title: Neuroplasticity-based computerized cognitive remediation for geriatric depression.
abstract: OBJECTIVE
  This article describes a novel treatment model designed to target specific neurocognitive deficits in geriatric depression with neuroplasticity-based computerized cognitive remediation (NBCCR).
  
  
  METHODS
  The recent National Institute of Mental Health (NIMH) report "From Discovery to Cure" calls for studies focusing on mechanisms of treatment response with the goal of arriving at new interventions for those who do not respond to existing treatments. We describe the process that led to the identification of specific executive deficits and their underlying neurobiology, as well as the rationale for targeting these symptoms as a part of a strategy intended to improve both executive dysfunction and depression. We then propose a strategy for further research in this emerging area.
  
  
  CONCLUSIONS
  Despite significant developments, conventional antidepressant treatments leave many older adults still depressed and suffering. Psychotherapy may be effective in some depressed elders, although a recent review concluded that none of the available treatment studies meets stringent criteria for efficacy in the acute treatment of geriatric depression. Appropriately developed and targeted NBCCR, has the potential to serve as a novel treatment intervention for geriatric depression. Pathophysiological changes associated with executive dysfunction may be an appropriate target for NBCCR. Examining both behavioral changes and indices of structural integrity and functional change of networks related to cognitive and emotional regulation may lead to a novel treatment and elucidate the role of specific cerebral networks in geriatric depression.
authors.affiliation: Department of Psychiatry, Institute of Geriatric Psychiatry, Weill Cornell Medical College, White Plains, NY, USA. ssm9006@med.cornell.edu
authors.forename: Sarah Shizuko
authors.initials: SS
authors.lastname: Morimoto
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Wexler
authors.forename: George S
authors.initials: GS
authors.lastname: Alexopoulos
mesh_terms: D003072:Cognition Disorders / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003866:Depressive Disorder / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D056344:Executive Function / Q000502:physiology; D005852:Geriatric Psychiatry; D006801:Humans; D009473:Neuronal Plasticity / Q000502:physiology; D009483:Neuropsychological Tests; D013813:Therapy, Computer-Assisted