Executive Dysfunction Predicts Treatment Response to Neuroplasticity-Based Computerized Cognitive Remediation (nCCR-GD) in Elderly Patients with Major Depression
Open accessAbstract
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, R(2) = 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.
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Behavioral treatments can improve executive dysfunction and traits linked to neuroticism in older people.
“increasing evidence suggests executive dysfunction and constructs associated with neuroticism respond to behavioral interventions in older adults15–17.”
From State of the Science of Neural Systems in Late‐Life Depression: Impact on Clinical Presentation and Treatment Outcome (2018) · cites this paper as [15]
Computerized cognitive training, unlike escitalopram, improved cognitive flexibility; poorer baseline cognitive flexibility predicted greater depression improvement among those given this training.
“Treatment with CCT, but not escitalopram, also improved cognitive flexibility and results indicated worse cognitive flexibility at baseline was associated with larger improvements in depression in those who received CCT15.”
From State of the Science of Neural Systems in Late‐Life Depression: Impact on Clinical Presentation and Treatment Outcome (2018) · cites this paper as [15]
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- Authors
- Morimoto, S. S., Gunning, F. M., Wexler, B. E., Hu, W., Ilieva, I., Liu, J., Nitis, J., & Alexopoulos, G. S.
- Affiliations
- Cornell University (US)
- Weill Cornell Medicine (US)
- Yale University (US)
- Zhongda Hospital Southeast University (CN)
- Corresponding author
- Morimoto, Sarah Shizuko
- Venue
- The American Journal of Geriatric Psychiatry
- Publisher
- Elsevier BV
- Published
- 2016-10
- Volume
- 24
- Issue
- 10
- Pages
- 816-820
- ISSN
- 1064-7481 (ISSN-L)
- PMC
- PMC5873289
- OpenAlex
- W2462841403
- Cited by
- 35
- References
- 13
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 3 · 2022: 9 · 2021: 4 · 2020: 5 · 2019: 5 · 2018: 2 · 2017: 4 · 2016: 1
- FWCI
- 3.23
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Geriatric Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (P30 MH68638, R01 MH079414, T32 MH019132, K23 MH095830, UL1TR000457)
- Sanchez Foundation
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- executive dysfunction, treatment-resistant depression, major depressive disorder, elderly patients, neuroplasticity, treatment response prediction, geriatric depression
- MeSH terms
- Cognitive Remediation, Aged, Aged, 80 and over, Antidepressive Agents, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Neuronal Plasticity, Neuropsychological Tests, Treatment Outcome, Executive Function, Depressive Disorder, Treatment-Resistant
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