Scientists have identified a novel form of depression known as the cognitive biotype. This type of depression is characterized by difficulties in planning, self-control, focus, and suppressing inappropriate behavior.
Accounting for 27% of depressed patients, this form of depression does not respond well to commonly prescribed serotonin-targeting antidepressants called SSRIs. Brain imaging studies have shown decreased activity in two specific brain regions responsible for these cognitive functions.
The researchers at Stanford Medicine in the US suggest that targeting these cognitive dysfunctions with alternative antidepressants or other treatments could alleviate symptoms and improve social and occupational abilities. The current trial-and-error approach to depression treatment needs to be replaced with a more individualized and effective method.
In a study published in the journal JAMA Network Open, 1,008 adults with major depressive disorder who had not previously taken medication were given one of the commonly prescribed antidepressants. Out of these participants, 712 completed the eight-week treatment.
The participants’ depressive symptoms were evaluated before and after treatment using two surveys. These surveys assessed sleep patterns, eating habits, social functioning, occupational functioning, and overall quality of life.
Additionally, cognitive tests were conducted before and after treatment to measure verbal and working memory, decision speed, and sustained attention, among other cognitive abilities.
Prior to treatment, 96 individuals underwent functional MRI scans while performing a cognitive task known as the “GoNoGo” task. The scans showed decreased activity levels in certain brain regions associated with this task compared to individuals without depression.
The researchers found that 27% of the participants exhibited symptoms of cognitive slowing, insomnia, impaired cognitive function, and reduced activity in specific frontal brain regions. This profile was labeled the cognitive biotype.
Using imaging techniques in depression treatment studies is a novel approach that provides objective measures to guide treatment decisions. This is particularly important as psychiatrists currently rely mainly on observations and self-report measures.
Participants with the cognitive biotype showed significantly reduced activity in the dorsolateral prefrontal cortex and dorsal anterior cingulate regions during the GoNoGo task compared to those without the cognitive biotype.
These two brain regions form the cognitive control circuit, which is responsible for regulating thoughts and responses and improving goal selection.
After treatment, the overall remission rates for depressive symptoms were 38.8% for participants with the cognitive biotype and 47.7% for those without it. The remission rates were the lowest for the antidepressant sertraline.
According to Leanne Williams, the senior author and professor of psychiatry and behavioral sciences, finding commonalities like shared brain function profiles can help medical professionals personalize depression treatment for better outcomes.
(This story has not been edited by News18 staff and is published from a syndicated news agency feed – PTI)
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