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Executive dysfunction and treatment response in late‐life depression
Author(s) -
Pimontel Monique A.,
CulangReinlieb Michelle E.,
Morimoto Sarah S.,
Sneed Joel R.
Publication year - 2012
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.2808
Subject(s) - executive dysfunction , psychology , verbal fluency test , antidepressant , executive functions , dorsolateral prefrontal cortex , prefrontal cortex , depression (economics) , clinical psychology , cognitive psychology , neuroscience , cognition , neuropsychology , hippocampus , economics , macroeconomics
Objectives Executive dysfunction in geriatric depression has been shown to predict poor response to antidepressant medication. The purpose of this review is to clarify which aspects of executive functioning predict poor antidepressant treatment response. Methods Literature review. Results From our review, the aspects of executive functioning that appear to be associated with antidepressant response rates are verbal fluency and response inhibition. There is some indication that the semantic strategy component may account for the effects of verbal fluency, although evidence comes from one study and needs replication. Processing speed has been proposed as a substrate that may underlie the effects of executive dysfunction on treatment response. Although processing speed does not appear to account for the relationship between response inhibition and treatment outcome, this issue has yet to be assessed with respect to verbal fluency. Conclusions Verbal fluency and response inhibition are specific aspects of executive dysfunction that appear to impact antidepressant response rates. Disruption of the frontostriatal limbic circuit (particularly the anterior cingulate and dorsolateral prefrontal cortex) may explain the relation between these two mechanisms. Copyright © 2011 John Wiley & Sons, Ltd.