The THINC-it Tool for Cognitive Assessment and Measurement in Major Depressive Disorder: Sensitivity to Change

Abstract

Background Herein, we sought to determine the sensitivity to change in cognitive function, as measured by the THINC-it tool, in a sample of adults with major depressive disorder (MDD) receiving standardized antidepressant therapy. Methods Adults meeting the DSM-5 criteria for MDD with at least moderate depressive symptom severity [ i.e. , Montgomery Åsberg Depression Rating Scale (MADRS) total score ≥ 20] were treated with open-label vortioxetine (10–20 mg/day, flexibly-dosed) for 8 weeks. The previously validated THINC-it tool was the primary dependent measure. The THINC-it tool was validated against the paper and pencil version of the Digit Symbol Substitution Test (DSST) and the Trails Making Test B (TMTB). Results After 8 weeks of treatment, adults with MDD exhibited improvement in cognitive function relative to healthy controls ( e.g. , processing speed) (p = 0.031). A subdomain measure of working memory ( i.e. , symbol check; SC) exhibited significant improvement at Weeks 2 and 8 in latency (p = 0.032), SC accuracy (p = 0.046), and objective z-score (p = 0.001) independent of depressive symptoms. A linear regression analysis determined that the THINC-it tool measures of processing speed, as well as executive function were significantly associated with changes observed on the pencil and paper version the Digit Symbol Substitution Test (DSST) (p = 0.002) and in Trails Making Test B (TMTB) (p = 0.003), respectively. Conclusion The THINC-it tool demonstrates sensitivity to change in adults with MDD and is highly correlated with improvements on pencil and paper versions of DSST and TMTB. Clinical Trial Registration ClinicalTrials.gov, identifier NCT03053362.

The Relationship Between Cognitive Dysfunction Through THINC-Integrated Tool (THINC-it) and Psychosocial Function in Chinese Patients With Major Depressive Disorder

“…In the study herein, through the THINC-it test, the cognitive function including subjective cognition, objective cognition and comprehensive score of MDD were significantly different from healthy controls. In accordance with previous research, the cognitive function of patients with MDD was significantly impaired when compared to healthy individuals ( 10 , 13 , 23 , 24 ).…”

“…The THINC-it tool is a simple cognitive screening tool, divided into subjective cognition and objective cognition assessment, including attention, information processing speed, executive function, memory and learning function, which can comprehensively measure cognitive impairment in MDD. The THINC-it has been validated at home and abroad ( 10 , 11 , 23 ). Our team has previously validated and reported on psychometric characteristics of the Chinese version of the THINC-it tool, and it is also the first-ever clinical cognitive screening tool applied to Chinese patients with MDD ( 11 ).…”

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An App-Based Digit Symbol Substitution Test for Assessment of Cognitive Deficits in Adults With Major Depressive Disorder: Evaluation Study

“…The THINC-it Tool has been previously validated as a screening tool and as a repeat measure for cognitive function in adults with MDD [ 12 , 23 ]. A variant of the DSST was included in the THINC-it Tool and accounted for significant variance in the tool’s overall performance, suggesting that the DSST alone may provide sufficient conceptual coverage [ 12 , 23 , 24 ]. This study demonstrated the validity of the app-based Cognition Kit DSST to assess cognitive impairment in patients with MDD and represents a personalized assessment approach that may help guide MBC to inform psychotherapeutic and pharmacologic treatment options.…”