Hot and cold cognitive disturbances in antidepressant-free patients with major depressive disorder: a NeuroPharm study

Abstract

Background Cognitive disturbances are common and disabling features of major depressive disorder (MDD). Previous studies provide limited insight into the co-occurrence of hot (emotion-dependent) and cold (emotion-independent) cognitive disturbances in MDD. Therefore, we here map both hot and cold cognition in depressed patients compared to healthy individuals. Methods We collected neuropsychological data from 92 antidepressant-free MDD patients and 103 healthy controls. All participants completed a comprehensive neuropsychological test battery assessing hot cognition including emotion processing, affective verbal memory and social cognition as well as cold cognition including verbal and working memory and reaction time. Results The depressed patients showed small to moderate negative affective biases on emotion processing outcomes, moderate increases in ratings of guilt and shame and moderate deficits in verbal and working memory as well as moderately slowed reaction time compared to healthy controls. We observed no correlations between individual cognitive tasks and depression severity in the depressed patients. Lastly, an exploratory cluster analysis suggested the presence of three cognitive profiles in MDD: one characterised predominantly by disturbed hot cognitive functions, one characterised predominantly by disturbed cold cognitive functions and one characterised by global impairment across all cognitive domains. Notably, the three cognitive profiles differed in depression severity. Conclusion We identified a pattern of small to moderate disturbances in both hot and cold cognition in MDD. While none of the individual cognitive outcomes mapped onto depression severity, cognitive profile clusters did. Overall cognition-based stratification tools may be useful in precision medicine approaches to MDD.

Emotional faces processing in major depressive disorder and prediction of antidepressant treatment response: A NeuroPharm study

“…At baseline, depressed individuals responded statistically significantly slower (5%) to faces stimuli relatively to healthy controls. Reaction time to faces and shapes stimuli correlated with basic psychomotor speed, measured with a neuropsychological test outside the MRI environment and unrelated to the task (Dam et al, 2021). This indicates that the slowed psychomotor speed profile also manifests during the emotional faces task.…”

“…Participants completed a comprehensive neuropsychological test battery, including measures of hot and cold cognition (Dam et al, 2021). Here, we report performance from a Simple Reaction Time (SRT) task, which provides a basic measure of psychomotor speed.…”

Table_2.pdf

“…Data on estradiol levels were missing for five women, and data on progesterone levels were missing for six women. Most women were within the normal range of BMI (weight in kg/height in m 2 ), except three who were underweight (BMI <18,5), 11 who were overweight (25)(26)(27)(28)(29)(30), and one who was obese (BMI >30). BMI was significantly higher in non-users.…”

“…All cognitive tests were performed by or supervised by a trained neuropsychologist. The single tests in the program are described in further details in Dam et al, 2020. The main task used to index WM function was the Letter Number Sequencing (LNS) test from WAIS-III.…”

Table_1.pdf

“…We further want to examine the relationship between WM and OC use as sex steroids, especially estradiol, appear to affect cognitive functions and in particular working memory (WM) (24), which notably is also impaired in MDD (25). WM is the ability to temporarily store and manipulate information that is required to carry out cognitive tasks such as comprehension, thinking and reasoning.…”