Vancappel Alexis, Dansou Yecodji, Godin Ophelia, Haffen Emmanuel, Yrondi Antoine, Stephan Florian, Richieri Raphaelle Marie, Molière Fanny, Holtzmann Jérôme, Horn Mathilde, Allauze Etienne, Genty Jean Baptiste, Bouvard Alex, Dorey Jean-Michel, Hennion Vincent, Camus Vincent, Fond Guillaume, Peran Barbara, Walter Michel, Anguill Loic, Scotto D'apolina Charlotte, Vilà Estelle, Fredembach Benjamin, Petrucci Jean, Rey Romain, Nguon Anne Sophie, Etain Bruno, Carminati Mathilde, Courtet Philippe, Vaiva Guillaume, Llorca Pierre Michel, Leboyer Marion, Aouizerate Bruno, Bennabi Djamila, El Hage Wissam
Fondation FondaMental, 94000 Créteil, France.
CHRU de Tours, UMR 1253, iBrain, Université de Tours, Inserm, 37000 Tours, France.
Brain Sci. 2023 Jul 24;13(7):1120. doi: 10.3390/brainsci13071120.
Previous studies set out profound cognitive impairments in subjects with treatment-resistant depression (TRD). However, little is known about the course of such alterations depending on levels of improvement in those patients followed longitudinally. The main objective of this study was to describe the course of cognitive impairments in responder versus non-responder TRD patients at one-year follow-up. The second aim was to evaluate the predictive aspect of cognitive impairments to treatment resistance in patients suffering from TRD. We included 131 patients from a longitudinal cohort (FACE-DR) of the French Network of Expert TRD Centers. They undertook comprehensive sociodemographic, clinical, global functioning, and neuropsychological testing (TMT, Baddeley task, verbal fluencies, WAIS-4 subtests, D2 and RLRI-16) at baseline (V0) and one-year follow-up (V1). Most patients ( = 83; 63.36%) did not respond (47 women, 49.47 ± 12.64 years old), while one-third of patients responded ( = 48, 30 women, 54.06 ± 12.03 years old). We compared the cognitive performances of participants to average theoretical performances in the general population. In addition, we compared the cognitive performances of patients between V1 and V0 and responder versus non-responder patients at V1. We observed cognitive impairments during the episode and after a therapeutic response. Overall, each of them tended to show an increase in their cognitive scores. Improvement was more prominent in responders at V1 compared to their non-responder counterparts. They experienced a more marked improvement in code, digit span, arithmetic, similarities, and D2 tasks. Patients suffering from TRD have significant cognitive impairments that persist but alleviate after therapeutic response. Cognitive remediation should be proposed after therapeutic response to improve efficiency and increase the daily functioning.
以往研究表明，难治性抑郁症（TRD）患者存在严重的认知障碍。然而，对于这些患者纵向随访时认知改变过程与改善程度之间的关系却知之甚少。本研究的主要目的是描述TRD患者在一年随访期内，有反应者与无反应者的认知障碍过程。第二个目的是评估认知障碍对TRD患者治疗抵抗的预测作用。我们纳入了法国TRD专家中心网络纵向队列（FACE-DR）中的131名患者。他们在基线（V0）和一年随访（V1）时接受了全面的社会人口学、临床、整体功能和神经心理学测试（数字符号替换测验、Baddeley任务、语言流畅性、韦氏成人智力量表第4版分测验、D2和RLRI-16）。大多数患者（n = 83；63.36%）无反应（47名女性，49.47±12.64岁），而三分之一的患者有反应（n = 48，30名女性，54.06±12.03岁）。我们将参与者的认知表现与一般人群的平均理论表现进行了比较。此外，我们比较了V1和V0时患者的认知表现，以及V1时有反应者与无反应者的认知表现。我们观察到在发作期间和治疗反应后均存在认知障碍。总体而言，他们每个人的认知分数都有上升趋势。与无反应者相比，有反应者在V1时的改善更为显著。他们在编码、数字广度、算术、相似性和D2任务中经历了更明显的改善。TRD患者存在显著的认知障碍，这些障碍持续存在，但在治疗反应后有所缓解。治疗反应后应进行认知康复训练，以提高效率并改善日常功能。
