Thursday, April 14, 2022

Digital Tool May Improve Cognitive Functioning Among Adults With MDD

Adults who continue to experience symptoms of major depressive disorder (MDD) while taking antidepressants may benefit from playing a video game-based intervention called AKL-T03, according to a study published this week in the American Journal of Psychiatry. Adults with MDD who played AKL-T03 for six weeks showed improvements in sustained attention and cognitive functioning compared with those who played a different video game.

“Society is facing a growing mental health crisis, with depression rates in the U.S. increasing about 20% during the pandemic. While mood symptoms are most often associated with MDD, equally concerning are the frequent associated cognitive impairments,” lead author Richard Keefe, Ph.D., of Duke University Medical Center said in a news release. “More than ever, we need safe and effective ways to support these patients—new tools that can be easily and broadly accessed.” Keefe is a consultant for Akili Interactive, maker of AKL-T03, and he is the co-founder of VeraSci, which provides support for business entities, including Akili.

Keefe and colleagues conducted the Software Treatment for Actively Reducing the Severity of Cognitive Deficits in Major Depressive Disorder (STARS-MDD) study, a randomized, double-blind six-week controlled trial. The participants were between the ages 25 and 55 years; had an MDD diagnosis; scored between 14 and 22 on the 17-item Hamilton Depression Rating Scale during the study’s screening phase and at its start; scored 50 or less on the Brief Assessment of Cognition; were on antidepressant medication for at least eight weeks prior to screening and at the start of the study; and were kept at a stable antidepressant dosage for at least four weeks prior to the start of the study. Participants’ level of sustained attention and inhibitory control were assessed at baseline and after six weeks using the Test of Variables of Attention (TOVA).

Participants were randomized into two groups: one group was given access to the AKL-T03 intervention, and the other group was given access to a word-based video game (control group). The AKL-T03 interface displays two tasks that participants must complete by multitasking. “[U]sers are presented a perceptual discrimination targeting task in which they must respond to the designated stimulus targets and ignore the stimulus distractors (similar to a go/no-go task) and a sensory motor navigation task in which they must continuously adjust their location to interact with or avoid positional targets,” the authors wrote. In the control group, participants played a video game that involved connecting letters in a grid on the screen vertically, horizontally, or diagonally to form as many words as possible. Both the AKL-T03 and control participants were instructed to complete 25 minutes of game play a day, five times a week for six weeks.

There were 37 participants each in the AKL-T03 and control groups. Those in the AKL-T03 group showed a statistically significant improvement in their sustained attention compared with those in the control group on the TOVA. There was no significant difference between the two groups in other measures assessing working memory, processing speed, task switching, depressive symptoms, and other cognitive symptoms.

“AKL-T03 shows promise for reducing cognitive impairment during a current episode of depression,” the authors wrote. “Further research looking at longitudinal data and durability of effect is needed to confirm the hypothesis that cognitive improvements may have an impact on functional outcomes and potentially on future relapses.”

For related information, see the Psychiatric News article “FDA OKs ADHD Video Game Therapy.”

(Image: iStock/PeopleImages)

COVID-19 Public Health Emergency Extended Through Mid-July

The Department of Health and Human Services has renewed the public health emergency until July 15 due to the continued consequences of COVID-19. States will be given 60 days’ notice before termination of the public health emergency. The public health emergency was initially declared in January 2020, when the coronavirus pandemic began.


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