A cognitive-emotional treatment for depression, using software developed by researchers at Mount Sinai Health System, has proven to be as effective as antidepressant drug therapy.
The digital therapeutic, Emotional Faces Memory Task (EFMT), a form of psychological test to ascertain the subject's emotional well-being, was tested in a trial at Mount Sinai that resulted in a significantly greater reduction of major depressive disorder (MDD) symptoms compared with a control group, according to initial clinical results presented last month at the Society of Biological Psychiatry Annual Scientific Convention in San Diego.
In the six-week trial involving 51 patients, the web-based intervention reduced MDD symptoms by 42 percent in the experimental group of 28 patients, versus 15.7 percent in the control group of 23 patients.
EFMT identifies an imbalance in the activity of specific brain regions, specifically, an overactive amygdala characterized by hyperactivity of neural systems involved in emotion processing, as well as an underactive dorsolateral prefrontal cortex involving decreased activity of systems involved in cognitive control and emotion regulation.
“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,” says Brian Iacoviello, assistant professor in the Department of Psychiatry at Mount Sinai and director of scientific affairs at 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.”
Patients use EFMT to practice “engaging and disengaging the cognitive control that is impaired,” adds Iacoviello. “It helps retrain the brain to learn a more balanced pattern of activation and functioning when processing emotionally salient information.”
Iacoviello and Dennis Charney, MD, Anne and Joel Ehrenkranz Dean and Professor of Psychiatry, Neuroscience, and Pharmacological Sciences, developed the treatment at Mount Sinai’s Icahn School of Medicine.
The EFMT technology used to develop the therapeutic was licensed to digital health vendor Click Therapeutics by Mount Sinai Innovation Partners, the commercialization-arm of Mount Sinai’s Icahn School of Medicine. The cognitive-emotional treatment is delivered via an app on the Click Neurobehavioral Intervention (CNI) platform, a clinically validated patient engagement platform developed by Click Therapeutics.
“It’s now in Click Therapeutics’ hands for further development, refinement and conversion into a real top-notch mobile device that we will move towards FDA trial and approval as an indication for the treatment of major depressive disorder,” added Iacoviello. “This will be an app.”
According to Iacoviello, the app will run on both iOS and Android mobile platforms. “The whole point of delivering it through a mobile app is so patients can have it in their hands when they want to use it,” he concludes.
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