Cognitive Functioning in Psychiatric Disorders Following Deep Brain Stimulation

Insufficient outcomes amongst adults with major depressive disorder (MDD) provide the impetus to identify and refine therapeutic targets that are most critical to outcome from patient, provider, and societal perspectives. Towards this aim, a pivotal shift towards the transnosological domain, cognition, is occurring in the study of MDD and other brain disorders. This paper aims to provide a framework for conceptualizing and prioritizing cognitive function amongst adults with MDD with a particular view to provide a conceptual framework for research and clinical priorities. We also summarize extant data pertaining to psychotropic effects, notably antidepressants, on the cognitive dimension/domain. This narrative review was based on articles identified through a PubMed/MEDLINE search of all English-language articles published between January 1966 and October 2014. The search words were major depressive disorder, depression, unipolar depression, cognition, cognitive dysfunction, cognitive deficit, and cognitive function. The search was supplemented with a manual review of relevant references. The selection of articles for inclusion in this review was based on overall methodological quality as well as on their pertinence to informing the framework described herein. Cognitive dysfunction in MDD is a discrete domain subserved by discrete yet overlapping substrates. There is a need to provide a glossary of terms commonly employed in the cognition literature for consensus as to the appropriate screening, measurement, and monitoring tools. The guiding principle of measurement-based care should include systematic assessment and measurement of cognition in subpopulations with MDD, as a tactic to improve outcome. Relatively few treatment strategies have demonstrated efficacy specifically for the cognitive domain in MDD. The antidepressant vortioxetine has replicated evidence of specific pro-cognitive effects in adults with MDD across multiple subdomains of cognitive function. Vortioxetine is a novel antidepressant that is hypothesized to act through a combination of direct effects on receptor activity and serotonin receptor inhibition, as well as other systems. Pro-cognitive effects for other US FDA-approved agents are suggested, but pseudospecificity has not been excluded as a possible explanation of their beneficial effects on cognitive function. A disparate assortment of other agents are currently under investigation for possible benefit in mitigating cognitive deficits and improving cognitive performance (e.g., intranasal insulin, erythropoietin, anti-inflammatory agents). Non-pharmacological approaches including, but not limited to, cognitive remediation (CR), aerobic exercise, and neuromodulation are promising.

show abstract

“…Preliminary evidence also indicates that deep brain stimulation (DBS) may have beneficial effects on measures of cognition [65,66].…”

Section: Neurostimulationmentioning

confidence: 99%

The Prevalence, Measurement, and Treatment of the Cognitive Dimension/Domain in Major Depressive Disorder

et al. 2015

View full text Add to dashboard Cite

show abstract

“…However, these previously cited studies did not have a control group, and, if they did (Moreines et al, 2014), it was not followed over time. As concluded in a recent review (Bergfeld et al, 2013), DBS seems to be cognitively safe in most of the psychiatric diseases and, particularly, in TRD. However, the authors also point out the necessity of more studies adding further evidence to give support to these findings that in turn overcome some of the limitations of previous works.…”

Section: Introductionmentioning

confidence: 93%

Cognitive functioning after deep brain stimulation in subcallosal cingulate gyrus for treatment-resistant depression: An exploratory study

Serra-Blasco

Vita

Rodríguez

et al. 2015

Psychiatry Research

View full text Add to dashboard Cite

“…De lagere testscores hadden overigens geen beperkend effect op het dagelijks functioneren. In een review van Bergfeld et al werd bij 56 OCS-patiënten geen cognitieve achteruitgang gevonden bij DHS [11]. Sterker nog, in enkele studies werd zelfs een verbetering gezien van het cognitief functioneren.…”

Section: Cognitieve Effectenunclassified

Diepe hersenstimulatie bij obsessieve-compulsieve stoornis: 10 jaar ervaring in het AMC

Bais

Figee

Schuurman³

et al. 2015

Neuroprax

Self Cite

View full text Add to dashboard Cite

Cognitive Functioning in Psychiatric Disorders Following Deep Brain Stimulation

Cited by 33 publications

References 52 publications

The Prevalence, Measurement, and Treatment of the Cognitive Dimension/Domain in Major Depressive Disorder

The Prevalence, Measurement, and Treatment of the Cognitive Dimension/Domain in Major Depressive Disorder

Cognitive functioning after deep brain stimulation in subcallosal cingulate gyrus for treatment-resistant depression: An exploratory study

Diepe hersenstimulatie bij obsessieve-compulsieve stoornis: 10 jaar ervaring in het AMC

Contact Info

Product

Resources

About