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

Published online by Cambridge University Press:  16 September 2019

Isabella Schneider Open the ORCID record for Isabella Schneider [Opens in a new window] ,
Mike M. Schmitgen ,
Claudia Bach ,
Lena Listunova ,
Johanna Kienzle ,
Fabio Sambataro ,
Malte S. Depping ,
Katharina M. Kubera ,
Daniela Roesch-Ely  and
Robert C. Wolf
Isabella Schneider*
Affiliation:
Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg Germany, Voßstr. 4, 69115Heidelberg, Germany
Mike M. Schmitgen
Affiliation:
Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg Germany, Voßstr. 4, 69115Heidelberg, Germany
Claudia Bach
Affiliation:
Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg Germany, Voßstr. 4, 69115Heidelberg, Germany
Lena Listunova
Affiliation:
Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg Germany, Voßstr. 4, 69115Heidelberg, Germany
Johanna Kienzle
Affiliation:
Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg Germany, Voßstr. 4, 69115Heidelberg, Germany
Fabio Sambataro
Affiliation:
Department of Neuroscience (DNS), University of Padova, Padua, Italy
Malte S. Depping
Affiliation:
Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg Germany, Voßstr. 4, 69115Heidelberg, Germany
Katharina M. Kubera
Affiliation:
Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg Germany, Voßstr. 4, 69115Heidelberg, Germany
Daniela Roesch-Ely
Affiliation:
Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg Germany, Voßstr. 4, 69115Heidelberg, Germany
Robert C. Wolf
Affiliation:
Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg Germany, Voßstr. 4, 69115Heidelberg, Germany
*
Author for correspondence: I. Schneider, E-mail: [email protected]
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Abstract

Background

Cognitive 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.

Methods

In 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).

Results

MDD 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.

Conclusions

Our findings support the role of intrinsic neural activity of the prefrontal cortex as a possible mediator of cognitive improvement following CRT in MDD.

Keywords

Cognitiondepressionfrontal lobeparietal lobeprefrontal cortex
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 14 , October 2020 , pp. 2335 - 2345
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Copyright
Copyright © Cambridge University Press 2019

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