Effectiveness of a standardised cognitive training in depression and the interaction with HPA-axis regulation

Cognitive impairments are frequently observed among depressed patients. Recent studies have shown that these impairments often persist after recovery from mood symptoms, suggesting dissociation between mood and cognition in depression. Impaired regulation of the hypothalamus-pituitary-adrenocortical (HPA) system during an acute episode is the most consistent laboratory finding in depression and cognitive dysfunction in depression has been linked to hypercortisolism as a result of impaired HPA axis regulation. In a subproject of the Munich-Antidepressant-Response-Signature (MARS) study we evaluated the effect of standardised attention training on cognitive functions in depressed patients and examined whether cognitive improvement depends on HPA-axis regulation. Training effects were evaluated with a comprehensive neuropsychological test battery administered before and after training. We found a significant improvement of attention and transfer effects to the domains of learning and executive functions, but no effect on long term verbal memory. There was no influence of HPA-axis regulation on cognitive deficits or improvement to the training. Systematic cognitive training seems to be an effective intervention strategy to improve in particular attention in depressed patients and should therefore be integrated in the treatment regimen. HPA-axis regulation was not associated with cognitive deficits in general or with the effectiveness of the training procedure.

This study was supported by NCSys Neuro Cognitive Systems.