ENABLING DISCOVERY, DEVELOPMENT,
AND TRANSLATION OF TREATMENTS
FOR COGNITIVE DYSFUNCTION
IN DEPRESSION
WORKSHOP SUMMARY
Lisa Bain and Clare Stroud, Rapporteurs
Forum on Neuroscience and
Nervous System Disorders
Board on Health Sciences Policy
Institute of Medicine
THE NATIONAL ACADEMIES PRESS
Washington, D.C.
THE NATIONAL ACADEMIES PRESS • 500 Fifth Street, NW • Washington, DC 20001
This activity was supported by contracts between the National Academy of Sciences and the Alzheimer’s Association; Brain Canada Foundation; the Department of Health and Human Services’ Food and Drug Administration and National Institutes of Health (NIH, Contract No. HHSN26300026 [Under Master Base #DHHS-10001292]) through the National Center for Complementary and Integrative Health, National Eye Institute, National Institute of Mental Health, National Institute of Neurological Disorders and Stroke, National Institute on Aging, National Institute on Alcohol Abuse and Alcoholism, National Institute on Drug Abuse, and NIH Blueprint for Neuroscience Research; the Department of Veterans Affairs (VA240-14-C-0057); Eli Lilly and Company; Foundation for the National Institutes of Health; the Gatsby Charitable Foundation; GlaxoSmithKline, Inc.; Johnson & Johnson Pharmaceutical Research and Development, LLC; Lundbeck Research USA; Merck Research Laboratories; The Michael J. Fox Foundation for Parkinson’s Research; the National Multiple Sclerosis Society; the National Science Foundation (BCS-1064270); One Mind for Research; Orion Bionetworks; Pfizer Inc.; Pharmaceutical Product Development, LLC; Sanofi; the Society for Neuroscience; Takeda Pharmaceutical Company Limited; and Wellcome Trust. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-37393-7
International Standard Book Number-10: 0-309-37393-X
DOI: 10.17226/21745
Additional copies of this report are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.
Copyright 2015 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America
Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2015. Enabling discovery, development, and translation of treatments for cognitive dysfunction in depression: Workshop summary. Washington, DC: The National Academies Press.
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PLANNING COMMITTEE ON ENABLING DISCOVERY,
DEVELOPMENT, AND TRANSLATION OF TREATMENTS FOR
COGNITIVE DYSFUNCTION IN DEPRESSION1
THOMAS INSEL (Co-Chair), National Institute of Mental Health
THOMAS LAUGHREN (Co-Chair), Laughren Psychopharm Consulting, LLC
DEANNA BARCH, Washington University in St. Louis
STEPHEN BRANNAN, Takeda Pharmaceuticals
BRUCE CUTHBERT, National Institute of Mental Health
TIFFANY FARCHIONE, Food and Drug Administration
PHILIP HARVEY, University of Miami Miller School of Medicine
ALAN LESHNER, American Association for the Advancement of Science
RANDALL MORRISON, Janssen Research and Development
JOSEPH PALUMBO, Mitsubishi Tanabe Pharma Development America
DIEGO PIZZAGALLI, Harvard Medical School
WILLIAM RILEY, National Institutes of Health
BARBARA SAHAKIAN, University of Cambridge
TORBJÖRN WAERNER, H. Lundbeck A/S
MOLLY WAGSTER, National Institute on Aging
STEVIN ZORN, Lundbeck Research USA
IOM Staff
CLARE STROUD, Project Director
SHEENA M. POSEY NORRIS, Associate Program Officer
ANNALYN WELP, Senior Program Assistant
ANDREW M. POPE, Director, Board on Health Sciences Policy
_____________
1Institute of Medicine planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.
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FORUM ON NEUROSCIENCE AND NERVOUS
SYSTEM DISORDERS1
STEVEN HYMAN (Chair), The Broad Institute of Massachusetts Institute of Technology and Harvard University
STORY LANDIS (Vice Chair), Former Director, National Institute of Neurological Disorders and Stroke
SUSAN AMARA, Society for Neuroscience
STEPHEN BRANNAN, Takeda Pharmaceuticals International, Inc.
KATJA BROSE, Cell Press
DANIEL BURCH, Pharmaceutical Product Development, LLC
SARAH CADDICK, Gatsby Charitable Foundation
ROSA CANET-AVILES, Foundation for the National Institutes of Health
MARIA CARRILLO, Alzheimer’s Association
C. THOMAS CASKEY, Baylor College of Medicine
KAREN CHANDROSS, Sanofi US
TIMOTHY COETZEE, National Multiple Sclerosis Society
FAY LOMAX COOK, National Science Foundation
WILLIAM DUNN, Food and Drug Administration
EMMELINE EDWARDS, National Center for Complementary and Integrative Medicine
MARTHA FARAH, University of Pennsylvania
DANIEL GESCHWIND, University of California, Los Angeles
HANK GREELY, Stanford University
MAGALI HAAS, Orion Bionetworks
RAMONA HICKS, One Mind for Research
RICHARD HODES, National Institute on Aging
STUART HOFFMAN, Department of Veterans Affairs
THOMAS INSEL, National Institute of Mental Health
PHILIP IREDALE, Pfizer Global Research and Development
JOHN ISAAC, Wellcome Trust
INEZ JABALPURWALA, Brain Canada Foundation
FRANCES JENSEN, University of Pennsylvania School of Medicine
GEORGE KOOB, National Institute on Alcohol Abuse and Alcoholism
_____________
1Institute of Medicine forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.
WALTER KOROSHETZ, National Institute of Neurological Disorders and Stroke
ALAN LESHNER, American Association for the Advancement of Science (Emeritus)
HUSSEINI MANJI, Johnson & Johnson Pharmaceutical Research and Development, LLC
DAVID MICHELSON, Merck Research Laboratories
RICHARD MOHS, Lilly Research Laboratories
JAMES OLDS, National Science Foundation
ATUL PANDE, Tal Medical
STEVEN PAUL, Weill Cornell Medical College
TODD SHERER, The Michael J. Fox Foundation for Parkinson’s Research
DAVID SHURTLEFF, National Center for Complementary and Integrative Medicine
PAUL SIEVING, National Eye Institute
NORA VOLKOW, National Institute on Drug Abuse
STEVIN ZORN, Lundbeck Research USA
IOM Staff
BRUCE M. ALTEVOGT, Forum Co-Director (until May 2015)
CLARE STROUD, Forum Co-Director
SHEENA M. POSEY NORRIS, Associate Program Officer
ANNALYN M. WELP, Senior Program Assistant
ANDREW M. POPE, Director, Board on Health Sciences Policy
Reviewers
This workshop summary has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published workshop summary as sound as possible and to ensure that the workshop summary meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this workshop summary:
CHRISTOPHER BOWIE, Queen’s University
DAN IOSIFESCU, Icahn School of Medicine at Mount Sinai
ANDREW NIERENBERG, Massachusetts General Hospital
RICHARD PORTER, University of Otago, Christchurch
Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the workshop summary before its release. The review of this workshop summary was overseen by JOSEPH T. COYLE, Harvard Medical School. He was responsible for making certain that an independent examination of this workshop summary was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this workshop summary rests entirely with the rapporteurs and the institution.
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Contents
Topics Highlighted During Presentations and Discussions
2 The Burden of Cognitive Dysfunction in Depression
Cognitive Dysfunction: A Core Element of Depression
Neurobiology of Cognitive Impairment in Depression
Defining Cognitive Impairment in Depression
3 State of the Science: Treatment Development
Psychotherapy and Cognitive Remediation
Combining and Personalizing Therapies
4 Challenges and Potential Solutions to Enable Development of Successful Treatments
Early Detection and Treatment and the Importance of Biomarkers