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Xue Y, Wang L, Liu T, Zhao T, Xie K, Guo J, Chen J, Tang H, Tang M. Omega-3 polyunsaturated fatty acids supplementation improves memory in first-diagnosed, drug-naïve patients with depression: Secondary analysis of data from a randomized controlled trial. J Affect Disord 2024; 350:403-410. [PMID: 38244783 DOI: 10.1016/j.jad.2024.01.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 01/09/2024] [Accepted: 01/14/2024] [Indexed: 01/22/2024]
Abstract
INTRODUCTION Cognitive impairments are found in most patients with major depressive disorder (MDD). It is believed that low Omega-3 polyunsaturated fatty acids (n-3 PUFAs) level raise the risk of anxiety, depressive symptoms and cognition dysfunction. Since our previous research has found n-3 PUFAs supplementation improves anxiety in MDD, this study was to further explore the effectiveness on cognitive impairment among depressed patients. METHODS A total of 72 venlafaxine treated outpatients with first-diagnosed, drug-naïve depression were enrolled. Daily n-3 PUFAs supplementation (2.4 g/d of fish oil, including 1440 mg eicosapentaenoic acid and 960 mg of docosahexaenoic acid) or placebo was used for 12 weeks. Cognitive function, measure by repeatable battery for the assessment of neuropsychological status ([RBANS]) scores, was compared over time. RESULTS Immediate memory, delayed memory and RBANS total scores were significant higher in both groups at week 4 and week 12 compared with baseline. Both groups exhibited improvement on attention scores at week 12. No significant differences were observed comparing n-3 PUFAs with placebo groups in the improvement of total RBANS scores and other subscales except in the change of immediate memory at both week 4 and week 12 (p < 0.05). LIMITATIONS Sample size was relatively low. Moreover, multiple ethnic populations and the income of patients should be considered. Lastly, we used raw scores instead of the standardized scores of RBANS. CONCLUSION N-3 PUFAs supplementation yielded a small but statistically significant improvement on immediate memory in first-diagnosed, drug-naïve depressed patients. While, antidepressant treatment resulted in significant improvement of cognitive function.
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Affiliation(s)
- Ying Xue
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Lu Wang
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders and Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China; Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, and China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Ting Liu
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Tingyu Zhao
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Kaiqiang Xie
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Jimin Guo
- College of Materials Sciences and Engineering, Beijing University of Chemical Technology, Beijing 100029, China
| | - Jindong Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, and China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Hui Tang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, and China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
| | - Mimi Tang
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China.
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Zhou J, Zhou J, Feng Z, Feng L, Xiao L, Chen X, Yang J, Feng Y, Wang G. Identifying the core residual symptom in patients with major depressive disorder using network analysis and illustrating its association with prognosis: A study based on the national cohorts in China. Gen Hosp Psychiatry 2024; 87:68-76. [PMID: 38325144 DOI: 10.1016/j.genhosppsych.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE To identify the core residual symptom of MDD and assess its relationship with patients' long-term outcomes. METHOD All patients were administered antidepressants during the acute phase and treated continuously. The 521 patients remitted at month 6 of a multicenter prospective project were included. Remission was defined as a Quick Inventory of Depressive Symptoms-Self-Report total score of ≤5. Functional impairments were measured with the Sheehan Disability Scale, quality of life with the Quality of Life Enjoyment and Satisfaction Questionnaire - short form, and family burden with the Family Burden Scale of Disease. Visits were scheduled at baseline, weeks 2, 8, 12, and month 6. RESULTS Difficulty with concentration/decision making was the core residual symptom of MDD, determined with the centrality measure of network analysis. It was positively associated with functional impairments and family burden (r = 0.35, P < 0.01 and r = 0.31, P < 0.01, respectively) and negatively associated with life satisfaction (r = -0.29, P < 0.01). The exhibition of this residual symptom was associated with a family history of psychiatric disorders (OR = 2.610 [1.242-5.485]). CONCLUSIONS The core residual symptom of MDD, difficulty with concentration/decision making, is associated with poorer social functioning, heavier family burden, and lower life satisfaction. Early detection and intervention of this symptom may be beneficial. CLINICAL TRIALS REGISTRATION NUMBER (Chinese Clinical Trials.gov identifier) ChiCTR-OOC-17012566 and ChiCTR-INR-17012574.
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Affiliation(s)
- Jingjing Zhou
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Jia Zhou
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zizhao Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Lei Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Le Xiao
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xu Chen
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Jian Yang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yuan Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Gang Wang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
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Peng RJ, Fan Y, Li J, Zhu F, Tian Q, Zhang XB. Abnormalities of electroencephalography microstates in patients with depression and their association with cognitive function. World J Psychiatry 2024; 14:128-140. [PMID: 38327889 PMCID: PMC10845229 DOI: 10.5498/wjp.v14.i1.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/09/2023] [Accepted: 12/22/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND A growing number of recent studies have explored underlying activity in the brain by measuring electroencephalography (EEG) in people with depression. However, the consistency of findings on EEG microstates in patients with depression is poor, and few studies have reported the relationship between EEG microstates, cognitive scales, and depression severity scales. AIM To investigate the EEG microstate characteristics of patients with depression and their association with cognitive functions. METHODS A total of 24 patients diagnosed with depression and 32 healthy controls were included in this study using the Structured Clinical Interview for Disease for The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. We collected information relating to demographic and clinical characteristics, as well as data from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS; Chinese version) and EEG. RESULTS Compared with the controls, the duration, occurrence, and contribution of microstate C were significantly higher [depression (DEP): Duration 84.58 ± 24.35, occurrence 3.72 ± 0.56, contribution 30.39 ± 8.59; CON: Duration 72.77 ± 10.23, occurrence 3.41 ± 0.36, contribution 24.46 ± 4.66; Duration F = 6.02, P = 0.049; Occurrence F = 6.19, P = 0.049; Contribution F = 10.82, P = 0.011] while the duration, occurrence, and contribution of microstate D were significantly lower (DEP: Duration 70.00 ± 15.92, occurrence 3.18 ± 0.71, contribution 22.48 ± 8.12; CON: Duration 85.46 ± 10.23, occurrence 3.54 ± 0.41, contribution 28.25 ± 5.85; Duration F = 19.18, P < 0.001; Occurrence F = 5.79, P = 0.050; Contribution F = 9.41, P = 0.013) in patients with depression. A positive correlation was observed between the visuospatial/constructional scores of the RBANS scale and the transition probability of microstate class C to B (r = 0.405, P = 0.049). CONCLUSION EEG microstate, especially C and D, is a possible biomarker in depression. Patients with depression had a more frequent transition from microstate C to B, which may relate to more negative rumination and visual processing.
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Affiliation(s)
- Rui-Jie Peng
- Suzhou Medical College, Soochow University, Suzhou 215123, Jiangsu Province, China
| | - Yu Fan
- Department of Psychiatry, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou 215137, Jiangsu Province, China
| | - Jin Li
- Department of Psychiatry, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou 215137, Jiangsu Province, China
| | - Feng Zhu
- Department of Psychiatry, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou 215137, Jiangsu Province, China
| | - Qing Tian
- Department of Psychiatry, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou 215137, Jiangsu Province, China
| | - Xiao-Bin Zhang
- Department of Psychiatry, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou 215137, Jiangsu Province, China
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Yan S, Shen S, Lu Q, Zhong S, Lv S, Lai S, Luo Y, Ran H, Duan M, Song K, Ye K, Jia Y. Virtual reality working memory training improves cognitive performance of acute and remitted patients with major depressive disorder. J Affect Disord 2024; 344:267-276. [PMID: 37838265 DOI: 10.1016/j.jad.2023.10.067] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 09/14/2023] [Accepted: 10/09/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND Cognitive training is effective in treating neuropsychological impairment in patients with major depressive disorder (MDD), and virtual reality (VR) is a promising tool to provide such training. However, studies using VR-based working memory (WM) training in treating depressed patients' cognitive impairment are extremely scarce and how it affects cognitive performance remains unclear. Therefore, we aimed to determine the efficacy of VR-WM training in acute and remitted depressed patients and try to investigate its potential mechanisms. METHODS Forty-two patients with MDD (22 acute patients and 20 remitted patients) received 20-session VR-WM training, while 22 healthy controls (HC) received no intervention. WM and other cognitive domains' performance were assessed by the Massachusetts General Hospital Cognitive and Physical Functioning Questionnaire (CPFQ) and the MATRICS Consensus Cognitive Battery (MCCB) before and after the intervention. Depressive symptoms were assessed by the 24-item Hamilton Depression Rating Scale (24-HDRS) at the same time points. RESULTS Acute and remitted MDD patients both exhibited significant improvements from pre- to post-training in WM, processing speed, visual learning, reasoning and problem-solving, and total cognition (all p < 0.05). Significant groups-by-time interactions were observed for the 24-HDRS score (p < 0.05). Mediation analysis showed that 24-HDRS score partially mediated the association between the effect of VR-WM training on WM and total cognition performance in total depressive samples. CONCLUSIONS VR-WM training effectively improved WM and other cognitive domains' performance in both acute and remitted MDD patients. Besides, VR-WM training improves WM and total cognition performance in MDD patients partially via the enhancement of depressive symptoms.
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Affiliation(s)
- Shuya Yan
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shiyi Shen
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; School of Management, Jinan University, Guangzhou 510630, China
| | - Qianyi Lu
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Guangdong University of Finance, Guangzhou 510521, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Sihui Lv
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shunkai Lai
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Yange Luo
- School of Management, Jinan University, Guangzhou 510630, China; Department of Clinical Psychology, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen 518033, China
| | - Hanglin Ran
- School of Management, Jinan University, Guangzhou 510630, China; School of Public Health, Chongqing Medical University, Chongqing 400016, China
| | - Manying Duan
- School of Management, Jinan University, Guangzhou 510630, China
| | - Kailin Song
- School of Management, Jinan University, Guangzhou 510630, China
| | - Kaiwei Ye
- School of Management, Jinan University, Guangzhou 510630, China
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
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Almeida SS, Christensen MC, Simonsen K, Adair M. Effectiveness of vortioxetine in patients with major depressive disorder and co-morbid generalized anxiety disorder in routine clinical practice: A subgroup analysis of the RELIEVE study. J Psychopharmacol 2022; 37:279-288. [PMID: 36377523 PMCID: PMC10076342 DOI: 10.1177/02698811221132468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Generalized anxiety disorder (GAD) is commonly co-morbid with major depressive disorder (MDD) and is associated with greater functional impairment and poorer treatment outcomes than MDD alone. However, studies on treatment with drugs for depression in patients with MDD and co-morbid GAD are limited. AIMS To examine the effectiveness of vortioxetine treatment in patients with MDD and co-morbid GAD in a subgroup analysis of the real-world RELIEVE study. METHODS The analysis included outpatients diagnosed with MDD and co-morbid GAD who initiated vortioxetine treatment at their physician's discretion in the 24-week, observational RELIEVE study. Primary outcome was patient functioning (Sheehan Disability Scale (SDS)) after 12 and 24 weeks of vortioxetine treatment; secondary outcomes included depression severity (9-item Patient Health Questionnaire (PHQ-9)), cognitive symptoms (5-item Perceived Deficits Questionnaire - Depression (PDQ-D-5)) and cognitive performance (Digit Symbol Substitution Test (DSST)). RESULTS Overall, 180 patients with MDD and co-morbid GAD were included in the analysis. Following vortioxetine initiation, clinically significant improvements in patient functioning (SDS total score) were observed at week 12 (least-squares (LS) mean reduction from baseline, 7.5 points), sustained through week 24 (9.2 points) (both p < 0.0001). LS mean PHQ-9, PDQ-D-5 and DSST scores improved by 7.9, 4.8 and 7.4 points at week 24, respectively (all p < 0.0001 vs baseline). Adverse events were reported by 33.9% of patients (most commonly nausea, 13.3%). CONCLUSIONS In routine clinical practice, vortioxetine was associated with clinically meaningful, sustained improvements in functioning, and depressive and cognitive symptoms, in patients with MDD and co-morbid GAD. CLINICAL TRIALS REGISTRY NAME AND IDENTIFIER Real-life Effectiveness of Vortioxetine in Depression (RELIEVE) (NCT03555136) https://clinicaltrials.gov/ct2/show/NCT03555136.
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Affiliation(s)
- Susana S Almeida
- Psychiatry Service, Instituto Português de Oncologia, Porto, Portugal.,Faculty of Medicine, University of Porto, Porto, Portugal
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The Impact of Chronic Unpredictable Mild Stress-Induced Depression on Spatial, Recognition and Reference Memory Tasks in Mice: Behavioral and Histological Study. Behav Sci (Basel) 2022; 12:bs12060166. [PMID: 35735376 PMCID: PMC9219659 DOI: 10.3390/bs12060166] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/23/2022] [Accepted: 05/26/2022] [Indexed: 02/05/2023] Open
Abstract
Depression-induced cognitive impairment has recently been given more attention in research. However, the relationship between depression and different types of memory is still not clear. Chronic unpredictable mild stress (CUMS) is a commonly used animal model of depression in which animals are exposed to chronic unpredictable environmental and psychological stressors, which mimics daily human life stressors. This study investigated the impact of different durations of CUMS on various types of memory (short- and long-term spatial memory and recognition memory) and investigated CUMS’ impact on the ultrastructural level by histological assessment of the hippocampus and prefrontal cortex. Twenty male C57BL/J6 mice (6 weeks old, 21.8 ± 2 g) were randomly divided into two groups (n = 10): control and CUMS (8 weeks). A series of behavioral tasks were conducted twice at weeks 5–6 (early CUMS) and weeks 7–8 (late CUMS). A tail-suspension test (TST), forced swimming test (FST), elevated zero maze (EZM), elevated plus maze (EPM), open field test (OFT), and sucrose-preference test (SPT) were used to assess anxiety and depressive symptoms. The cognitive function was assessed by the novel object recognition test (NORT; for recognition memory), Y-maze (for short-term spatial memory), and Morris water maze (MWM: for long-term spatial memory) with a probe test (for reference memory). Our data showed that 8 weeks of CUMS increased the anxiety level, reported by a significant increase in anxiety index in both EPM and EZM and a significant decrease in central preference in OFT, and depression was reported by a significant increase in immobility in the TST and FST and sucrose preference in the SPT. Investigating the impact of CUMS on various types of memory, we found that reference memory is the first memory to be affected in early CUMS. In late CUMS, all types of memory were impaired, and this was consistent with the abnormal histological features of the memory-related areas in the brain (hippocampus and prefrontal cortex).
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Lang X, Wen D, Li Q, Yin Q, Wang M, Xu Y. fNIRS Evaluation of Frontal and Temporal Cortex Activation by Verbal Fluency Task and High-Level Cognition Task for Detecting Anxiety and Depression. Front Psychiatry 2021; 12:690121. [PMID: 34267690 PMCID: PMC8277106 DOI: 10.3389/fpsyt.2021.690121] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 05/24/2021] [Indexed: 11/28/2022] Open
Abstract
Anxiety and depression are widespread psychosis which are believed to affect cerebral metabolism, especially in frontal and temporal cortex. The comorbidity patients of anxiety and depression (A&D) have more serious clinical symptoms. Functional near-infrared spectroscopy (fNIRS) is a noninvasive modality used to monitor human brain oxygenation, and it could be considered as a potential tool to detect psychosis which may lead to abnormal cerebral oxygen status when the brain is activated. However, how sensitive the cerebral oxygenation response to the cortex activation and whether these responses are consistent at different stages of A&D or different regions still remains unclear. In this study, a conventional physiological paradigm for cortex activation, i.e., verbal fluency task (VFT), and a relatively new paradigm, i.e., high-level cognition task (HCT), were compared to detect A&D through a longitudinal measurement of cerebral oxygen status by fNIRS. The A&D patients at the acute, consolidation and maintenance stages as well as the healthy subjects participated in the VFT and HCT paradigms, respectively. For the VTF paradigm, the subject was instructed to answer questions of phrase constructions within 60 s. For the HCT paradigm, the subject was instructed to categorize items, logical reasoning, and comprehensive judgment and write down the answers within 60 s. For most of the subjects, the oxy-Hb is found to increase remarkably, accompanied with a relatively small reduction in deoxy-Hb when subject to both paradigms. The statistical analyses show a relatively large variability within any group, leading to the significant difference that was only found between A&D at the acute stage and healthy subjects in the temporal lobe region (p < 0.001). Nevertheless, HCT would activate more oxygen increment when compared with the VFT, with a large integral value in oxy-Hb. On average, the oxy-Hb integral value of the A&D patients differs substantially at different stages when subject to HCT paradigm. Moreover, the prefrontal lobe and temporal lobe responses were more consistent to the HCT paradigm rather than the VFT paradigm. Under the VFT paradigm, however, no remarkable difference in integral value was found among the three stages, either at the prefrontal lobe or at the temporal lobe. This study indicated that HCT, which is intensively involved in brain function, would activate more oxygenation changes in the cerebral cortex. Additionally, with good performance at distinguishing different stages according to the oxy-Hb criterion, the HCT has the potential to evaluate the therapeutic effects for A&D patients.
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Affiliation(s)
- Xuenan Lang
- First Hospital of Shanxi Medical University, Taiyuan, China
| | - Dan Wen
- First Hospital of Shanxi Medical University, Taiyuan, China
| | - Qiqi Li
- First Hospital of Shanxi Medical University, Taiyuan, China
| | - Qin Yin
- First Hospital of Shanxi Medical University, Taiyuan, China
| | - Mingyu Wang
- First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yong Xu
- First Hospital of Shanxi Medical University, Taiyuan, China.,Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,Department of Mental Health, Shanxi Medical University, Taiyuan, China
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Bomfim AJDL, Chagas NMDS, Leal LR, Pessoa RMDP, Ferreira BLC, Chagas MHN. Cognitive performance of older adults with a low level of education with and without depression. Dement Neuropsychol 2021; 15:121-127. [PMID: 33907605 PMCID: PMC8049573 DOI: 10.1590/1980-57642021dn15-010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 12/29/2020] [Indexed: 11/21/2022] Open
Abstract
Major depression can develop in individuals aged 60 years or older and is commonly associated with cognitive decline in this population, especially the domains of working memory, attention, executive functions, and processing speed. Schooling is a protective factor with regard to cognitive decline. OBJECTIVE To compare the cognitive performance of community-dwelling older adults with a low level of schooling with and without major depression. METHODS A descriptive, analytical, cross-sectional study was conducted with 22 community-dwelling older adults with depression and 187 without depression. The following assessment tools were employed: Mini Mental Health Examination, Brief Cognitive Screening Battery, Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Digit Span Test (forward and backward), and an object similarity test. RESULTS No statistically significant differences were found between the groups with and without depression on any of the tests. CONCLUSIONS This study demonstrated that there are no differences in the cognitive performance of older people with and without depression on neurocognitive tests commonly used in clinical practice. Future studies with different designs and methods as well as specific tests for older people with a low level of schooling could assist in the understanding of these relations and the mechanisms involved.
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Affiliation(s)
- Ana Julia de Lima Bomfim
- Department of Neurosciences and Behavioral Sciences,
Universidade de São Paulo – Ribeirão Preto, SP, Brazil
- Research Group on Mental Health, Cognition and Aging,
Universidade Federal de São Carlos – São Carlos, SP, Brazil
| | | | - Lívio Rodrigues Leal
- Department of Neurosciences and Behavioral Sciences,
Universidade de São Paulo – Ribeirão Preto, SP, Brazil
- Research Group on Mental Health, Cognition and Aging,
Universidade Federal de São Carlos – São Carlos, SP, Brazil
| | - Rebeca Mendes de Paula Pessoa
- Department of Neurosciences and Behavioral Sciences,
Universidade de São Paulo – Ribeirão Preto, SP, Brazil
- Research Group on Mental Health, Cognition and Aging,
Universidade Federal de São Carlos – São Carlos, SP, Brazil
| | - Bianca Letícia Cavalmoretti Ferreira
- Department of Neurosciences and Behavioral Sciences,
Universidade de São Paulo – Ribeirão Preto, SP, Brazil
- Research Group on Mental Health, Cognition and Aging,
Universidade Federal de São Carlos – São Carlos, SP, Brazil
| | - Marcos Hortes Nisihara Chagas
- Department of Neurosciences and Behavioral Sciences,
Universidade de São Paulo – Ribeirão Preto, SP, Brazil
- Research Group on Mental Health, Cognition and Aging,
Universidade Federal de São Carlos – São Carlos, SP, Brazil
- Bairral Institute of Psychiatry – Itapira, SP, Brazil
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9
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Atique-Ur-Rehman H, Neill JC. Cognitive dysfunction in major depression: From assessment to novel therapies. Pharmacol Ther 2019; 202:53-71. [DOI: 10.1016/j.pharmthera.2019.05.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 05/24/2019] [Indexed: 02/07/2023]
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10
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Baune BT, Christensen MC. Differences in Perceptions of Major Depressive Disorder Symptoms and Treatment Priorities Between Patients and Health Care Providers Across the Acute, Post-Acute, and Remission Phases of Depression. Front Psychiatry 2019; 10:335. [PMID: 31178765 PMCID: PMC6537882 DOI: 10.3389/fpsyt.2019.00335] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 04/29/2019] [Indexed: 11/15/2022] Open
Abstract
Limited data exist on concordance between patients' and health care providers' (HCPs) perceptions regarding symptoms of major depressive disorder (MDD) and treatment priorities, particularly across disease phases. This study examined concordance during the acute, post-acute, and remission phases of MDD. In an online survey, 2,008 patients responded based on their experience with MDD, and 1,046 HCPs responded based on their clinical experience treating patients with MDD. Questions included symptom frequency and severity, treatment priorities, and impact on psychosocial functioning. Patients reported more frequently mood, physical, and cognitive symptoms than HCPs in the post-acute and remission phases and greater impact on psychosocial functioning. Patients reported that all these symptoms require high treatment priority across the phases of MDD, generally to a greater extent than HCPs. Patients also gave high emphasis to addressing impairment in psychosocial functioning early in the treatment course. A substantial difference in the effectiveness of treating symptoms of MDD between patients and HCPs was observed. This is the first study to quantify, broadly, differences in perceptions of MDD symptom prevalence, severity, and treatment priorities across MDD phases, and the study findings highlight a need for improved communication between patients and HCPs about symptoms, their impact on psychosocial functioning, and treatment priorities across phases.
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Affiliation(s)
- Bernhard T Baune
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany.,Department of Psychiatry, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia.,Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
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Abstract
PURPOSE/BACKGROUND Development of the Digit Symbol Substitution Test (DSST) was initiated over a century ago as an experimental tool to understand human associative learning. Its clinical utility, owing to its brevity and high discriminant validity, was first recognized in the 1940s, and now the DSST is among the most commonly used tests in clinical neuropsychology. METHODS Specific studies and articles were reviewed to illustrate what the test measures, to evaluate its sensitivity to change, and to discuss its use in clinical practice. RESULTS The DSST is a valid and sensitive measure of cognitive dysfunction impacted by many domains. Performance on the DSST correlates with real-world functional outcomes (eg, the ability to accomplish everyday tasks) and recovery from functional disability in a range of psychiatric conditions including schizophrenia and major depressive disorder. Importantly, the DSST has been demonstrated to be sensitive to changes in cognitive functioning in patients with major depressive disorder and offers promise as a clinical decision-making tool for monitoring treatment effects in this and other disorders affecting cognition. IMPLICATIONS/CONCLUSIONS The DSST is sensitive to the presence of cognitive dysfunction as well as to change in cognitive function across a wide range of clinical populations but has low specificity to determine exactly which cognitive domain has been affected. However, the DSST offers a practical and effective method to monitor cognitive functions over time in clinical practice.
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Affiliation(s)
- Judith Jaeger
- From CognitionMetrics, LLC, Wilmington, DE; and Albert Einstein College of Medicine, Bronx, NY
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12
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Christensen MC, Florea I, Lindsten A, Baldwin DS. Efficacy of vortioxetine on the physical symptoms of major depressive disorder. J Psychopharmacol 2018; 32:1086-1097. [PMID: 30047820 PMCID: PMC6380624 DOI: 10.1177/0269881118788826] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Efficacy has been proven for vortioxetine in short-term and long-term treatment of major depressive disorder (MDD), with broad beneficial effects on emotional, physical and cognitive symptoms. Limited specific data on the effects of vortioxetine on depression-related physical symptoms have been published. METHODS A meta-analysis was carried out of five short-term multinational, double-blind, placebo-controlled studies. These studies were conducted in a total of 2105 adult MDD outpatients (18-75 years) with a major depressive episode of ⩾3 months' duration. Only patients treated with a dose of 5 or 10 mg vortioxetine (therapeutic doses) or placebo were included in this analysis. Efficacy assessment of vortioxetine on the physical symptoms of depression included all items of the Hamilton Depression Scale (HAM-D) assessing physical symptoms, and all somatic items in the Hamilton Anxiety Scale (HAM-A). A subgroup analysis in MDD patients with coexisting anxiety symptoms (i.e. those with a HAM-A ⩾20 at baseline) was also performed. RESULTS A significant improvement ( p<0.05) of vortioxetine versus placebo was observed on all HAM-D items measuring physical symptoms, except for the somatic gastrointestinal symptoms and loss of weight items. Significant effects were also observed on the HAM-A somatic items: general somatic symptoms, gastrointestinal symptoms, and autonomic symptoms. In patients with a high baseline level of anxiety, a significant effect of vortioxetine was also observed on the physical symptoms of depression. CONCLUSIONS These analyses indicate that patients with MDD, including those with a high level of anxiety symptoms, have significant improvements in MDD-associated physical symptoms when treated with vortioxetine.
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Affiliation(s)
| | | | | | - David S Baldwin
- Clinical and Experimental Sciences,
Faculty of Medicine, University of Southampton, UK,University Department of Psychiatry and
Mental Health, University of Cape Town, South Africa
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13
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Neurocognitive Effects of Agomelatine Treatment in Schizophrenia Patients Suffering From Comorbid Depression: Results From the AGOPSYCH Study. J Clin Psychopharmacol 2018; 38:357-361. [PMID: 29912792 DOI: 10.1097/jcp.0000000000000909] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cognitive impairment in schizophrenia is highly disabling and remains one of the major therapeutic challenges. Agomelatine (AGO), an agonist at melatonergic MT1/MT2 receptors and antagonist at 5-HT2C receptors, increases dopamine and norepinephrine in the prefrontal cortex and may therefore have the potential of improving neurocognition in patients with schizophrenia. METHODS Twenty-seven patients with schizophrenia and comorbid depression were treated with AGO in addition to stable doses of antipsychotic drugs. Cognitive abilities were assessed with the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery (MCCB) at study entry and after 12 weeks of AGO treatment after the intention-to-treat principle. RESULTS We observed statistically significant yet clinically negligible increases of the MCCB composite score and the reasoning/problem solving subscore. Patients with unimpaired sleep at baseline showed greater improvements over time than those with sleep disturbances. Changes on the MCCB were not correlated with other psychometric variables. CONCLUSIONS Despite statistically significant, cognitive improvements after 12 weeks of AGO treatment were clinically irrelevant. Our findings may be limited by baseline properties of the study sample and the study design. In particular, lacking a control group, it cannot be ruled out that improvements were unrelated to AGO treatment. That is why randomized controlled trials are needed to validate the relevance of AGO as a cognitive enhancer in schizophrenia.
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14
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Edusei E, Kim KY, Anoushiravani AA, Yu S, Steiger D, Slover JD. Prevalence of Neurocognitive Dysfunction and Its Effects on Postoperative Outcomes in Total Joint Arthroplasty. J Arthroplasty 2018; 33:350-354. [PMID: 28988611 DOI: 10.1016/j.arth.2017.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 08/29/2017] [Accepted: 09/05/2017] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The prevalence of neurocognitive dysfunction (NCD) and its effects on postoperative outcomes have not been well characterized following total joint arthroplasty (TJA) population. This study aims at better understand this relationship. METHODS Patients were evaluated for neurocognitive function using the grooved pegboard test for the dominant (PEG-D) and nondominant hand (PEG-N), and the Rey Auditory Verbal Learning Test (RAVLT). The patient scores for each test was compared to age-controlled normative values in order to identify NCD. Baseline characteristics and postoperative outcomes were then compared amongst the two cohorts. RESULTS Ninety-nine consecutive patients were prospectively enrolled. Nearly 54% were identified as neurocognitively deficient on at least 1 of the 3 tests (31% by RAVLT, 21% by PEG-D, and 30% by PEG-N). There was a statistically significant prevalence of NCD in patients older than 60 years when compared to normative controls for RAVLT (P < .001). Patients with depression or an American Society of Anesthesiologist score of 3 were 5 times as likely to have NCD, while patients with a body mass index between 20-30 kg/m2 were 5 times less likely to have NCD. Furthermore, patients identified as NCD preoperatively were significantly more likely to be transferred to the intensive care unit (48% vs 14%) and fail physical therapy (64% vs 17%), respectively. CONCLUSION NCD is highly prevalent within total joint arthroplasty candidates and may be correlated with higher body mass index, American Society of Anesthesiologist scores, and rates of depression. The condition predisposes patients to suboptimal postoperative outcomes including increased intensive care unit admissions and prolonged rehabilitation.
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Affiliation(s)
- Emmanuel Edusei
- New York University Langone Medical Center, Hospital for Joint Diseases, New York, New York
| | - Kelvin Y Kim
- New York University Langone Medical Center, Hospital for Joint Diseases, New York, New York
| | - Afshin A Anoushiravani
- New York University Langone Medical Center, Hospital for Joint Diseases, New York, New York
| | - Stephen Yu
- New York University Langone Medical Center, Hospital for Joint Diseases, New York, New York
| | - David Steiger
- New York University Langone Medical Center, Hospital for Joint Diseases, New York, New York
| | - James D Slover
- New York University Langone Medical Center, Hospital for Joint Diseases, New York, New York
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15
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Yun JY, Choi Y, Kwon Y, Lee HY, Choi SH, Jang JH. Hubness of strategic planning and sociality influences depressive mood and anxiety in College Population. Sci Rep 2017; 7:17856. [PMID: 29259322 PMCID: PMC5736715 DOI: 10.1038/s41598-017-18189-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 12/07/2017] [Indexed: 12/13/2022] Open
Abstract
Depressive mood and anxiety can reduce cognitive performance. Conversely, the presence of a biased cognitive tendency may serve as a trigger for depressive mood-anxiety. Previous studies have largely focused on group-wise correlations between clinical-neurocognitive variables. Using network analyses for intra-individual covariance, we sought to decipher the most influential clinical-neurocognitive hub in the differential severity of depressive-anxiety symptoms in a college population. Ninety college students were evaluated for depressive-anxiety symptoms, Minnesota multiphasic personality inventory-2(MMPI-2), and neuro-cognition. Weighted and undirected version of the intra-individual covariance networks, comprised of 18 clinical-neurocognitive variables satisfied small-worldness and modular organization in the sparsity range of K = 0.20-0.21. Furthermore, betweenness centrality of perseverative error for the Wisconsin card sorting test was reduced in more depressive individuals; higher anxiety was related to the increased betweenness centrality of MMPI-2 clinical scale 0(Si). Elevated edge-betweenness centrality of covariance between the MMPI-2 clinical scale 7(Pt) versus commission error of the continuous performance test predicted more anxiety higher than depressive mood. With intra-individual covariance network of clinical-neurocognitive variables, this study demonstrated critical drivers of depressive mood[attenuated influence of strategic planning] or anxiety[domination of social introversion/extroversion, in addition to the influence of compulsivity-impulsivity covariance as a shortcut component among various clinical-neurocognitive features].
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Affiliation(s)
- Je-Yeon Yun
- Seoul National University Hospital, Seoul, Republic of Korea.,Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yoobin Choi
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yoonhee Kwon
- Department of Psychiatry, Seoul National University Health Service Center, Seoul, Republic of Korea
| | - Hwa Young Lee
- Department of Psychiatry, Seoul National University Health Service Center, Seoul, Republic of Korea
| | - Soo-Hee Choi
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Joon Hwan Jang
- Department of Psychiatry, Seoul National University Health Service Center, Seoul, Republic of Korea. .,Department of Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
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