A new category of depression known as the cognitive biotype has been uncovered by researchers at Stanford Medicine (1^✔ ✔Trusted Source
Stanford Medicine-led research identifies a subtype of depression

Go to source). This type of depression, which affects 27% of depressed patients, is characterized by cognitive dysfunction and is less responsive to commonly prescribed antidepressants that target serotonin.

The cognitive tasks performed by these patients revealed difficulties in planning, self-control, sustained focus, and inhibiting inappropriate behavior. Additionally, brain imaging showed decreased activity in specific regions responsible for these cognitive functions. Recognizing the limitations of traditional mood-based definitions of depression, scientists are now exploring alternative treatments that target cognitive dysfunctions to alleviate symptoms and restore social and occupational abilities.

Unveiling Cognitive Biotype: A New Type of Depression

The study involved 1,008 adults with previously unmedicated major depressive disorder who were randomly assigned one of three widely prescribed antidepressants: escitalopram, sertraline, or venlafaxine-XR. Depressive symptoms were measured using surveys, and cognitive tests were conducted to assess verbal memory, working memory, decision speed, and sustained attention. Functional magnetic resonance imaging (fMRI) was used to scan participants’ brain activity during a cognitive task called “GoNoGo.” The results identified 27% of participants who exhibited cognitive slowing, insomnia, impaired cognitive function, and reduced activity in certain frontal brain regions, defining the cognitive biotype.

Implications for Treatment and Personalized Care of Depression

The study’s findings have important implications for the treatment of depression. Traditional methods of diagnosing and treating depression often rely on subjective observations and self-report measures. However, the use of cognitive tasks and imaging during treatment studies is a novel approach that offers valuable insights. By identifying depression biotypes through behavior measurement and imaging, medical professionals can tailor treatments more effectively. The researchers propose the integration of surveys and imaging as diagnostic tools to guide personalized treatment decisions. Ongoing research is exploring medications such as guanfacine, which specifically target the brain regions associated with the cognitive biotype, as well as alternative treatments like transcranial magnetic stimulation and cognitive behavioral therapy.

Paving the Way for Improved Depression Care

The cognitive biotype study sheds light on the heterogeneity of depression and highlights the need for individualized care. Current trial-and-error approaches often lead to prolonged suffering, loss of hope, and increased suicidality among individuals with depression. By expanding the understanding of depression biotypes and exploring diverse treatment options, researchers aim to revolutionize depression care. Conducting further studies with participants displaying the cognitive biotype will allow for comparisons between different medications, transcranial magnetic stimulation, and cognitive behavioral therapy. Ultimately, the goal is to provide more targeted and effective treatments, transforming the current treatment landscape and offering hope to those living with depression.