The Predictive Effect Of Early Changes In Neurocognitive Function On Treatment Outcomes In Patients With Depression After Antidepressant Therapy

Objective: Cognitive dysfunction occurs in patients with Major depressive disorder(depressive disorder);however,the effects of antidepressant treatment in depressive patients are not known.This project intends to use The MATRICS Consensus Cognitive Battery(MCCB)to first understand the impact of early antidepressant treatment on neurocognitive function of depression.Then,the relationship between early changes in cognitive function and acute antidepressant efficacy was explored,with the aim of identifying potential predictors of efficacy and thus providing a theoretical basis for individualized clinical treatment guidance.Methods: A total of 56 patients with depression who met the diagnostic criteria for first episode or recurrent depression in DSM-5were treated with antidepressants such as serotonin reuptake inhibitors(SSRIs)and serotonin-norepinephrine reuptake inhibitors(SNRIs),followed up at the end of two and eight weeks of treatment.Clinical assessment and neurocognitive assessment were performed before treatment and at the end of the second week,and clinical symptom assessment at the end of the eighth week.After all data were collected,the following analyses were performed: The independent sample T-test and Chi-square test were used to compare the demographic,clinical scale,and cognitive data on admission between the effective and ineffective groups of clinical symptom relief.The paired T-test was used to compare differences in each area of cognitive function before and after treatment.Repeated measure analysis of variance was used to explore the difference in cognitive function between effective and ineffective groups before and after drug treatment.The Logistics regression model was used to analyze the relationship between the changes of early cognitive function and the main clinical outcomes of the treatment effect at the 8th week.Results: At baseline,65 treatment-naive patients with depression were enrolled,9 patients dropped out,56 patients completed 2 weeks of antidepressant treatment,clinical assessment and MCCB assessment,and56 patients completed 8 weeks of follow-up.Based on the collected data,we found that:1.After 2 weeks of SSRIs or SNRIs treatment,cognitive domains such as attention/alertness,information processing speed,reasoning and problem solving,and mean T-scores increased from baseline with statistically significant differences(P<0.001).2.Effects of antidepressant therapy on cognitive function in Verballearing after 2 weeks,there was an interaction between groups and time(F=7.997,P=0.007),and there was a significant difference between the time before and after treatment(F=4.431,P<0.05).Post hoc analysis showed that Verballearing cognitive function was worse in the non-response group after antidepressant treatment compared with baseline(P<0.005).Effects of antidepressant treatment on overall cognitive function after 2 weeks,there was an interaction between group and time(F=5.103,P=0.028),and there was a significant difference between the time before and after treatment(F=13.416,P=0.001).Post hoc analysis showed that after antidepressant treatment,the score of overall cognitive function in the response group was higher than the baseline value(P<0.001).3.After antidepressant treatment,early information processing speed(OR=1.414,P=0.028),attention(OR=1.614,P=0.026),Verballearing(OR=1.667,P=0.025),visual learning(OR=1.546,P=0.035),social cognition(OR=1.731,P=0.012)was positively correlated with the improvement of depressive symptoms at 8 weeks,suggesting that subjects with greater early improvement in cognitive function were more likely to be effective at 8 weeks,with statistical significance(P<0.05).Conclusion: This study showed that antidepressant therapy significantly improved early cognitive function in patients.Verballearing function may be an objective marker of neurocognitive changes in the treatment response group compared with the treatment response group.This study also showed that early changes in information processing speed,attention,Verballearing,visual learning,and social cognition were positively correlated with improvement in depressive symptoms at 8weeks,suggesting that subjects with greater early improvement in cognitive function were more likely to be effective at 8 weeks.The findings of this study may provide a theoretical basis for guiding clinical individualized therapy.