title: Neuroplasticity-based computerized cognitive remediation for treatment-resistant geriatric depression.
abstract: Executive dysfunction (ED) in geriatric depression (GD) is common, predicts poor clinical outcomes and often persists despite remission of symptoms. Here we develop a neuroplasticity-based computerized cognitive remediation-geriatric depression treatment (nCCR-GD) to target ED in GD. Our assumption is that remediation of these deficits may modulate the underlying brain network abnormalities shared by ED and depression. We compare nCCR-GD to a gold-standard treatment (escitalopram: 20 mg per 12 weeks) in 11 treatment-resistant older adults with major depression; and 33 matched historical controls. We find that 91% of participants complete nCCR-GD. nCCR-GD is equally as effective at reducing depressive symptoms as escitalopram but does so in 4 weeks instead of 12. In addition, nCCR-GD improves measures of executive function more than the escitalopram. We conclude that nCCR-GD may be equally effective as escitalopram in treating GD. In addition, nCCR-GD participants showed greater improvement in executive functions than historical controls treated with escitalopram.
authors.affiliation: Weill Cornell Medical College, Institute of Geriatric Psychiatry, New York, New York 10605, USA.
authors.forename: Sarah Shizuko
authors.initials: SS
authors.lastname: Morimoto
authors.affiliation: Department of Psychiatry, Yale Medical School, New Haven, Connecticut 06519, USA.
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Wexler
authors.affiliation: 1] Department of Psychiatry, Yale Medical School, New Haven, Connecticut 06519, USA [2] Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, China.
authors.forename: Jiacheng
authors.initials: J
authors.lastname: Liu
authors.affiliation: Weill Cornell Medical College, Institute of Geriatric Psychiatry, New York, New York 10605, USA.
authors.forename: Willie
authors.initials: W
authors.lastname: Hu
authors.affiliation: Weill Cornell Medical College, Institute of Geriatric Psychiatry, New York, New York 10605, USA.
authors.forename: Joanna
authors.initials: J
authors.lastname: Seirup
authors.affiliation: Weill Cornell Medical College, Institute of Geriatric Psychiatry, New York, New York 10605, USA.
authors.forename: George S
authors.initials: GS
authors.lastname: Alexopoulos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D016022:Case-Control Studies; D015283:Citalopram / Q000627:therapeutic use; D003071:Cognition; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000628:therapy*; D003865:Major Depressive Disorder / Q000628:therapy*; D056344:Executive Function; D005260:Female; D005853:Geriatrics / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009473:Neuronal Plasticity; D012984:Software; D016896:Treatment Outcome
chemical_list: D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram
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