Cognitive Impairment Along the Course of Depression: Non-Pharmacological Treatment Options

Listunova, Lena; Roth, Corinna; Bartolovic, Marina; Kienzle, Johanna; Bach, Claudia; Weisbrod, Matthias; Roesch-Ely, Daniela

doi:10.1159/000492620

Cited by 35 publications

(30 citation statements)

References 90 publications

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“…Когнитивные нарушения, особенно сохраняющиеся по достижении симптоматической ремиссии, хуже поддаются терапии по сравнению с другими симптомами депрессии. По разным оценкам, устойчивые когнитивные нарушения отмечаются у 30-50% пациентов [37] -то есть в достаточно большом проценте случаев в отношении когнитивных симптомов лечение оказывается неэффективным, наблюдается неполный терапевтический ответ. Поскольку восстановление когнитивных функций необходимо для возвращения к доболезненному уровню функционирования, в последнее время эта проблема привлекает все более пристальное внимание исследователей.…”

Section: Guidelines For the Practitioner в помощь практикующему врачуunclassified

“…Согласно данным обзора, сравнивающего результаты применения ламотриджина, вальпроатов, карбамазепина и окскарбазепина, топирамата и зонисамида при биполярной депрессии, наиболее благоприятным профилем побочных действий в плане когнитивного функционирования обладает ламотриджин [22]. У отдельных групп пациентов он улучшает показатели внимания и памяти, например, при резистентной к клозапину шизофрении [37] или биполярном расстройстве [34].…”

Section: влияние препаратов используемых для терапии депрессии на кunclassified

“…Наконец, нельзя не упомянуть о программах когнитивноповеденческой терапии, направленных на коррекцию когнитивных искажений у пациентов с депрессивными состояниями. Существуют вмешательства, специально разработанные для профилактики депрессии: когнитивная ремедиация, терапия, основанная на осознанности [37]. Последний метод рекомендуется применять после достижения ремиссии; он весьма эффективен в плане коррекции когнитивных нарушений в данный период [74].…”

Section: Guidelines For the Practitioner в помощь практикующему врачуunclassified

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Contemporary approaches to correction of cognitive impairment in endogenous depression

Олейчик¹,

Шишковская²,

Баранов³

2020

V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY

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Cognitive dysfunction is one of the basic symptoms of endogenous depression, gaining much of the researchers’ interest lately. It is observed at the initial stage, at the peak intensity of depressive symptoms and even after their reduction, which leads to the persistence of residual depressive state. Cognitive impairment during the depressive episode can be detected by objective methods (clinical and neuropsychological), and their subjective importance is being revealed by standardized questionnaires. Depressed patients show lower results in executive functions, working memory, reaction speed, verbal learning, immediate and delayed recall subtests of neuropsychological batteries. There are few pharmacological agents (mostly antidepressants) with well-proven procognitive activity in depression. Besides, some new pharmacological and non-pharmacological approaches for treatment of cognitive impairment in depression have appeared lately and are described in literature as promising.

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Section: Guidelines For the Practitioner в помощь практикующему врачуunclassified

Section: влияние препаратов используемых для терапии депрессии на кunclassified

Section: Guidelines For the Practitioner в помощь практикующему врачуunclassified

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Contemporary approaches to correction of cognitive impairment in endogenous depression

Олейчик¹,

Шишковская²,

Баранов³

2020

V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY

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“…Although recent reviews of physical, physiological, and biological therapies have been promising, analysis of these interventions is beyond the scope of this review . We refer the reader to studies on deep brain stimulation (Bergfeld et al, 2017;Kubu et al, 2017), repetitive transcranial magnetic stimulation (Noda et al, 2018), transcranial direct current stimulation, (Salehinejad et al, 2017;Martin et al, 2018), cognitive remediation (Bowie et al, 2013;Trapp et al, 2016;Motter et al, 2016), exercise (Brondino et al, 2017;Buschert et al, 2018) and other physical therapies (Greer et al, 2017;Listunova et al, 2018). Table 5 outlines the main study characteristics for novel therapies used for cognitive impairment in recent trials, generally as augmentation with concomitant antidepressant treatment, and only those with cognitive outcomes have been included.…”

Section: Evaluation Of Novel Treatments On Cognitive Impairmentmentioning

confidence: 99%

Cognitive dysfunction in major depression: From assessment to novel therapies

Atique-Ur-Rehman

Neill

2019

Pharmacology & Therapeutics

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Major depressive disorder (MDD) is a disabling disease associated with profound functional impairment. Cognitive deficits, increasingly recognized as a core feature of MDD, reduce educational, occupational and social outcomes, and impair quality of life and functionality. Unlike cognitive impairments associated with schizophrenia (CIAS), cognitive impairments in depression have been under diagnosed and are poorly understood. Consensus has yet to be reached regarding the nature of these deficits, their appropriate assessment and treatment options. It is unclear whether existing treatments have an impact on cognitive deficits. Here, we conduct a thorough and extensive review o f recent published work on this unmet clinical need (2014-2018). We evaluate the validity of available assessment tools, and examine the evidence for efficacy of current and novel pharmacological therapies. From our analysis, we have established that cognitive deficits are indeed widespread in MDD patients. The THINC-it tool, a recently validated and sensitive cognitive assessment instrument, shows promise for earlier detection of Cognitive Impairment Associated with MDD and could be easily applied in clinical practice. Several potential novel therapies are emerging. Methodological inconsistencies and small underpowered studies, however, have led to conflicting results and inconclusive evidence. Our recommendations include: development of a standardized neurocognitive test battery for MDD, improving clinical trial design, investigating sex differences, and patient stratification. These changes should support the development of improved therapeutic strategies for cognitive dysfunction in MDD patients, as well as facilitate their use in clinical practice.

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“…(2016) found effects of computerized cognitive training, specifically for attention, working memory, and global functioning. In addition, further evidence suggests beneficial effects of CRT on functional outcome (Listunova et al ., 2018). Though accumulating evidence suggests that CRT can be a treatment option in MDD presenting with prominent cognitive impairment, the number of studies so far is small, and definitive statements considering the improvement of daily functioning or depressive symptom reduction cannot be made at present (Kim et al ., 2018).…”

Section: Introductionmentioning

confidence: 99%

Cognitive remediation therapy modulates intrinsic neural activity in patients with major depression

et al. 2019

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BackgroundCognitive impairment is a core feature of major depressive disorder (MDD). Cognitive remediation may improve cognition in MDD, yet so far, the underlying neural mechanisms are unclear. This study investigated changes in intrinsic neural activity in MDD after a cognitive remediation trial.MethodsIn a longitudinal design, 20 patients with MDD and pronounced cognitive deficits and 18 healthy controls (HC) were examined using resting-state functional magnetic resonance imaging. MDD patients received structured cognitive remediation therapy (CRT) over 5 weeks. The whole-brain fractional amplitude of low-frequency fluctuations was computed before the first and after the last training session. Univariate methods were used to address regionally-specific effects, and a multivariate data analysis strategy was employed to investigate functional network strength (FNS).ResultsMDD patients significantly improved in cognitive function after CRT. Baseline comparisons revealed increased right caudate activity and reduced activity in the left frontal cortex, parietal lobule, insula, and precuneus in MDD compared to HC. In patients, reduced FNS was found in a bilateral prefrontal system at baseline (p < 0.05, uncorrected). In MDD, intrinsic neural activity increased in right inferior frontal gyrus after CRT (p < 0.05, small volume corrected). Left inferior parietal lobule, left insula, left precuneus, and right caudate activity showed associations with cognitive improvement (p < 0.05, uncorrected). Prefrontal network strength increased in patients after CRT, but this increase was not associated with improved cognitive performance.ConclusionsOur findings support the role of intrinsic neural activity of the prefrontal cortex as a possible mediator of cognitive improvement following CRT in MDD.

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Cognitive Impairment Along the Course of Depression: Non-Pharmacological Treatment Options

Cited by 35 publications

References 90 publications

Contemporary approaches to correction of cognitive impairment in endogenous depression

Contemporary approaches to correction of cognitive impairment in endogenous depression

Cognitive dysfunction in major depression: From assessment to novel therapies

Cognitive remediation therapy modulates intrinsic neural activity in patients with major depression

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