People with major depressive disorder (MDD) tend to have a brain activity imbalance: hyperactivity in areas involved in emotion processing and decreased activity in areas of cognitive control and emotion regulation.
Now, a new cognitive-emotional treatment delivered via application aims to balance brain activity in these regions so they can work together in a healthier way. The app uses Emotional Faces Memory Task (EFMT), a technology originally developed by two researchers at the Icahn School of Medicine at Mount Sinai.
In a new study, whose findings were presented at the Society of Biological Psychiatry Annual Scientific Convention, this technology was shown to significantly reduce MDD symptoms compared to a control group.
MDD patients show hyperactivity in neural systems involved in emotion processing, such as the amygdala. But they show decreased activity in systems involved in cognitive control and emotion regulation, such as the prefrontal cortex.
The amygdala processes incoming emotionally salient stimuli, whereas the prefrontal cortex, as the executive center of the brain, decides whether the incoming stimuli are noteworthy.
While using the technology, patients are asked to identify the emotions displayed in a series of faces, and for each face, they are asked to identify the number of faces earlier in the series in which they encountered the same emotion. This activity aims to balance the brain activity in these regions.
During the trial, the treatment was shown to reduce MDD symptoms by 42 percent in the experimental group after six weeks compared to 15.7 percent in the control group, which was given a similar task using simple shapes instead of emotions.
“The aim is to target the thinking abnormality we see in patients with MDD — that of perseverating, ruminating, obsessing, dwelling on the negative — by activating these two nodes (emotion processing and cognitive control) simultaneously,” said treatment developer Brian Iacoviello, Ph.D., an assistant professor of psychiatry at Mount Sinai and director of scientific affairs for Click Therapeutics.
“Thus, higher cognitive control regions will stay active even while the brain is processing salient emotional stimuli, giving the individual the capacity to shift their mindfulness and attention so that they are not perseverating.”
The initial results demonstrate the efficacy of this digital therapeutic is comparable to drug therapy, with a highly favorable safety profile.
EFMT is a cognitive-emotional treatment that is delivered via an app on the Click Neurobehavioral Intervention (CNI) platform, a clinically-validated patient engagement platform developed by Click Therapeutics.
Iacoviello developed this treatment with Dennis S. Charney, M.D., Anne and Joel Ehrenkranz Dean and Professor of Psychiatry, Neuroscience, and Pharmacological Sciences.