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Combined Cognitive Training and Vortioxetine Mitigates Age-Related Declines in Functional Brain Network Integrity

Published:January 13, 2023DOI:https://doi.org/10.1016/j.jagp.2023.01.004

      Highlights

      • What is the primary question addressed by this study?The primary question addressed was whether adding a pro-cognitive medication (vortioxetine) to cognitive training would alter the association of aging with changes in resting state brain networks across a 6-month trial period.
      • What is the main finding of this study?Vortioxetine added to computerized cognitive training produced significantly greater changes in older adult brain network organization than cognitive training alone over 6 months. Discrete intervention group effects were most evident in the interactions of aging with longitudinal changes in whole brain network segregation and with cingulo-opercular network strength.
      • What is the meaning of the finding?For older adults experiencing age-related cognitive decline, adding vortioxetine to intensive cognitive training has a potentially beneficial effect on the correspondence between aging and functional brain network organization.

      Abstract

      Objective

      Age-related cognitive decline is common and potentially modifiable with cognitive training. Combining cognitive training with pro-cognitive medication offers an opportunity to modify brain networks to mitigate age-related cognitive decline. We tested the hypothesis that the efficacy of cognitive training could be amplified by combining it with vortioxetine, a pro-cognitive and pro-neuroplastic multimodal antidepressant.

      Methods

      We evaluated the effects of 6 months of computerized cognitive training plus vortioxetine (versus placebo) on resting state functional connectivity in older adults (age 65+) with age-related cognitive decline. We first evaluated the association of functional connectivity with age and cognitive performance (N = 66). Then we compared the effects of vortioxetine plus cognitive training versus placebo plus cognitive training on connectivity changes over the training period (n = 20).

      Results

      At baseline, greater age was significantly associated with lower within-network strength and network segregation, and poorer cognitive function. Cognitive training plus vortioxetine over 6 months positively impacted the relationship between age to mean network segregation. These effects were not observed in the placebo group. In contrast, vortioxetine did not modify the relationship of age to change in mean within-network strength. Exploratory analyses identified the cingulo-opercular network as the network most affected by cognitive training plus vortioxetine.

      Conclusion

      This preliminary study provides evidence that combining cognitive training with pro-cognitive medication may modulate the effects of aging on functional brain networks. Results indicate that for older adults experiencing age-related cognitive decline, vortioxetine has a potentially beneficial effect on the correspondence between aging and functional brain network segregation. These results await replication in a larger sample.

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