Mindfulness-Enhanced Computerized Cognitive Training for Depression: An Integrative Review and Proposed Model Targeting the Cognitive Control and Default-Mode Networks

Abstract

Depression is often associated with co-occurring neurocognitive deficits in executive function (EF), processing speed (PS) and emotion regulation (ER), which impact treatment response. Cognitive training targeting these capacities results in improved cognitive function and mood, demonstrating the relationship between cognition and affect, and shedding light on novel targets for cognitive-focused interventions. Computerized cognitive training (CCT) is one such new intervention, with evidence suggesting it may be effective as an adjunct treatment for depression. Parallel research suggests that mindfulness training improves depression via enhanced ER and augmentation of self-referential processes. CCT and mindfulness training both act on anti-correlated neural networks involved in EF and ER that are often dysregulated in depression—the cognitive control network (CCN) and default-mode network (DMN). After practicing CCT or mindfulness, downregulation of DMN activity and upregulation of CCN activity have been observed, associated with improvements in depression and cognition. As CCT is posited to improve depression via enhanced cognitive function and mindfulness via enhanced ER ability, the combination of both forms of training into mindfulness-enhanced CCT (MCCT) may act to improve depression more rapidly. MCCT is a biologically plausible adjunct intervention and theoretical model with the potential to further elucidate and target the causal mechanisms implicated in depressive symptomatology. As the combination of CCT and mindfulness has not yet been fully explored, this is an intriguing new frontier. The aims of this integrative review article are four-fold: (1) to briefly review the current evidence supporting the efficacy of CCT and mindfulness in improving depression; (2) to discuss the interrelated neural networks involved in depression, CCT and mindfulness; (3) to present a theoretical model demonstrating how MCCT may act to target these neural mechanisms; (4) to propose and discuss future directions for MCCT research for depression.

Combining mindfulness and cognitive training in children with attention deficit hyperactivity disorder: study protocol of a pilot randomized controlled trial (the NeuroMind study)

“…One previous study of the group evidenced the short-term efficacy (i.e., post-intervention) compared to TAU of the M4H ( Huguet, 2021 ) and there is mounting evidence that CT interventions could be used as effective ways for treating ADHD ( Cortese et al, 2015 ; Caye et al, 2019 ; Fernández-Daza, 2019 ; Drechsler et al, 2020 ; Veloso et al, 2020 ). Particularly, Bursky et al (2022) and Sanchez-Lara et al (2023) suggest the potential benefits of combining CT and MBIs in the treatment of depression and in the improvement of cognition, mood and quality of life of older adults, respectively. However, as far as we know, no study assessed the benefits of combining both approaches in children with ADHD.…”

“…In this line, a recent article suggests the potential benefits of the combination of Computerized CT and MBI in depression, considering that CT may improve EF affected in ADHD and MBIs target emotional regulation deficits, so the combination of both may cause a faster and more robust clinical improvement ( Bursky et al, 2022 ). In this regard, Computerized CT may be a highly applicable approach due to smartphone use and MBIs may provide tools that patients can use in their daily living ( Bursky et al, 2022 ). Another recent article highlights the benefits of this combination of interventions in the cognition, mood and quality of life of older adults ( Sanchez-Lara et al, 2023 ).…”