The THINC-it Tool for Cognitive Assessment and Measurement in Major Depressive Disorder: Sensitivity to Change
Roger S McIntyre, Mehala Subramaniapillai, Caroline Park, Hannah Zuckerman, Bing Cao, Yena Lee, Michelle Iacobucci, Flora Nasri, Dominika Fus, Christopher R Bowie, Tanya Tran, Joshua D Rosenblat, Rodrigo B Mansur, Roger S McIntyre, Mehala Subramaniapillai, Caroline Park, Hannah Zuckerman, Bing Cao, Yena Lee, Michelle Iacobucci, Flora Nasri, Dominika Fus, Christopher R Bowie, Tanya Tran, Joshua D Rosenblat, Rodrigo B Mansur
Abstract
Background: Herein, we sought to determine the sensitivity to change in cognitive function, as measured by the THINC-it tool, in a sample of adults with major depressive disorder (MDD) receiving standardized antidepressant therapy.
Methods: Adults meeting the DSM-5 criteria for MDD with at least moderate depressive symptom severity [i.e., Montgomery Åsberg Depression Rating Scale (MADRS) total score ≥ 20] were treated with open-label vortioxetine (10-20 mg/day, flexibly-dosed) for 8 weeks. The previously validated THINC-it tool was the primary dependent measure. The THINC-it tool was validated against the paper and pencil version of the Digit Symbol Substitution Test (DSST) and the Trails Making Test B (TMTB).
Results: After 8 weeks of treatment, adults with MDD exhibited improvement in cognitive function relative to healthy controls (e.g., processing speed) (p = 0.031). A subdomain measure of working memory (i.e., symbol check; SC) exhibited significant improvement at Weeks 2 and 8 in latency (p = 0.032), SC accuracy (p = 0.046), and objective z-score (p = 0.001) independent of depressive symptoms. A linear regression analysis determined that the THINC-it tool measures of processing speed, as well as executive function were significantly associated with changes observed on the pencil and paper version the Digit Symbol Substitution Test (DSST) (p = 0.002) and in Trails Making Test B (TMTB) (p = 0.003), respectively.
Conclusion: The THINC-it tool demonstrates sensitivity to change in adults with MDD and is highly correlated with improvements on pencil and paper versions of DSST and TMTB.
Clinical trial registration: ClinicalTrials.gov, identifier NCT03053362.
Keywords: THINC-it tool; major depressive disorder; measurement; screening; sensitivity; validation.
Copyright © 2020 McIntyre, Subramaniapillai, Park, Zuckerman, Cao, Lee, Iacobucci, Nasri, Fus, Bowie, Tran, Rosenblat and Mansur.
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Source: PubMed