Impacts Of Neuroplasticity-based Computerized Cognitive Remediation On The Executive Function In Patients With Major Depressive Disorder By MRI

BACKGROUND AND OBJECTIVE Previous studies have mostly explored the clinical efficacy of neuroplasticity-based computerized cognitive remediation(NBCCR)in patients with depression.However,little is known about the mediated improvement of brain function and its related mechanisms.The purpose of the study is to investigate whether NBCCR can improve the brain function and cerebral cortex reconstruction of the executive function of depressed patients through neuropsychological tests,structure and Stroop task-state functional magnetic resonance imaging,thereby promoting execution functional performance.METHODS A total of 40 patients with depression were enrolled in this study,all of whom were recruited from Zhongda Hospital,the treatment(n CCR)group and the control group each included 20 patients.The study used neuropsychological tests,structural and functional magnetic resonance imaging techniques to explore the executive function performance of patients with depression at the time of enrollment and one week later of NBCCR treatment.Patients in the n CCR group received cognitive training(1 week,10 hours in total),while patients in the control group did not.The neuropsychological tests used in the study included MOCA,MMSE,MADRS,and TMT.The MRI data analysis was based on SPM8,RESTPlus and VBM8.The neuropsychological tests and behavioral analysis between the n CCR group and the control group were made by using RStudio and SPSS22.In the study,RStudio software was used to extract the correct response accuracy and correct response time of each patient under different conditions(congruent and incongruent)of the Stroop task.For the comparison of the results of the MOCA,MMSE and MADRS scales between the two groups,a two-sample t-test was performed.Paired sample t-test was performed for trail making test(TMT),response accuracy(%)and correct response time(s)of Stroop test before and after one week of enrollment.In addition,the two-sample t-test included in SPM8 was utilized to analyze the difference in activation between the treatment group and the control group one week later and the enrolled time.Correlation analysis was made between the change value of the mean of the region of interest(ROI)extracted by RESTPlus and the change value of the corresponding psychological test scale and behavioral performance.The time at enrollment and one week later,voxel-based morphological analysis on the difference of grey matter volume between the two groups was compared by two-sample t-test.RESULTS Short-term NBCCR can lead to behavioral(response accuracy and correct reaction time in congruent and incongruent conditions)and scales(TMTA,TMTB)improvements in executive function performance and functional change in Stroop tasks of the n CCR group,while there was no such change in the control group.In the congruent condition,patients in n CCR group displayed higher activation than controls in a region of the right calcarine gyrus,left anterior cingulate gyrus,right insula,right lingual and right superior temporal gyrus following one week of NBCCR;in the incongruent condition,the areas of increased activation included right lingual gyrus,left anterior cingulate gyrus,right insula and right superior temporal gyrus.Following remediation,it was also found that compared with the control group,patients in the n CCR group revealed an increase in the grey matter volume of the right inferior frontal gyrus.Besides,one week later in congruent condition,in n CCR group,value change of left cerebellum,left anterior cingulate gyrus,right insula,right superior temporal gyrus,left fusiform gyrus,right lingual gyrus,left thalamus and left putamen were respectively positively correlated with improved executive function performance;in incongruent condition,these regions included left thalamus,right superior temporal gyrus,left fusiform gyrus,left putamen,right lingual gyrus.CONCLUSION Short-term NBCCR may lead to plastic activation changes(hyperactivation)in the anterior cingulate gyrus,insula,superior temporal gyrus,lingual gyrus,which promotes the improvement of executive function in patients with depression.