title: Improving late life depression and cognitive control through the use of therapeutic video game technology: A proof-of-concept randomized trial.
abstract: Existing treatments for depression are known to have only modest effects, are insufficiently targeted, and are inconsistently utilized, particularly in older adults. Indeed, older adults with impaired cognitive control networks tend to demonstrate poor response to a majority of existing depression interventions. Cognitive control interventions delivered using entertainment software have the potential to not only target the underlying cerebral dysfunction associated with depression, but to do so in a manner that is engaging and engenders adherence to treatment protocol.
  
  
  
  In this proof-of-concept trial (Clinicaltrials.gov #: NCT02229188), individuals with late life depression (LLD) (22; 60+ years old) were randomized to either problem solving therapy (PST, n = 10) or a neurobiologically inspired digital platform designed to enhance cognitive control faculties (Project: EVO™, n = 12). Given the overlapping functional neuroanatomy of mood disturbances and executive dysfunction, we explored the impact of an intervention targeting cognitive control abilities, functional disability, and mood in older adults suffering from LLD, and how those outcomes compare to a therapeutic gold standard.
  
  
  
  EVO participants demonstrated similar improvements in mood and self-reported function after 4 weeks of treatment to PST participants. The EVO participants also showed generalization to untrained measures of working memory and attention, as well as negativity bias, a finding not evident in the PST condition. Individuals assigned to EVO demonstrated 100% adherence.
  
  
  
  This study provides preliminary findings that this therapeutic video game targeting cognitive control deficits may be an efficacious LLD intervention. Future research is needed to confirm these findings.
authors.affiliation: Department of Neurology, University of California, San Francisco, CA, USA.|Department of Psychiatry, University of California, San Francisco, CA, USA.
authors.forename: Joaquin A
authors.initials: JA
authors.lastname: Anguera
authors.affiliation: Department of Psychiatry, Weil Cornell Medicine, New York, NY, USA.
authors.forename: Faith M
authors.initials: FM
authors.lastname: Gunning
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Areán
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology*; D003072:Cognition Disorders / Q000628:therapy*; D003866:Depressive Disorder / Q000628:therapy*; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D011340:Problem Solving / Q000502:physiology*; D000075082:Proof of Concept Study; D013813:Therapy, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D018910:Video Games
keywords: behavioral therapy; cognitive control; depression; problem solving therapy; video game technology