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

doi:10.3389/fpsyt.2020.00546

The THINC-it Tool for Cognitive Assessment and Measurement in Major Depressive Disorder: Sensitivity to Change

Front Psychiatry. 2020 Jun 24:11:546. doi: 10.3389/fpsyt.2020.00546. eCollection 2020.

Authors

Roger S McIntyre^{1

2

3

4

5}, Mehala Subramaniapillai¹, Caroline Park^{1

5}, Hannah Zuckerman¹, Bing Cao¹, Yena Lee^{1

5}, Michelle Iacobucci¹, Flora Nasri¹, Dominika Fus¹, Christopher R Bowie^{6

7}, Tanya Tran⁶, Joshua D Rosenblat¹, Rodrigo B Mansur^{1

3}

Affiliations

¹ Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.
² Brain and Cognition Discovery Foundation, Toronto, ON, Canada.
³ Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
⁴ Department of Pharmacology, University of Toronto, Toronto, ON, Canada.
⁵ Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
⁶ Department of Psychology, Queen's University, Kingston, ON, Canada.
⁷ Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.

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.

Associated data

ClinicalTrials.gov/NCT03053362