Motivational enhancement of cognitive control depends on depressive symptoms

Pharmacological targeting of cognitive impairment in depression: recent developments and challenges in human clinical research

Impaired cognition is often overlooked in the clinical management of depression, despite its association with poor psychosocial functioning and reduced clinical engagement. There is an outstanding need for new treatments to address this unmet clinical need, highlighted by our consultations with individuals with lived experience of depression. Here we consider the evidence to support different pharmacological approaches for the treatment of impaired cognition in individuals with depression, including treatments that influence primary neurotransmission directly as well as novel targets such as neurosteroid modulation. We also consider potential methodological challenges in establishing a strong evidence base in this area, including the need to disentangle direct effects of treatment on cognition from more generalised symptomatic improvement and the identification of sensitive, reliable and objective measures of cognition.

Prospective Associations Between Home Practice and Depressive Symptoms in Mindfulness-Based Cognitive Therapy for Recurrent Depression: A 15 Months Follow-Up Study

Background

Home practice is considered a key element in increasing treatment effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for depression. However, long-term longitudinal research into the associations between home practice and depression outcomes is scarce. The current study examined the prospective associations between the extent of formal home practice and subsequent depression severity during 15 months of follow-up.

Methods

Data from two randomized-controlled trials on MBCT for recurrent depression were used (n = 200). Depressive symptoms were assessed at 3-month intervals: 0 (baseline), 3 (posttreatment), 6, 9, 12, and 15 months. Formal home practice frequency was calculated for each 3-month period. Autoregressive latent trajectory (ALT) modelling was applied.

Results

Participants practiced formal exercises on 57% (SD = 0.22, range 0–1) of the days during MBCT, equivalent to an average of 4 days per week, which showed a rapid decline after MBCT. The level of depressive symptoms did not change over the full study period. A small positive association was found between formal home practice frequency during each three-month period on subsequent depressive symptoms, but sensitivity analyses did not confirm this. More robust, a small negative association was found between levels of depressive symptoms at each measurement point and formal home practice frequency during the subsequent three-month periods.

Conclusions

The hypothesis that more frequent home practice would lead to reductions in depressive symptoms was not confirmed in the current study. Rather, it seems that patients with higher levels of depression may subsequently practice less frequently at home. The interplay between home practice and outcome might not be as straightforward as expected. However, these results are preliminary and should be replicated first before recommendations for clinical practice can be formulated.

Smartphone Use and Academic Performance of University Students: A Mediation and Moderation Analysis

The purpose of the undertaken study is to examine the influence of smartphones on the performance of university students in Pakistan. This paper also investigates the functions of a smartphone as exogenous predictors such as smartphone applications, multimedia messaging service (MMS), short message service (SMS), warp-speed processing, and entertainment on the academic performance of a student. This paper also addresses the impact of electronic word of mouth (eWOM) and attitude as mediating variables between exogenous and endogenous variables. Finally, we incorporated technology and addiction as moderating variables between independent variables and the outcome variable to measure the influence of moderating variables. We have taken 684 responses from seven universities in Pakistan and employed the SEM-based multivariate approach for the analysis of the data. The findings of this paper demonstrate that smartphone functions have a significant influence on students’ academic performance, and moderating and mediating variables also have a significant influence on exogenous and endogenous variables. The practical implications have provided a guideline for university teachers, parents, and decision-makers of how a smartphone could be used to improve student academic performance inside and outside university campuses.

Motivation and cognitive control in depression

Depression is linked to deficits in cognitive control and a host of other cognitive impairments arise as a consequence of these deficits. Despite of their important role in depression, there are no mechanistic models of cognitive control deficits in depression. In this paper we propose how these deficits can emerge from the interaction between motivational and cognitive processes. We review depression-related impairments in key components of motivation along with new cognitive neuroscience models that focus on the role of motivation in the decision-making about cognitive control allocation. Based on this review we propose a unifying framework which connects motivational and cognitive control deficits in depression. This framework is rooted in computational models of cognitive control and offers a mechanistic understanding of cognitive control deficits in depression.

Memory differences by sex, but not by previous diagnosis of major depressive disorder

Memory difficulties are consistently reported in Major Depressive Disorder (MDD). Nonetheless, it has not been thoroughly investigated as to whether these deficits persist during remission from MDD. A group of 32 healthy young adults with no history of a mood disorder (M_age = 20.8, SD = 2.1) and 62 remitted depressed young adults (M_age = 21.1, SD = 1.9) completed a neuropsychological battery. The test battery included two measures of nonverbal memory, two measures of verbal memory, and a measure of performance validity. The testing session was repeated three to six weeks later to determine performance stability. No differences were found between healthy controls and remitted depressed patients in either memory domain (all ps > .05) and improvement in performance was exhibited over time for both groups (p = 0.004). Potential practice effects are examined. We found a stronger performance for women than men (p = 0.003), particularly for the Semantic List Learning Task (SLLT) (p = .047). Verbal and nonverbal memory and effort may not be impacted in those who are in a remitted state of MDD, early in the course of the illness. Women demonstrated auditory memory superiority over men, similar to prior research.

The Neurobiology of Personal Control During Reward Learning and Its Relationship to Mood

BACKGROUND

The majority of reward learning neuroimaging studies have not focused on the motivational aspects of behavior, such as the inherent value placed on choice itself. The experience and affective value of personal control may have particular relevance for psychiatric disorders, including depression.

METHODS

We adapted a functional magnetic resonance imaging reward task that probed the value placed on exerting control over one's decisions, termed choice value, in 122 healthy participants. We examined activation associated with choice value; personally chosen versus passively received rewards; and reinforcement learning metrics, such as prediction error. Relationships were tested between measures of motivational orientation (categorized as autonomy, control, and impersonal) and subclinical depressive symptoms.

RESULTS

Anticipating personal choice activated left insula, cingulate, right inferior frontal cortex, and ventral striatum (p_{familywise error-corrected} < .05). Ventral striatal activations to choice were diminished in participants with subclinical depressive symptoms. Personally chosen rewards were associated with greater activation of the insula and inferior frontal gyrus, cingulate cortex, hippocampus, thalamus, and substantia nigra compared with rewards that were passively received. In participants who felt they had little control over their own behavior (impersonal orientation), prediction error signals in nucleus accumbens were stronger during passive trials.

CONCLUSIONS

Previous findings regarding personal choice have been verified and advanced through the use of both reinforcement learning models and correlations with psychopathology. Personal choice has an impact on the extended reward network, potentially allowing these clinically important areas to be addressed in ways more relevant to personality styles, self-esteem, and symptoms such as motivational anhedonia.

Cognitive persistence: Development and validation of a novel measure from the Wisconsin Card Sorting Test

The Wisconsin Card Sorting Test (WCST) has long been used as a neuropsychological assessment of executive function abilities, in particular, cognitive flexibility or "set-shifting". Recent advances in scoring the task have helped to isolate specific WCST performance metrics that index set-shifting abilities and have improved our understanding of how prefrontal and parietal cortex contribute to set-shifting. We present evidence that the ability to overcome task difficulty to achieve a goal, or "cognitive persistence", is another important prefrontal function that is characterized by the WCST and that can be differentiated from efficient set-shifting. This novel measure of cognitive persistence was developed using the WCST-64 in an adult lifespan sample of 230 participants. The measure was validated using individual variation in cingulo-opercular cortex function in a sub-sample of older adults who had completed a challenging speech recognition in noise fMRI task. Specifically, older adults with higher cognitive persistence were more likely to demonstrate word recognition benefit from cingulo-opercular activity. The WCST-derived cognitive persistence measure can be used to disentangle neural processes involved in set-shifting from those involved in persistence.

Perceptual salience does not influence emotional arousal's impairing effects on top-down attention

Emotional arousal impairs top-down attentional control while strengthening bottom-up attentional biases. In this study, we examined whether top-down impairments due to arousal can be modulated by increasing the perceptual salience of the target stimulus. To examine this question, we briefly displayed positive and negative arousing images prior to the encoding of 2 emotionally neutral items, 1 of which was to be remembered and 1 of which was perceptually salient (the to-be-remembered and the salient items were either the same item or different items). Eye tracking was used to measure attention biases during the encoding of the 2 competing neutral items, as well as to measure pupillary responses to the preceding modulator image. Viewing emotional images, regardless of valence, impaired top-down attention to animate stimulus targets (i.e., animals), regardless of perceptual salience. However, these effects on encoding had no influence on recognition memory. Taken together, these findings reveal that exposure to emotionally arousing images impairs top-down attention to animate stimuli, regardless of whether that stimulus is perceptually salient. (PsycINFO Database Record

Distinct Reward Properties are Encoded via Corticostriatal Interactions

The striatum serves as a critical brain region for reward processing. Yet, understanding the link between striatum and reward presents a challenge because rewards are composed of multiple properties. Notably, affective properties modulate emotion while informative properties help obtain future rewards. We approached this problem by emphasizing affective and informative reward properties within two independent guessing games. We found that both reward properties evoked activation within the nucleus accumbens, a subregion of the striatum. Striatal responses to informative, but not affective, reward properties predicted subsequent utilization of information for obtaining monetary reward. We hypothesized that activation of the striatum may be necessary but not sufficient to encode distinct reward properties. To investigate this possibility, we examined whether affective and informative reward properties were differentially encoded in corticostriatal interactions. Strikingly, we found that the striatum exhibited dissociable connectivity patterns with the ventrolateral prefrontal cortex, with increasing connectivity for affective reward properties and decreasing connectivity for informative reward properties. Our results demonstrate that affective and informative reward properties are encoded via corticostriatal interactions. These findings highlight how corticostriatal systems contribute to reward processing, potentially advancing models linking striatal activation to behavior.

Subthreshold depression is associated with impaired resting-state functional connectivity of the cognitive control network

Subthreshold depression (StD) is a prevalent condition associated with social morbidity and increased service utilization, as well as a high risk of developing into a major depressive disorder (MDD). The lack of well-defined diagnostic criteria for StD has limited research on this disorder, with very few brain-imaging studies examining the neurobiology of StD. Yet, identifying the neural pathology of StD has the potential to elucidate risk factors and prognostic markers for major depression and is crucial for developing tailored treatments for patients at mild stages of depression. We investigated resting-state functional connectivity (rs-FC) of the cognitive control network (CCN), known to be dysregulated in MDD, using the bilateral dorsolateral prefrontal cortex (DLPFC) as a seed, focusing on two cohorts of StD subjects (young and middle aged) as well as matched controls. Irrespective of age, we found a significant rs-FC decrease in the CCN of the StD subjects, compared with matched controls, particularly between the DLPFC and the brain regions associated with the representation of self and other mental states (temporo-parietal junction (TPJ) and precuneus), as well as salience detection and orienting (insula). The functional connectivity between the DLPFC and the left TPJ was also associated with depressive symptom scores measured by the Center for Epidemiologic Studies Depression Scale. This finding may shed light on the neural pathology of StD, leading to better understanding of mild stages of depression, its diagnosis and the development of new treatments.