Dissociating the Effect of Treatment-Resistance on Neuropsychological Performance in Patients with Major Depressive Disorder Open Access
Moreines, Jared (2010)
Published
Abstract
Dissociating the Effect of Treatment-Resistance on Neuropsychological Performance in Patients with Major Depressive Disorder
By Jared L. Moreines
Abstract
Deficits in cognitive functioning are common in depression and
may vary according to a patient's course of illness. Differences in
resting functional magnetic resonance imaging (rfMRI) Functional
Connectivity (FC) of brain regions involved in mood and cognition
have been shown to be associated with cognitive ability and
depressive state. In the present study, healthy controls and
individuals with depression who were either treatment-naïve or
severely treatment-resistant underwent rfMRI scanning and
neuropsychological testing on subtests from the Cambridge
Neuropsychological Test Automated Battery and standard and
emotional versions of the Stroop Task, all previously shown to be
deficient in individuals with depression. Comparisons between all
patients and controls revealed differences in measures of
processing speed, bias for negative information, and executive
functioning. Comparisons between the treatment-naïve and
treatment-resistant groups revealed differences in processing speed
of directed response to emotional words. Due to an issue in the
rfMRI data, it could not be analyzed for this thesis. However, the
results of neuropsychological testing suggest select differences in
the neurocognitive profiles of treatment-naïve versus
treatment-resistant depression related to processing speed.
Limitations of the current study include inability to dissociate
past and current medication effects from treatment-resistance,
small sample size, and no correction for multiple
comparisons.
Table of Contents
Table of Contents
Introduction
Major Depression and Treatment Resistance……………………………………..1
Neuropsychological Functioning in Depression…………………………………..2
Functional Neuroimaging in Depression and Neuropsychology………….5
Present Study Intentions………………………………………………………….........10
Methods Subjects………………………………………………………………………................…..12Neuropsychological Testing Procedure………………………………………….....16
Neurocognitive Battery…………………………………………………………............17
Table 1. Description of Neurocognitive Tests and Expected
Results……..............................................................29
Imaging Protocol…………..……………………………………………...........………..32
ResultsDemographic and Clinical Data………………………………………………….......36
Table 2. Group Demographic Data………………………………………...37
Table 3. Patient Clinical Data……………………………………………......37
Neuropsychological Data………………………………………………………...........38
Table 4. Regular and Emotional Stroop Task Group Data………40
Table 5. Cambridge Neuropsychological Test Automated
Battery Group Data by Subtest……………………………42-45
Imaging Results…………………………………………………………………..............51
Figure 1. Results from T-Test (HC vs. MDD) of Whole Brain
rfMRI FC for Elliot ROI………………………………………….…51
Figure 2. Comparison of Maps Resulting from Seeds in
Affected and Unaffected Slices…………………………….…52
DiscussionSummary and Evaluation of Findings………………………………………….....53
Limitations and Recommendations for Future Studies………….……....61
Conclusion……………………………………………………………………………........….63 References……………………………………………………………………………...............…..64About this Honors Thesis
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