Department of Psychology (JDW, SEW, AP), Saint Louis University, St. Louis, MO.
Department of Psychology (JDW, SEW, AP), Saint Louis University, St. Louis, MO.
Am J Geriatr Psychiatry. 2023 Jun;31(6):385-397. doi: 10.1016/j.jagp.2023.01.004. Epub 2023 Jan 14.
Age-related cognitive decline is common and potentially modifiable with cognitive training. Combining cognitive training with pro-cognitive medication offers an opportunity to modify brain networks to mitigate age-related cognitive decline. We tested the hypothesis that the efficacy of cognitive training could be amplified by combining it with vortioxetine, a pro-cognitive and pro-neuroplastic multimodal antidepressant.
We evaluated the effects of 6 months of computerized cognitive training plus vortioxetine (versus placebo) on resting state functional connectivity in older adults (age 65+) with age-related cognitive decline. We first evaluated the association of functional connectivity with age and cognitive performance (N = 66). Then we compared the effects of vortioxetine plus cognitive training versus placebo plus cognitive training on connectivity changes over the training period (n = 20).
At baseline, greater age was significantly associated with lower within-network strength and network segregation, and poorer cognitive function. Cognitive training plus vortioxetine over 6 months positively impacted the relationship between age to mean network segregation. These effects were not observed in the placebo group. In contrast, vortioxetine did not modify the relationship of age to change in mean within-network strength. Exploratory analyses identified the cingulo-opercular network as the network most affected by cognitive training plus vortioxetine.
This preliminary study provides evidence that combining cognitive training with pro-cognitive medication may modulate the effects of aging on functional brain networks. Results indicate that for older adults experiencing age-related cognitive decline, vortioxetine has a potentially beneficial effect on the correspondence between aging and functional brain network segregation. These results await replication in a larger sample.
与认知训练一样，与认知训练相结合的认知增强药物具有潜在的可调节作用，可以改变大脑网络，从而减轻与年龄相关的认知能力下降。我们检验了这样一种假设，即通过将认知训练与认知增强和神经可塑性多模式抗抑郁药沃替西汀相结合，可以增强认知训练的功效。
我们评估了 6 个月的计算机认知训练加沃替西汀（与安慰剂相比）对认知能力下降的老年（年龄≥65 岁）患者静息状态功能连接的影响。我们首先评估了功能连接与年龄和认知表现的相关性（N=66）。然后，我们比较了沃替西汀加认知训练与安慰剂加认知训练对训练期间连接变化的影响（n=20）。
在基线时，较大的年龄与网络内强度和网络分离的降低以及认知功能较差显著相关。6 个月的认知训练加沃替西汀对年龄与平均网络分离之间的关系产生了积极影响。这些效果在安慰剂组中没有观察到。相比之下，沃替西汀并没有改变年龄与网络内强度变化之间的关系。探索性分析确定了扣带-顶叶网络是受认知训练加沃替西汀影响最大的网络。
这项初步研究提供了证据表明，将认知训练与认知增强药物相结合可能会调节衰老对功能大脑网络的影响。结果表明，对于经历与年龄相关的认知能力下降的老年人，沃替西汀可能对衰老与功能大脑网络分离之间的一致性有潜在的有益影响。这些结果有待更大样本的复制。
