Brain Mechanism Of Computerized Executive Function Training In Patients With Depression

Part 1 Neuroplasticity-based computerized cognitive remediation for Rich-Club organization alterations in patients with depression Objective: The purpose of this study is to investigate the changes in brain network and functional connectivity caused by computerized cognitive training through magnetic resonance research to identify targets for treatment response in patients with depression.Methods: A total of 40 patients with depression were included in this study,17 in the treatment group and 23 in the control group.Both groups underwent two(baseline and week 4)neuropsychological assessments and magnetic resonance imaging.Participants in the n CCR group completed 30 hours of computerized cognitive remediation over 4weeks of 2-3 hours sessions 4-5 times per week on a computer in a private treatment room at the Affiliated Zhong Da Hospital,Southeast University.This paper mainly discusses the Rich-Club organization of the structural brain network,calculates the relevant graph topological indicators,and conducts a correlation analysis with the behavioral indicators.And using the resting-state functional connectivity and structural connectivity coupling methods to demonstrate changes in brain network connectivity.Results: 1)Depressed patients in the treatment group showed an increase in the number of Rich-Club connections after 4 weeks of cognitive training,and it was significantly negatively correlated with the score of TMT-B(Trail Making Test-B);2)We also found an increase in the global efficiency of the structural network connection in the treatment group,which was negatively correlated with the TMT-B score and significantly positively correlated with the number of rich-club connections;3)The global efficiency of the Rich-Club connection of the corresponding functional network also shows an increasing trend,and is negatively correlated with the TMT-B score;4)Additionally,structural connectivity-functional connectivity(SC-FC)coupling between structural network connections and functional network connections in depressed patients was confirmed,especially in the rich-club connectivity,which is negatively correlated with the scores of TMT-A(Trail Making Test-A)and TMT-B.Conclusion: These neuroimaging results prove that computerized cognitive function training could improve the executive function of patients with depression,and it also increases our understanding of the biological mechanisms underlying the treatment effect.Part 2 Neuroplasticity-based computerized cognitive remediation for the local large-scale network connectivity alterations in patients with depressionObjective: Neuroplasticity-based computerized cognitive remediation has the potential to accelerate clinical responses to antidepressants in patients with major depressive disorder and potentially improve patients’ executive function,but the mechanism of its specific antidepressant efficacy remains unclear.We want to understand the changes of the specific resting-state brain network in patients with depression,in order to explore the specific brain targets of this therapy to improve cognitive function,and provide directions for the future clinical treatment of psychiatric diseases.Methods: Forty patients with depression were divided into treatment group(n=17)and control group(n=23).Both groups underwent two neuropsychological evaluations and magnetic resonance imaging(baseline and post 4 weeks).Participants in the n CCR group completed 30 hours of computerized cognitive remediation over 4 weeks of 2-3hours sessions 4-5 times per week on a computer in a private treatment room at the Affiliated Zhong Da Hospital,Southeast University.We intended to explore five wellvalidated resting-state networks consisting of 36 regions of interest(ROI),including default mode network(DMN),dorsal attention network(DAN),control network(CON),salience network(SAL),and sensory-motor network(SMN).The global index,local index and modular index of the functional connection matrix are calculated.Results: 1)Compared with the control group,the depression patients in the treatment group showed changes in global characteristics.There was a significant interaction between the clustering coefficient and the global efficiency,and the global efficiency was negatively correlated with the scores of TMT-A(Trail Making Test-A)and TMTB(Trail Making Test-B);2)The depression patients in the treatment group showed an increase in node centralities,including the dorsal medial prefrontal cortex(dmPFC),the right anterior prefrontal cortex(raPFC)and the right superior parietal regions(r SP),which mainly exist in the CON,and the reduction of node centralities,such as the medial prefrontal region(mPFC),is mainly in the DMN.Among them,the degree values of mPFC and dmPFC are positively correlated and negatively correlated with the score of TMT-B,respectively;3)The depressed patients in the n CCR group exhibited increased internetwork connectivity strength in DAN-CON pair and increased intra-network connectivity strength within the CON and SMN post-treatment compared to baseline.The intra-network connectivity strength within the CON at 4weeks in the treatment group was negatively correlated with the TMT-B score.Conclusion: These results indicate that computerized cognitive training can improve the executive function of patients with depression,and identify the brain regions related to the improvement of executive function,as well as changes in brain networks and functional connections.It also proves that computerized cognitive training can reshape the functional connections of the brain and improve the ability of information interaction between networks.