Major Depressive Disorder
Conditions
Keywords
Drug Therapy
Brief summary
The purpose of this study was to evaluate the feasibility and compliance with a novel method for assessing mood and cognition in participants with major depressive disorder (MDD).
Detailed description
The novel method being tested in this study for assessing mood and cognition in participants with MDD was wearable technology. This study looked at the correlation of mood and cognition outcomes on wearable technology with traditional objective neuropsychological cognitive function tests and self-reported mood outcomes. The study enrolled approximately 30 patients. Participants were provided with a watch on which brief cognitive and mood tests were evaluated daily up to 6 weeks. All participants prompted to complete cognitive and mood assessments on 3 occasions across the day. Two occasions (morning and afternoon) comprised assessment of cognition, and the final assessment in the evening constituted a review of the day focusing on self-reported depressed mood. This single-center trial was conducted in United Kingdom. The overall time to participate in this study was 6 weeks. Participants took part up to 5 study visits (1 in-person on-site visit, 3 web-based and 1 at home visit) assessing performance on traditional objective neuropsychological cognitive function tests and self-reported measures of depression symptom severity and social function.
Interventions
OTHERNo intervention
No intervention
Sponsors
Takeda
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
1. Has MDD as the primary psychiatric diagnosis. 2. Has been treated previously with at least 1 antidepressant (monotherapy). 3. Has scores on Participant Health Questionnaire-9 items (PHQ-9) ≥5 and PHQ-9 ≤15 at Screening
Exclusion criteria
1. Has a significant risk of suicide according to the investigator's clinical judgment or has made an actual suicide attempt in the previous 6 months prior to Screening. 2. Has a history of only responding to either combination or augmentation therapy in the current episode and has had been treated for more than a year without any period of remission. 3. Has 1 or more of the following: 1. Current or history of: manic or hypomanic episode, schizophrenia or any other psychotic disorder, including schizoaffective disorder, major depression with psychotic features, bipolar depression with psychotic features, obsessive compulsive disorder, mental retardation, organic mental disorders, or mental disorders due to a general medical condition as defined in Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). 2. Current diagnosis or history of alcohol or other substance abuse or dependence (excluding nicotine or caffeine). 3. Neurodegenerative disorder (Alzheimer disease, Parkinson disease, multiple sclerosis, Huntington disease, etc).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Days on Which Daily N-back Sessions Were Completed | Baseline up to Week 6 | The cognitive assessment n-back test was completed on the wearable technology (Apple watch) on 3 occasions across the day in the morning, afternoon and evening. |
| Percentage of Days on Which Daily Mood Assessment Tests Were Completed | Baseline up to Week 6 | The Daily Mood assessments were completed on the wearable technology (Apple watch) once per day in the afternoon or evening. |
| Correlation Coefficient Between Measures of Cognition (N-back Scores) and Performance on the Cambridge Neuropsychological Test Automated Battery (CANTAB) Tests: Spatial Working Memory Between Errors (SWMBE) and Spatial Working Memory Strategy (SWMS) | Baseline up to Week 6 | The n-back was used to assess cognition 3 times a day. Participants responded by touching the watch face when a symbol matched the one presented 2-back. Average daily n-back score (d-prime) was calculated. CANTAB tests consists of a battery of neuropsychological tests. Spatial Working Memory (SWM) assessed retention of spatial data, ability to manipulate remembered items and strategize. Participant was asked to find tokens in on-screen boxes and move them. SWMBE=cumulative number of times participant went back to box that a token was previously removed per each successful study. Lower score was better. SWMS=number of unique boxes participant searched in two 6 and 8 box trials. Total of 4 trial scores ranged from 4-28. Lower score indicated better performance. Pearson's correlation coefficient measured linear correlation between n-back scores from Apple Watch and CANTAB tests, provided as a value +1=positive correlation to -1=negative correlation. 0=no correlation. |
| Correlation Coefficient Between Measures of Cognition (N-back Scores) and Performance on the CANTAB Test: Rapid Visual Information Processing (RVP) | Baseline up to Week 6 | The n-back was used to assess cognition 3 times a day. Participants responded by touching the watch face when a symbol matched the one presented 2-back. Average daily n-back score (d-prime) was calculated. CANTAB tests consists of a battery of neuropsychological tests. RVP measures sustained attention. A white box appears in the center of the computer screen, inside which digits, from 2 to 9, appear in a pseudo-random order, at the rate of 100 digits per minute. Participants are requested to detect target sequences of digits. RVPA=measure of sensitivity to the target, regardless of response tendency (expected range is 0.00 to 1.00). Speed of Processing (RVPMDL)=The mean response latency during assessment sequence blocks where the participant responded correctly. Pearson's correlation coefficient measured linear correlation between n-back scores from Apple Watch and CANTAB tests, provided a value +1=positive correlation to -1=negative correlation. 0=no correlation. |
Countries
United Kingdom
Participant flow
Recruitment details
Participants took part in the study at 1 investigative site in the United Kingdom from 29 February 2017 to 03 July 2017.
Pre-assignment details
Participants with a diagnosis of major depressive disorder (MDD) prescribed first-, second- or third-line antidepressant monotherapy were provided with an Apple watch on which brief cognitive and mood tests were evaluated.
Participants by arm
| Arm | Count |
|---|---|
| Participants With Major Depressive Disorder (MDD) Participants with MDD were provided with an Apple watch on which brief cognitive and mood tests were evaluated daily up to 6 weeks. | 30 |
| Total | 30 |
Baseline characteristics
| Characteristic | Participants With Major Depressive Disorder (MDD) | — |
|---|---|---|
| Age, Continuous | 37.23 years STANDARD_DEVIATION 10.41 | — |
| Comorbid Anxiety | 20 participants | — |
| Current Medication Amitriptyline | 4 participants | — |
| Current Medication Citalopram | 9 participants | — |
| Current Medication Escitalopram | 1 participants | — |
| Current Medication Fluoxetine | 2 participants | — |
| Current Medication Mirtazapine | 2 participants | — |
| Current Medication Sertraline | 8 participants | — |
| Current Medication Trazodone | 1 participants | — |
| Current Medication Venlafaxine | 3 participants | — |
| Current Medication by Category Selective Serotonin Reuptake Inhibitor (SSRI) | 20 participants | — |
| Current Medication by Category Serotonin Antagonist and Reuptake Inhibitor (SARI) | 1 participants | — |
| Current Medication by Category Serotonin-Norepinephrine Reuptake Inhibitor (SNRI) | 5 participants | — |
| Current Medication by Category Tricyclic Antidepressant (TCA) | 4 participants | — |
| Medical Switch | 24 participants | — |
| Race and Ethnicity Not Collected | — | — Participants |
| Region of Enrollment United Kingdom | 30 Participants | — |
| Screening Patient Health Questionnaire-9 items (PHQ 9) | 9.13 score on a scale STANDARD_DEVIATION 3.13 | — |
| Sex: Female, Male Female | 19 Participants | — |
| Sex: Female, Male Male | 11 Participants | — |
| Time on Current Medication | 9.93 months STANDARD_DEVIATION 9.74 | — |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 30 |
| other Total, other adverse events | 0 / 30 |
| serious Total, serious adverse events | 0 / 30 |
Outcome results
Primary
Correlation Coefficient Between Measures of Cognition (N-back Scores) and Performance on the Cambridge Neuropsychological Test Automated Battery (CANTAB) Tests: Spatial Working Memory Between Errors (SWMBE) and Spatial Working Memory Strategy (SWMS)
The n-back was used to assess cognition 3 times a day. Participants responded by touching the watch face when a symbol matched the one presented 2-back. Average daily n-back score (d-prime) was calculated. CANTAB tests consists of a battery of neuropsychological tests. Spatial Working Memory (SWM) assessed retention of spatial data, ability to manipulate remembered items and strategize. Participant was asked to find tokens in on-screen boxes and move them. SWMBE=cumulative number of times participant went back to box that a token was previously removed per each successful study. Lower score was better. SWMS=number of unique boxes participant searched in two 6 and 8 box trials. Total of 4 trial scores ranged from 4-28. Lower score indicated better performance. Pearson's correlation coefficient measured linear correlation between n-back scores from Apple Watch and CANTAB tests, provided as a value +1=positive correlation to -1=negative correlation. 0=no correlation.
Time frame: Baseline up to Week 6
Population: Analysis population included all participants with major depressive disorder (MDD) who were enrolled in the study.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Participants With Major Depressive Disorder (MDD) | Correlation Coefficient Between Measures of Cognition (N-back Scores) and Performance on the Cambridge Neuropsychological Test Automated Battery (CANTAB) Tests: Spatial Working Memory Between Errors (SWMBE) and Spatial Working Memory Strategy (SWMS) | SWMBE | -0.46 Correlation Coefficient (r) |
| Participants With Major Depressive Disorder (MDD) | Correlation Coefficient Between Measures of Cognition (N-back Scores) and Performance on the Cambridge Neuropsychological Test Automated Battery (CANTAB) Tests: Spatial Working Memory Between Errors (SWMBE) and Spatial Working Memory Strategy (SWMS) | SWMS | -0.37 Correlation Coefficient (r) |
Primary
Correlation Coefficient Between Measures of Cognition (N-back Scores) and Performance on the CANTAB Test: Rapid Visual Information Processing (RVP)
The n-back was used to assess cognition 3 times a day. Participants responded by touching the watch face when a symbol matched the one presented 2-back. Average daily n-back score (d-prime) was calculated. CANTAB tests consists of a battery of neuropsychological tests. RVP measures sustained attention. A white box appears in the center of the computer screen, inside which digits, from 2 to 9, appear in a pseudo-random order, at the rate of 100 digits per minute. Participants are requested to detect target sequences of digits. RVPA=measure of sensitivity to the target, regardless of response tendency (expected range is 0.00 to 1.00). Speed of Processing (RVPMDL)=The mean response latency during assessment sequence blocks where the participant responded correctly. Pearson's correlation coefficient measured linear correlation between n-back scores from Apple Watch and CANTAB tests, provided a value +1=positive correlation to -1=negative correlation. 0=no correlation.
Time frame: Baseline up to Week 6
Population: Analysis population included all participants with major depressive disorder (MDD) who were enrolled in the study.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Participants With Major Depressive Disorder (MDD) | Correlation Coefficient Between Measures of Cognition (N-back Scores) and Performance on the CANTAB Test: Rapid Visual Information Processing (RVP) | RVPA (Sensitivity to Target) | 0.50 Correlation Coefficient (r) |
| Participants With Major Depressive Disorder (MDD) | Correlation Coefficient Between Measures of Cognition (N-back Scores) and Performance on the CANTAB Test: Rapid Visual Information Processing (RVP) | RVPMDL (Speed of Processing) | -0.40 Correlation Coefficient (r) |
Primary
Percentage of Days on Which Daily Mood Assessment Tests Were Completed
The Daily Mood assessments were completed on the wearable technology (Apple watch) once per day in the afternoon or evening.
Time frame: Baseline up to Week 6
Population: Analysis population included all participants with major depressive disorder (MDD) who were enrolled in the study.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Participants With Major Depressive Disorder (MDD) | Percentage of Days on Which Daily Mood Assessment Tests Were Completed | 94.6 percentage of days | Standard Deviation 9.73 |
Primary
Percentage of Days on Which Daily N-back Sessions Were Completed
The cognitive assessment n-back test was completed on the wearable technology (Apple watch) on 3 occasions across the day in the morning, afternoon and evening.
Time frame: Baseline up to Week 6
Population: Analysis population included all participants with major depressive disorder (MDD) who were enrolled in the study.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Participants With Major Depressive Disorder (MDD) | Percentage of Days on Which Daily N-back Sessions Were Completed | 95.63 percentage of days | Standard Deviation 9.28 |