Executive dysfunction and treatment response in late-life depression.
OBJECTIVE
Executive dysfunction in geriatric depression has been shown to predict poor response to antidepressant medication. The purpose of this review is to clarify which aspects of executive functioning predict poor antidepressant treatment response.


METHODS
Literature review.


RESULTS
From our review, the aspects of executive functioning that appear to be associated with antidepressant response rates are verbal fluency and response inhibition. There is some indication that the semantic strategy component may account for the effects of verbal fluency, although evidence comes from one study and needs replication. Processing speed has been proposed as a substrate that may underlie the effects of executive dysfunction on treatment response. Although processing speed does not appear to account for the relationship between response inhibition and treatment outcome, this issue has yet to be assessed with respect to verbal fluency.


CONCLUSIONS
Verbal fluency and response inhibition are specific aspects of executive dysfunction that appear to impact antidepressant response rates. Disruption of the frontostriatal limbic circuit (particularly the anterior cingulate and dorsolateral prefrontal cortex) may explain the relation between these two mechanisms.
Queens College, City University of New York, NY, USA.
Monique A
MA
Pimontel
Michelle E
ME
Culang-Reinlieb
Sarah S
SS
Morimoto
Joel R
JR
Sneed
D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000503:physiopathology; D003866:Depressive Disorder / Q000188:drug therapy* / Q000503:physiopathology; D056344:Executive Function / Q000187:drug effects*; D015577:Geriatric Assessment; D006801:Humans; D007266:Inhibition, Psychological; D014705:Verbal Behavior / Q000187:drug effects / Q000502:physiology
D000928:Antidepressive Agents