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Targeting Network Dysfunction in Apathy of Late-life Depression Using Digital Therapeutics

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AdventHealth

Status

Begins enrollment in 1 month

Conditions

Apathy
Major Depressive Disorder

Treatments

Behavioral: General Cognitive Training Intervention
Behavioral: Targeted Cognitive Training Intervention

Study type

Interventional

Funder types

Other
NIH

Identifiers

NCT05877885
K23MH129882 (U.S. NIH Grant/Contract)
22-09025304

Details and patient eligibility

About

The goal of this randomized controlled trial is to evaluate the potential of a customized digital cognitive training intervention to target aspects of brain function in apathy of late-life depression and reduce symptoms of apathy and related cognitive and behavioral deficits. The investigators hypothesize that 4 weeks of a customized digital cognitive training program will lead to changes in brain connectivity, apathy severity, and cognitive control performance.

Enrollment

84 estimated patients

Sex

All

Ages

60+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  1. Age 60+ years
  2. Diagnosis of unipolar major depressive disorder without psychotic features, as assessed by the Mini International Neuropsychiatric Interview
  3. Montgomery-Åsberg Depression Rating Scale (MADRS) score > or = 16.
  4. Clinically significant apathy, determined by the Clinician-rated Apathy Evaluation Scale (C-AES > or = to 37)
  5. Off antidepressants or on a stable dose of an antidepressant for 8 weeks and do not intend to change the dose in the next 5 weeks.
  6. On a stable dose of other psychotropic medications, deemed by the investigator to be associated with brain networks of interest, for at least 8 weeks.
  7. Capacity to provide written consent for research assessment and treatment
  8. Ability to follow written and verbal instructions (English) as assessed by the PI and/or study staff.
  9. Total score of > 29 on the Telephone Interview for Cognitive Status (TICS)
  10. Eligible to undergo MRI
  11. Access to a computer or tablet with Wifi capabilities
  12. Able to comply with all testing and study requirements and willingness to participate in the full study duration.

Exclusion criteria

  1. History or presence of psychiatric diagnoses other than major depressive disorder without psychotic features, persistent depressive disorder, generalized anxiety disorder, social anxiety disorder, or specific phobia
  2. Use of cholinesterase inhibitors or psychoactive drugs other than antidepressants or benzodiazepines, including antipsychotics, that in the opinion of the Investigator may confound study data/assessments.
  3. Presence or history of significant neurologic or neurodegenerative disorder (e.g., Alzheimer's disease and other dementias, amnestic Mild Cognitive Impairment, history of stroke, Multiple Sclerosis, Parkinson's disease, epilepsy).
  4. Any other acute medical condition (e.g., cardiac, renal, or respiratory failure; severe chronic obstructive pulmonary disease; metastatic cancer; or debilitated states or less common medical illnesses) that may influence brain systems of interest or interfere with participation or interpretation of the study results.
  5. Participant is currently considered at risk for attempting suicide by the Investigator, has made a suicide attempt within the past year, or is currently demonstrating active suicidal ideation or self-injurious behavior.
  6. Electroconvulsive therapy within the past 12 months
  7. Recent history (within 6 months prior to screening/baseline) of Substance Use Disorder.
  8. Participant is currently enrolled in ongoing concurrent cognitive rehabilitation (note that if a subject is enrolled in psychotherapy, this will not be grounds for exclusion)
  9. Claustrophobia
  10. Color Blindness
  11. Sensory or physical impairment that would preclude cognitive testing or participation in the intervention (e.g., upper limb paralysis) as reported by the participant or observed by the Investigator.
  12. Travelling consecutively for 2+ weeks during the study period to a location that will preclude timely collection of post-treatment MRI data.
  13. Contraindications to MRI scanning including cardiac pacemaker, heart valve replacement, vascular stent, cochlear implant, any other metallic biomedical implant contraindicating to MRI.

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Double Blind

84 participants in 2 patient groups

Targeted Cognitive Training Intervention
Experimental group
Treatment:
Behavioral: Targeted Cognitive Training Intervention
General Cognitive Training Intervention
Active Comparator group
Treatment:
Behavioral: General Cognitive Training Intervention

Trial contacts and locations

2

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Central trial contact

Lauren Oberlin, PhD

Data sourced from clinicaltrials.gov

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