Depression symptoms and cognition in multiple sclerosis: Longitudinal evidence of a specific link to executive control

Abstract

Background:

Depression symptoms are prevalent in multiple sclerosis (MS) and associated with poorer cognition in cross-sectional studies; it is unknown whether changes in depression symptoms track with cognitive changes longitudinally.

Objective:

Investigate whether changes in depression symptoms correspond with cognitive changes over time in MS, and identify specific cognitive functions related to depression symptoms.

Method:

Persons with early relapse-onset MS (n = 165) completed a depression questionnaire (Beck Depression Inventory FastScreen) and tests of cognitive speed, executive control, and memory at baseline and 3-year follow-up. One-way ANOVAs assessed differences in cognitive change across participants with worsened, stable, or improved depression symptoms from baseline to year 3.

Results:

Change in depression symptoms was related to change in executive control (p = 0.001, η_p² = 0.08; worsened mood with worsened executive control; improved mood with improved executive control), even when adjusting for cognitive speed (p = 0.002, η_p² = 0.08). There were no links to cognitive speed (p = 0.826) or memory (p = 0.243). Regarding individual depression symptoms, executive control was related to loss of pleasure and suicidal thoughts.

Conclusions:

Executive control tracks with depression symptoms, raising hope that management of mood may improve executive control. The specific link between executive control and anhedonia implicates dysfunctional reward processing as a key component of MS depression.

Keywords

Depression cognition executive function cohort study multiple sclerosis

Get full access to this article

View all access options for this article.

References

Sumowski

Benedict

Enzinger

, et al. Cognition in multiple sclerosis: State of the field and priorities for the future. Neurology 2018; 90: 278–288.

Taylor

Mhizha-Murira

Smith

, et al. Memory rehabilitation for people with multiple sclerosis. Cochrane Database Syst Rev 2021; 10: Cd008754.

Amatya

Khan

Galea

. Rehabilitation for people with multiple sclerosis: An overview of Cochrane reviews. Cochrane Database Syst Rev 2019; 1: Cd012732.

Brandstadter

Katz Sand

Sumowski

. Beyond rehabilitation: A prevention model of reserve and brain maintenance in multiple sclerosis. Mult Scler 2019; 25(10): 1372–1378.

Feinstein

Magalhaes

Richard

, et al. The link between multiple sclerosis and depression. Nat Rev Neurol 2014; 10: 507–517.

Arnett

Higginson

Voss

, et al. Depression in multiple sclerosis: Relationship to working memory capacity. Neuropsychology 1999; 13(4): 546–556.

Patel

Zambrana

Walker

, et al. Distractibility in multiple sclerosis: The role of depression. Mult Scler J Exp Transl Clin 2016; 2: 2055217316653150.

Whitehouse

Fisk

Bernstein

, et al. Comorbid anxiety, depression, and cognition in MS and other immune-mediated disorders. Neurology 2019; 92: e406–e417.

Glukhovsky

Kurz

Brandstadter

, et al. Depression and cognitive function in early multiple sclerosis: Multitasking is more sensitive than traditional assessments. Mult Scler 2021; 27(8): 1276–1283.

10.

Semkovska

Quinlivan

O'Grady

, et al. Cognitive function following a major depressive episode: A systematic review and meta-analysis. Lancet Psychiatry 2019; 6(10): 851–861.

11.

McDermott

Ebmeier

. A meta-analysis of depression severity and cognitive function. J Affect Disord 2009; 119(1–3): 1–8.

12.

Millan

Agid

Brüne

, et al. Cognitive dysfunction in psychiatric disorders: Characteristics, causes and the quest for improved therapy. Nat Rev Drug Discov 2012; 11: 141–168.

13.

Anderson

Sumowski

. Towards a phenotypic understanding of multiple sclerosis depression. Mult Scler 2023; 29(7): 769–771.

14.

Marrie

Patel

Bernstein

, et al. Anxiety and depression affect performance on the symbol digit modalities test over time in MS and other immune disorders. Mult Scler 2021; 27(8): 1284–1292.

15.

Strober

Arnett

. Depression in multiple sclerosis: The utility of common self-report instruments and development of a disease-specific measure. J Clin Exp Neuropsychol 2015; 37(7): 722–732.

16.

Benedict

Fishman

McClellan

, et al. Validity of the Beck Depression Inventory-Fast Screen in multiple sclerosis. Mult Scler 2003; 9(4): 393–396.

17.

Lansbergen

Kenemans

van Engeland

. Stroop interference and attention-deficit/hyperactivity disorder: A review and meta-analysis. Neuropsychology 2007; 21(2): 251–262.

18.

Sandry

Simonet

Brandstadter

, et al. The Symbol Digit Modalities Test (SDMT) is sensitive but non-specific in MS: Lexical access speed, memory, and information processing speed independently contribute to SDMT performance. Mult Scler Relat Disord 2021; 51: 102950.

19.

Brandstadter

Fabian

Leavitt

, et al. Word-finding difficulty is a prevalent disease-related deficit in early multiple sclerosis. Mult Scler 2020; 26(13): 1752–1764.

20.

Katz Sand

Levy

Fitzgerald

, et al. Mediterranean diet is linked to less objective disability in multiple sclerosis. Mult Scler 2023; 29(2): 248–260.

21.

Kempton

Salvador

Munafò

, et al. Structural neuroimaging studies in major depressive disorder: Meta-analysis and comparison with bipolar disorder. Arch Gen Psychiatry 2011; 68(7): 675–690.

22.

Roddy

Farrell

Doolin

, et al. The hippocampus in depression: More than the sum of its parts? Advanced hippocampal substructure segmentation in depression. Biol Psychiatry 2019; 85: 487–497.

23.

Dewey

Mowry

, et al. Deep gray matter substructure volumes and depressive symptoms in a large multiple sclerosis cohort. Mult Scler 2023; 29(7): 809–818.

24.

Salamone

Cousins

Snyder

. Behavioral functions of nucleus accumbens dopamine: Empirical and conceptual problems with the anhedonia hypothesis. Neurosci Biobehav Rev 1997; 21(3): 341–359.

25.

Grahek

Shenhav

Musslick

, et al. Motivation and cognitive control in depression. Neurosci Biobehav Rev 2019; 102: 371–381.

26.

Westbrook

Braver

. Dopamine does double duty in motivating cognitive effort. Neuron 2016; 89: 695–710.

27.

Snyder

. Major depressive disorder is associated with broad impairments on measures of executive function: A meta-analysis and review. Psychol Bull 2013; 139: 81–132.

28.

Miller

Raison

. The role of inflammation in depression: From evolutionary imperative to modern treatment target. Nat Rev Immunol 2016; 16(1): 22–34.

29.

Heitmann

Andlauer

TFM

Korn

, et al. Fatigue, depression, and pain in multiple sclerosis: How neuroinflammation translates into dysfunctional reward processing and anhedonic symptoms. Mult Scler 2022; 28(7): 1020–1027.

30.

McIntosh

Liu

Allan

, et al. Clinical practice guidelines for the detection and treatment of depression in multiple sclerosis: A systematic review. Neurol Clin Pract 2023; 13(3): e200154.

31.

Cuthbert

. The RDoC framework: Facilitating transition from ICD/DSM to dimensional approaches that integrate neuroscience and psychopathology. World Psychiatry 2014; 13(1): 28–35.

32.

Benedict

Cox

Thompson

, et al. Reliable screening for neuropsychological impairment in multiple sclerosis. Mult Scler 2004; 10(6): 675–678.

33.

Shilyansky

Williams

Gyurak

, et al. Effect of antidepressant treatment on cognitive impairments associated with depression: A randomised longitudinal study. Lancet Psychiatry 2016; 3(5): 425–435.

34.

Fiest

Walker

Bernstein

, et al. Systematic review and meta-analysis of interventions for depression and anxiety in persons with multiple sclerosis. Mult Scler Relat Disord 2016; 5: 12–26.

35.

Fischer

Schröder

Vettorazzi

, et al. An online programme to reduce depression in patients with multiple sclerosis: A randomised controlled trial. Lancet Psychiatry 2015; 2(3): 217–223.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.03 MB