game technology.

Conflict of interest statement

CONFLICT OF INTEREST

All authors report no financial interests or potential conflicts of interests.

Figures

FIGURE 1
FIGURE 1
CONSORT diagram
FIGURE 2
FIGURE 2
Change in depressive symptoms over time. Both the EVO and PST groups showed a comparable improvement in depressive symptoms (as measured through the Hamilton Depression Rating Scale) over the course of treatment (4 weeks), with these improvements persisting to the 8-week mark. *P < .05
FIGURE 3
FIGURE 3
Cognitive control transfer effects. (A) Performance on the delayed-recognition working memory task: EVO participants showed a significant improvement beyond the PST group on a RT measure of working memory in the presence of distraction and (B) no distraction. (C) Performance on the sustained attention task (TOVA): EVO participants showed a significant improvement beyond the PST group on a RT measure of sustained attention. *P < .05

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