Evaluation of

attentional/executive difficulties

in unipolar major depression : a preliminary study

Raysséguier C., Vancappel A., Suarez S., El Hage W

L'Encephale, January 2023

Introduction:

Objective of the study:

• To assess executive and attentional deficits in unipolar major depression
• Validation of the MindPulse tool in a population with unipolar major depression

The evaluation is conducted on 46 participants diagnosed with major depressive disorder (65% women), with a mean age of 38.5 years.

Results

CORRELATIONS BETWEEN COGNITIVE TESTS:

*The correlation is significant at the 0.05 level (two-tailed); **The correlation is significant at the 0.01 level (two-tailed)

• The indicators measured by Mindpulse are correlated with different indicators from other
  neuropsychological tests:
  - Simple reaction time is positively correlated with the error rate of D2R (r=0.376, p=0.05)
  - Go No Go is positively correlated with the error rate of D2R and negatively with the processing speed of D2R (r=0.390, p=0.01, r=-0.497, p=0.01)
  - Complex Go No Go is negatively correlated with the processing speed of D2R (r=-0.410, p=0.05)
  - Executive speed is negatively correlated with the processing speed of D2R (r=-0.394, p=0.01)
  - Reaction to difficulty is correlated with the number of interference errors in the Stroop test (r=-0.427, p=0.01).

Example of a major depression case:

The 19-year-old patient is diagnosed with major depression (MADRS=26) and is under medication (Venlafaxine, Xanax). According to the STAI scales, anxiety levels are moderate (Y-A=49; Y-B=51). Regarding the symptomatology measured by ETE, the thresholds are pathological for both cognitive-affective (score=39) and physical (score=28) symptoms of depression, as well as for general anxiety symptoms (score=43). T2S informs us that the patient's planning skills (z-score=-3.02), emotion identification (z-score=-3.05), and problem-solving abilities (z-score=-2.25) are impaired. On the D2R, the patient shows a treatment style that is neither attentive nor focused (E%=97; CCT=69). On the Stroop, the scores are pathological, indicating difficulties in the C board of the Stroop (time=140sec, 90th percentile).

Comparison of cognitive results from MindPulse between depressed patients and matched controls

A slowing down is observed in depressed patients at the perceptual-motor level (Simple Reaction Time) (t= 2.72, p=0.94%) and more pronounced at the executive level (Executive Slowdown t= 3.99, p=0.03%). This double slowdown is accompanied by a loss of precision (increase in total errors t= 2.97, p=0.48%, mainly an increase in inhibition and flexibility errors).

The Drift (Perception of Difficulty) of the Decision Diffusion Model (DDM) of the 2 Go/NoGo tasks is significantly slower in depressed patients who require a higher rate of information accumulation towards the correct decision. This shows a more difficult adjustment process of decision-making and corresponds to data from the literature.

Conclusion

• Significant executive impairment in major unipolar depression population with executive slowing and selective attention
  deficit: better detection with Mindpulse
• Existing links between symptomatology and Mindpulse test: links not found with other tools
• The study continues: inclusions are still ongoing
• Mindpulse data will benefit from profile analysis with the Decision Diffusion Model and Artificial
  Intelligence (AI) using a classifier AI (neural network).