Cognitive control neuroimaging measures differentiate between those with and without future recurrence of depression

Abstract

BackgroundMajor Depressive Disorder (MDD) is a prevalent, disruptive illness. A majority of those with MDD are at high risk for recurrence and increased risk for morbidity and mortality. This study examined whether multimodal baseline (and retest) Cognitive Control performance and neuroimaging markers (task activation and neural connectivity between key brain nodes) could differentiate between those with and without future recurrence of a major depressive (MD) episode within one year. We hypothesized that performance and neuroimaging measures of Cognitive Control would identify markers that differ between these two groups.MethodsA prospective cohort study of young adults (ages 18–23) with history (h) of early-onset MDD (N = 60), now remitted, and healthy young adults (N = 49). Baseline Cognitive Control measures of performance, task fMRI and resting state connectivity (and reliability retest 4–12 weeks later) were used to compare those with future recurrence of MDD (N = 21) relative to those without future recurrence of MDD (N = 34 with resilience). The measures tested were (1) Parametric Go/No-Go (PGNG) performance, and task activation for (2) PGNG Correct Rejections, (3) PGNG Commission errors, and (4 & 5), resting state connectivity analyses of Cognitive Control Network to and from subgenual anterior cingulate.ResultsRelative to other groups at baseline, the group with MDD Recurrence had less bilateral middle frontal gyrus activation during commission errors. MDD Recurrence exhibited greater connectivity of right middle frontal gyrus to subgenual anterior cingulate (SGAC). SGAC connectivity was also elevated in this group to numerous regions in the Cognitive Control Network. Moderate to strong ICCs were present from test to retest, and highest for rs-fMRI markers. There were modest, significant correlations between task, connectivity and behavioral markers that distinguished between groups.ConclusionMarkers of Cognitive Control function could identify those with early course MD who are at risk for depression recurrence. Those at high risk for recurrence would benefit from maintenance or preventative treatments. Future studies could test and validate these markers as potential predictors, accounting for sample selection and bias in feature detection.

Predicting Antidepressant Citalopram Treatment Response via Changes in Brain Functional Connectivity After Acute Intravenous Challenge

“…These regions also display high individual prediction weights for all factors and might represent the influence of MDD on emotion processing (Loeffler et al, 2018 ). Furthermore, activation of these regions was shown to be indicative for future recurrence of depression (Langenecker et al, 2018b ) and can be modulated using SSRIs (Wolf et al, 2018 ). Leaver et al ( 2018 ) predicted electroconvulsive therapy outcomes with BACs of 58–68%: Across CV splits, FP, motor and superior temporal regions were most often selected as important nodes.…”

Cognitive Control as a 5-HT1A-Based Domain That Is Disrupted in Major Depressive Disorder

“…Some existing literature, although mainly with small N studies, suggest that executive functioning is also a good predictor of treatment response and functioning in MDD (Kampf-Sherf et al, 2004; Taylor et al, 2006; Jaeger et al, 2007; Dawson et al, 2017). Executive functioning also can be used to predict recurrence (Langenecker et al, 2018a) and workplace disability (Lee et al, 2018).…”

“…For example, preselecting individuals based upon poor Cognitive Control could lead to a larger percentage with low 5-HT 1A BP ND , facilitating identification of related biomarkers for treatment. As we already know that weaker CC is a predictor of poor treatment response, greater likelihood of recurrence, these individuals might benefit from different treatment algorithms [e.g., TMS trials (Kampf-Sherf et al, 2004; Januel et al, 2006; Siegle et al, 2006; Langenecker et al, 2007c,d, 2018a,b; Levkovitz et al, 2009; Drysdale et al, 2016; Crane et al, 2017; Dawson et al, 2017; Natania et al, 2018)].…”

“…The processing speed with interference resolution includes the trail making test, digit symbol substitution test, stroop color-word test, and response time to targets from the parametric go/no-go test. The parametric go/no-go test was programmed in EPrime 2 completed before the scanning session for practice (Langenecker, 2001; Langenecker et al, 2007a,b,c, 2018a; Votruba and Langenecker, 2013). It was also completed during fMRI.…”

Neurocognitive working mechanisms of the prevention of relapse in remitted recurrent depression (NEWPRIDE): protocol of a randomized controlled neuroimaging trial of preventive cognitive therapy

“…These processes are thought to lay at the core of the pathophysiology of MDD [23–29], and might add to the development and perpetuation of depression through overrepresentation and overinterpretation of negative information and negative affect [23, 30–33]. Several studies have shown that abnormalities in the prefrontal cortex persist in the remitted phase of MDD [34–37] and may predict disease course [38–43]. Furthermore, abnormal prefrontal regulation has been related to specific MDD typical cognitive processes [23, 44–49] that may persist after remission and have been linked to recurrence, such as cognitive biases towards negative information [49–51], heightened cognitive reactivity to stressful situations [52–54], negative rumination [55–58], affective reactivity [59], and inadequate emotion regulation (reflected in an increased tendency to engage in, and difficulty to disengage from, negative mood states) [32, 60, 61].…”