Association of pesticide exposure with neurobehavioral outcomes among avocado farmworkers in Mexico.

BACKGROUND AND AIM: To date, few studies have focused on the health effects of pesticide exposure among avocado farmworkers. We examined the association of exposure to insecticides, fungicides, and herbicides with cognitive and mental health outcomes among these avocado workers from Michoacan, Mexico. MATERIALS AND METHODS: We conducted a cross-sectional study of 105 avocado farmworkers between May and August 2021. We collected data on self-reported pesticide use during the 12 months prior to the baseline survey and estimated annual exposure-intensity scores (EIS) using a semi-quantitative exposure algorithm. We calculated specific gravity adjusted average concentrations of 12 insecticide, fungicide, or herbicide metabolites measured in urine samples collected during two study visits (8-10 weeks apart). We assessed participants' cognitive function and psychological distress using the NIH Toolbox Cognition Battery and the Brief Symptom Inventory 18 (BSI-18), respectively. We examined individual associations of EIS and urinary pesticide metabolites with neurobehavioral outcomes using generalized linear regression models. We also implemented Bayesian Weighted Quantile Sum (BWQS) regression to evaluate the association between a pesticide metabolite mixture and neurobehavioral outcomes. RESULTS: In individual models, after adjusting for multiple comparisons, higher concentrations of hydroxy-tebuconazole (OH-TEB, metabolite of fungicide tebuconazole) were associated with higher anxiety (IRR per two-fold increase in concentrations = 1.26, 95% CI:1.08, 1.48) and Global Severity Index (GSI) (IRR = 1.89, 95% CI:1.36, 2.75) scores, whereas higher concentrations of 3,5,6-trichloro-2-pyridinol (TCPy, metabolite of chlorpyrifos) were associated with lower GSI scores (IRR = 0.69, 95% CI: 0.56, 0.85). In BWQS analyses, we found evidence of a mixture association of urinary pesticide metabolites with higher anxiety (IRR = 1.72, 95% CrI: 1.12, 2.55), depression (IRR = 4.60, 95% CrI: 2.19, 9.43), and GSI (IRR = 1.99, 95% CrI: 1.39, 2.79) scores. OH-TEB and hydroxy-thiabendazole (metabolite of fungicide thiabendazole) combined contributed 54%, 40%, and 54% to the mixture effect in the anxiety symptoms, depression symptoms, and overall psychological distress models, respectively. CONCLUSIONS: We found that exposure to tebuconazole and thiabendazole, fungicides whose effects have been rarely studied in humans, may be associated with increased psychological distress among avocado farmworkers. We also observed that exposure to chlorpyrifos may be associated with decreased psychological distress.

Hypoconnectivity networks in schizophrenia patients: A voxel-wise meta-analysis of Rs-fMRI

In recent years several meta-analyses regarding resting-state functional connectivity in patients with schizophrenia have been published. The authors have used different data analysis techniques: regional homogeneity, seed-based data analysis, independent component analysis, and amplitude of low frequencies. Hence, we aim to perform a meta-analysis to identify connectivity networks with different activation patterns between people diagnosed with schizophrenia and healthy controls using voxel-wise analysis. Method: We collected primary studies exploring whole brain connectivity by functional magnetic resonance imaging at rest in patients with schizophrenia compared with healthy controls. We identified 25 studies included high-quality studies that included 1285 patients with schizophrenia and 1279 healthy controls. Results: The results indicate hypoactivation in the right precentral gyrus and the left superior temporal gyrus of patients with schizophrenia compared with healthy controls. Conclusions: These regions have been linked with some clinical symptoms usually present in Plea with schizophrenia, such as auditory verbal hallucinations, formal thought disorder, and the comprehension and production of gestures. (AU)

Hypoconnectivity networks in schizophrenia patients: A voxel-wise meta-analysis of Rs-fMRI.

In recent years several meta-analyses regarding resting-state functional connectivity in patients with schizophrenia have been published. The authors have used different data analysis techniques: regional homogeneity, seed-based data analysis, independent component analysis, and amplitude of low frequencies. Hence, we aim to perform a meta-analysis to identify connectivity networks with different activation patterns between people diagnosed with schizophrenia and healthy controls using voxel-wise analysis. METHOD: We collected primary studies exploring whole brain connectivity by functional magnetic resonance imaging at rest in patients with schizophrenia compared with healthy controls. We identified 25 studies included high-quality studies that included 1285 patients with schizophrenia and 1279 healthy controls. RESULTS: The results indicate hypoactivation in the right precentral gyrus and the left superior temporal gyrus of patients with schizophrenia compared with healthy controls. CONCLUSIONS: These regions have been linked with some clinical symptoms usually present in Plea with schizophrenia, such as auditory verbal hallucinations, formal thought disorder, and the comprehension and production of gestures.

The effect of second-generation antidepressant treatment on the attention and mental processing speed of patients with major depressive disorder: A meta-analysis study with structural equation models.

Major depressive disorder (MDD) has been linked to attention and mental processing speed deficits that can be improved after pharmacological treatment. However, it is unclear whether a class of antidepressants is more effective than others to ameliorate these deficits in MDD. Additionally, the possible effects of clinical and demographic variables on improving MDD attention and processing speed deficits after antidepressant treatment are unknown. We aimed to study the possible neuropsychological effects of second-generation antidepressant classes on the attention and processing speed of MDD patients and the potential influences of clinical and demographic variables as moderators of these effects using a meta-analytic approach. Twenty-five papers were included in our study. A structural equation model meta-analysis was performed. The improvement of attention and processing speed after pharmacological treatment is clinically relevant but incomplete. Selective serotonin reuptake inhibitors (SSRIs) and dual inhibitors are the drugs causing the greatest improvement in the processing speed of MDD patients. Antidepressant class is an important variable linked to processing speed improvement after MDD treatment. However, the degree of improvement in both cognitive functions is strongly influenced by some clinical and demographic variables of depressed patients, such are age and education of the MDD patients, the duration of the antidepressant treatment, and the depression status of the patients.

THE EFFECT OF SECOND-GENERATION ANTIDEPRESSANT TREATMENT ON THE EXECUTIVE FUNCTIONS OF PATIENTS WITH MAJOR DEPRESSIVE DISORDER: A META-ANALYSIS STUDY WITH STRUCTURAL EQUATION MODELS.

Major depressive disorder (MDD) has been linked to executive functions (EF) deficits that can be improved after pharmacological treatment, but it is unclear whether there is a class of antidepressants that is more effective than others to ameliorate these deficits in MDD. Additionally, the possible effects of clinical and demographic variables on the improvement of MDD EF deficits after pharmacological treatment are currently unknown. Our aim was to study the possible neuropsychological effects of second-generation antidepressant classes on the EF of MDD patients and the potential influence of clinical and demographic variables as moderators of these effects through a meta-analytic approach. Twenty-one papers were included in our study. A structural equation model meta-analysis was performed. The improvement of EF after pharmacological treatment is clinically relevant, but it is incomplete. This effect is influenced by age and years of education of the patients. Selective serotonin reuptake inhibitors (SSRIs) and dual inhibitors are the drugs causing the greatest improvement in EF of MDD patients. Antidepressant class is an important variable linked to EF improvement after MDD treatment, but the degree of improvement in these cognitive functions is strongly influenced by some clinical and demographic variables of patients with depression.

The Effect of Second-Generation Antidepressant Treatment on the Memory of Patients With Major Depressive Disorder: A Meta-analysis Study With Structural Equation Models.

BACKGROUND: Major depressive disorder (MDD) has been linked to episodic memory deficits that may be improved after pharmacological treatment, but it is unclear whether there is a class of antidepressants that is more effective than others to ameliorate these deficits in MDD. In addition, the possible effects of clinical and sociodemographic variables on the improvement of MDD memory deficits after pharmacological treatment are currently unknown. Our aims are to study the possible neuropsychological effects of second-generation antidepressant classes on the episodic memory of MDD patients and to study the potential effects of clinical and demographic variables as moderators of the effects of antidepressants on the memory of depressed patients through a meta-analysis approach. PROCEDURES: Nine articles were included in our study. A structural equation model meta-analysis was performed. RESULTS: Our results suggest that selective serotonin reuptake inhibitors and serotonine-noradrenaline reuptake inhibitors would bring about a substantial improvement in the memory of depressed patients, whereas other antidepressant classes would cause rather modest effects. Our results also suggest that clinical and demographic variables play a very important role as mediators of memory improvement after MDD treatment. Thus, a relatively low level of symptom severity, a high degree of clinical improvement, a younger age, and more years of education were positively related to memory improvement after MDD treatment. CONCLUSIONS: Although antidepressant class is an important variable linked to memory improvement in MDD, overall, the degree of memory amelioration in depression is very closely related to clinical and demographic variables of patients with depression.

Estimation of Brain Functional Connectivity in Patients with Mild Cognitive Impairment.

Mild cognitive impairment is defined as greater cognitive decline than expected for a person at a particular age and is sometimes considered a stage between healthy aging and Alzheimer's disease or other dementia syndromes. It is known that functional connectivity patterns change in people with this diagnosis. We studied functional connectivity patterns and functional segregation in a resting-state fMRI paradigm comparing 10 MCI patients and 10 healthy controls matched by education level, age and sex. Ninety ROIs from the automated anatomical labeling (AAL) atlas were selected for functional connectivity analysis. A correlation matrix was created for each group, and a third matrix with the correlation coefficient differences between the two matrices was created. Functional segregation was analyzed with the 3-cycle method, which is novel in studies of this topic. Finally, cluster analyses were also performed. Our results showed that the two correlation matrices were visually similar but had many differences related to different cognitive functions. Differences were especially apparent in the anterior default mode network (DMN), while the visual resting-state network (RSN) showed no differences between groups. Differences in connectivity patterns in the anterior DMN should be studied more extensively to fully understand its role in the differentiation of healthy aging and an MCI diagnosis.

Complex systems representing effective connectivity in patients with Type One diabetes mellitus.

BACKGROUND: Type 1 diabetes mellitus (T1D) affects the entire cellular network of the organism. Some patients develop cognitive disturbances due to the disease, but several authors have suggested that the brain develops compensatory mechanisms to minimize or prevent neuropsychological decline. The present study aimed to assess the effective connectivity underlying visuospatial working memory performance in young adults diagnosed with T1D using neuroimaging techniques (fMRI). METHODS: Fifteen T1D right-handed, young adults with sustained metabolic clinical stability and a control group matched by age, sex, and educational level voluntarily participated. All participants performed 2 visuospatial working memory tasks using a block design within an MRI scanner. Regions of interest and their signal values were obtained. Effective connectivity-by means of structural equations models-was evaluated for each group and task through maximum likelihood estimation, and the model with the best fit was chosen in each case. RESULTS: Compared to the control group, the patient group showed a significant reduction in brain activity in the two estimated networks (one for each group and task). The models of effective connectivity showed greater brain connectivity in healthy individuals, as well as a more complex network. T1D patients showed a pattern of connectivity mainly involving the cerebellum and the red nucleus. In contrast, the control group showed a connectivity network predominantly involving brain areas that are typically activated while individuals are performing working memory tasks. CONCLUSION: Our results suggest a specific effective connectivity between the cerebellum and the red nucleus in T1D patients during working memory tasks, probably reflecting a compensatory mechanism to fulfill task demands.

Longitudinal Estimation of the Clinically Significant Change in the Treatment of Major Depression Disorder.

Background: Although major depressive disorder is usually treated with antidepressants, only 50-70% of the patients respond to this treatment. This study applied Jacobson and Truax's (1991) methodology (reliable change index, RCI) to a sample of depressive patients being treated with one of two antidepressants to evaluate their functioning and the effect of certain variables such as severity and age. Method: Seventy-three depressive patients medicated with Escitalopram (n = 37) or Duloxetine (n = 36) were assessed using the Hamilton depression rating scale over a 24-week period. Results: They indicate that the RCI stabilizes in an absolute way starting in week 16, and it is not until week 24 that all of the patients become part of the functional population. We found limited statistical significance with respect to the RCI and the external variables. Conclusion: Our study suggests the need to accompany the traditional statistical methodology with some other clinical estimation systems capable of going beyond a simple subtraction between pre and posttreatment values. Hence, it is concluded that RCI estimations could be stronger and more stable than the classical statistical techniques.

Meta-Analysis of the Structural Equation Models' Parameters for the Estimation of Brain Connectivity with fMRI.

Structural Equation Models (SEM) is among of the most extensively applied statistical techniques in the study of human behavior in the fields of Neuroscience and Cognitive Neuroscience. This paper reviews the application of SEM to estimate functional and effective connectivity models in work published since 2001. The articles analyzed were compiled from Journal Citation Reports, PsycInfo, Pubmed, and Scopus, after searching with the following keywords: fMRI, SEMs, and Connectivity. Results: A 100 papers were found, of which 25 were rejected due to a lack of sufficient data on basic aspects of the construction of SEM. The other 75 were included and contained a total of 160 models to analyze, since most papers included more than one model. The analysis of the explained variance (R2) of each model yields an effect of the type of design used, the type of population studied, the type of study, the existence of recursive effects in the model, and the number of paths defined in the model. Along with these comments, a series of recommendations are included for the use of SEM to estimate of functional and effective connectivity models.

Effect of verbal task complexity in a working memory paradigm in patients with type 1 diabetes. A fMRI study.

Type 1 diabetes (T1D) is commonly diagnosed in childhood and adolescence, and the developing brain has to cope with its deleterious effects. Although brain adaptation to the disease may not result in evident cognitive dysfunction, the effects of T1D on neurodevelopment could alter the pattern of BOLD fMRI activation. The aim of this study was to explore the neural BOLD activation pattern in patients with T1D versus that of healthy matched controls while performing two visuospatial working memory tasks, which included a pair of assignments administered through a block design. In the first task (condition A), the subjects were shown a trial sequence of 3 or 4 white squares positioned pseudorandomly around a fixation point on a black background. After a fixed delay, a second corresponding sequence of 3 or 4 red squares was shown that either resembled (direct, 50%) or differed from (50%) the previous stimulation order. The subjects were required to press one button if the two spatial sequences were identical or a second button if they were not. In condition B, the participants had to determine whether the second sequence of red squares appeared in inverse order (inverse, 50%) or not (50%) and respond by pressing a button. If the latter sequence followed an order distinct from the inverse sequence, the subjects were instructed to press a different button. Sixteen patients with normal IQ and without diabetes complications and 16 healthy control subjects participated in the study. In the behavioral analysis, there were no significant differences between the groups in the pure visuo-spatial task, but the patients with diabetes exhibited poorer performance in the task with verbal stimuli (p < .001). However, fMRI analyses revealed that the patients with T1D showed significantly increased activation in the prefrontal inferior cortex, subcortical regions and the cerebellum (in general p < .001). These different activation patterns could be due to adaptive compensation mechanisms that are devoted to improving efficiency while solving more complex cognitive tasks.

Changes in brain connectivity related to the treatment of depression measured through fMRI: a systematic review.

Depression is a mental illness that presents alterations in brain connectivity in the Default Mode Network (DMN), the Affective Network (AN) and other cortical-limbic networks, and the Cognitive Control Network (CCN), among others. In recent years the interest in the possible effect of the different antidepressant treatments on functional connectivity has increased substantially. The goal of this paper is to conduct a systematic review of the studies on the relationship between the treatment of depression and brain connectivity. Nineteen studies were found in a systematic review on this topic. In all of them, there was improvement of the clinical symptoms after antidepressant treatment. In 18 out of the 19 studies, clinical improvement was associated to changes in brain connectivity. It seems that both DMN and the connectivity between cortical and limbic structures consistently changes after antidepressant treatment. However, the current evidence does not allow us to assure that the treatment of depression leads to changes in the CCN. In this regard, some papers report a positive correlation between changes in brain connectivity and improvement of depressive symptomatology, particularly when they measure cortical-limbic connectivity, whereas the changes in DMN do not significantly correlate with clinical improvement. Finally, some papers suggest that changes in connectivity after antidepressant treatment might be partly related to the mechanisms of action of the treatment administered. This effect has been observed in two studies with stimulation treatment (one with rTMS and one with ECT), and in two papers that administered three different pharmacological treatments. Our review allows us to make a series of recommendations that might guide future researchers exploring the effect of anti-depression treatments on brain connectivity.

Effective connectivity of visual word recognition and homophone orthographic errors.

The study of orthographic errors in a transparent language like Spanish is an important topic in relation to writing acquisition. The development of neuroimaging techniques, particularly functional magnetic resonance imaging (fMRI), has enabled the study of such relationships between brain areas. The main objective of the present study was to explore the patterns of effective connectivity by processing pseudohomophone orthographic errors among subjects with high and low spelling skills. Two groups of 12 Mexican subjects each, matched by age, were formed based on their results in a series of ad hoc spelling-related out-scanner tests: a high spelling skills (HSSs) group and a low spelling skills (LSSs) group. During the f MRI session, two experimental tasks were applied (spelling recognition task and visuoperceptual recognition task). Regions of Interest and their signal values were obtained for both tasks. Based on these values, structural equation models (SEMs) were obtained for each group of spelling competence (HSS and LSS) and task through maximum likelihood estimation, and the model with the best fit was chosen in each case. Likewise, dynamic causal models (DCMs) were estimated for all the conditions across tasks and groups. The HSS group's SEM results suggest that, in the spelling recognition task, the right middle temporal gyrus, and, to a lesser extent, the left parahippocampal gyrus receive most of the significant effects, whereas the DCM results in the visuoperceptual recognition task show less complex effects, but still congruent with the previous results, with an important role in several areas. In general, these results are consistent with the major findings in partial studies about linguistic activities but they are the first analyses of statistical effective brain connectivity in transparent languages.

Effects of remission speed and improvement of cognitive functions of depressed patients.

Major depressive disorder (MDD) presents neuropsychological alterations which improve after the treatment, but it might be mediated by clinical variables. Our goal is to study whether the speed of remission of MDD bears any relation to the improvement of the patients' cognitive functioning after a successful treatment. We carried out clinical and neuropsychological assessments of 51 patients with MDD. After these procedures they underwent a 24-week treatment with fluoxetine, and were assessed again with the same battery used prior to treatment. They were arranged into three groups according to how rapid their symptoms remitted. The patients with a rapid remission presented improvements in working memory, speed of information processing, and some executive functions, unlike the other groups. Rapid remitters also improved in episodic memory and executive functions more than the other patients.

Prediction of the time-course pattern of remission in depression by using clinical, neuropsychological, and genetic variables.

BACKGROUND: The prediction of remission in pharmacologically-treated MDD patients has been scarcely studied. The goal of our work is to study the possible effect of clinical variables, neuropsychological performance, and the 5HTTLPR, the rs25531 of the SLC6A4 gene, and the val108/58Met of the COMT gene polymorphisms on the prediction of the speed of remission in MDD patients. METHODS: Seventy-two depressed patients were genotyped according to the aforementioned polymorphisms and were clinically and neuropsychologically assessed before a 12-week fluoxetine treatment. RESULTS: From this original sample 51 patients were considered as remitters at the end of week 12. Thirteen out of those showed a rapid response pattern, 24 showed an oscillating response pattern, and 14 showed a slow response pattern. The following variable combination is capable of showing a statistically significant relationship with the pattern of remission of patients with MDD: initial Hamilton score, age at first depressive episode, AG and GG alleles of the val108/58Met COMT polymorphism, Stroop PC, and SWM Strategy. LIMITATIONS: We have a slightly small sample size, which came to prominence during the data analysis since we were working with 3 subgroups. In this study, the placebo effect has not been controlled. DISCUSSION: Our data suggest that the patients with MDD who remit after a 12-week treatment with fluoxetine show one of the following time-course patterns: a rapid symptomatic improvement, or a slow or oscillating pattern of remission. A combination of clinical, neuropsychological, and genetic variables allows us to predict these response patterns.

Neuropsychological rehabilitation and quality of life in patients with cognitive impairments: a meta-analysis study in Spanish-speaking populations.

OBJECTIVE: The purpose of this study is to conduct a meta-analysis on the effects of neuropsychological rehabilitation procedures on the quality of life in Spanish-speaking individuals with cognitive deficits. METHOD: Twenty four studies published during the last ten years were analyzed, and relevant information was extracted from each, including sample size, data analyses, measures, and publication year, among others. These data were then analyzed following the usual procedures for estimation of effect size. RESULTS: The data show a statistical significant value in all variables associated with the characteristics of the intervention (Duration, type of intervention, gender, year of publication and, more important, quality of life and neuropsychological outcomes). CONCLUSION: QOL can improve in certain conditions with neuropsychological rehabilitation, but this change is not permanent.

Prediction of remission of depression with clinical variables, neuropsychological performance, and serotonergic/dopaminergic gene polymorphisms.

OBJECTIVE: The aim of our work is to study the possible role of clinical variables, neuropsychological performance, and the 5HTTLPR, rs25531, and val108/58Met COMT polymorphisms on the prediction of depression remission after 12 weeks' treatment with fluoxetine. These variables have been studied as potential predictors of depression remission, but they present poor prognostic sensitivity and specificity by themselves. METHODS: Seventy-two depressed patients were genotyped according to the aforementioned polymorphisms and were clinically and neuropsychologically assessed before a 12-week fluxetine treatment. RESULTS: Only the La allele of rs25531 polymorphism and the GG and AA forms of the val 108/158 Met polymorphism predict major depressive disorder remission after 12 weeks' treatment with fluoxetine. None of the clinical and neuropsychological variables studied predicted remission. CONCLUSIONS: Our results suggest that clinical and neuropsychological variables can initially predict early response to fluoxetine and mask the predictive role of genetic variables; but in remission, where clinical and neuropsychological symptoms associated with depression tend to disappear thanks to the treatment administered, the polymorphisms studied are the only variables in our model capable of predicting remission. However, placebo effects that are difficult to control require cautious interpretation of the results.

The role of clinical variables, neuropsychological performance and SLC6A4 and COMT gene polymorphisms on the prediction of early response to fluoxetine in major depressive disorder.

INTRODUCTION: Major depressive disorder (MDD) is treated with antidepressants, but only between 50% and 70% of the patients respond to the initial treatment. Several authors suggested different factors that could predict antidepressant response, including clinical, psychophysiological, neuropsychological, neuroimaging, and genetic variables. However, these different predictors present poor prognostic sensitivity and specificity by themselves. The aim of our work is to study the possible role of clinical variables, neuropsychological performance, and the 5HTTLPR, rs25531, and val108/58Met COMT polymorphisms in the prediction of the response to fluoxetine after 4weeks of treatment in a sample of patient with MDD. METHODS: 64 patients with MDD were genotyped according to the above-mentioned polymorphisms, and were clinically and neuropsychologically assessed before a 4-week fluoxetine treatment. Fluoxetine response was assessed by using the Hamilton Depression Rating Scale. We carried out a binary logistic regression model for the potential predictive variables. RESULTS: Out of the clinical variables studied, only the number of anxiety disorders comorbid with MDD have predicted a poor response to the treatment. A combination of a good performance in variables of attention and low performance in planning could predict a good response to fluoxetine in patients with MDD. None of the genetic variables studied had predictive value in our model. LIMITATIONS: The possible placebo effect has not been controlled. Our study is focused on response prediction but not in remission prediction. CONCLUSIONS: Our work suggests that the combination of the number of comorbid anxiety disorders, an attentional variable, and two planning variables makes it possible to correctly classify 82% of the depressed patients who responded to the treatment with fluoxetine, and 74% of the patients who did not respond to that treatment.

Effects of selective serotonin reuptake and dual serotonergic-noradrenergic reuptake treatments on attention and executive functions in patients with major depressive disorder.

Several reports suggest that antidepressants may improve cognitive functioning in patients with major depressive disorder (MDD). The present work aims to study the effects of selective serotonin reuptake inhibitors (SSRIs) and serotonergic-noradrenergic reuptake inhibitors (SNRIs) treatments on the performance of working memory, attention and executive functions in patients with MDD. A total of 73 subjects meeting the Diagnostic and Statistical Manual of Mental Disorders version IV (DSM-IV) criteria for MDD, and 37 control subjects were assessed with the Hamilton Depression Rating Scale and a neuropsychological battery. The subjects were medicated with escitalopram (n=36) or duloxetine (n=37) for 24 weeks. At the end of the trial, the subjects were assessed again with the same tests. The depressed subjects showed alterations in attention and cognitive functions when compared to the control group. The administration of both treatments improved working memory, as well as attention and all the executive functions, but the cognitive functions of depressed patients do not improve enough to reach the levels of performance of the control subjects. Our results suggest that both SSRI and SNRI treatments presented the same efficacy in improving attention and the remaining executive functions.

Major Depressive Disorder in recovery and neuropsychological functioning: effects of selective serotonin reuptake inhibitor and dual inhibitor depression treatments on residual cognitive deficits in patients with Major Depressive Disorder in recovery.

INTRODUCTION: Cognitive disturbances in Major Depressive Disorder (MDD) could persist beyond the symptomatic phase of the illness. However, the works addressing this topic did not usually account for the possible impact of medication on the cognitive functions of depressed patients. The present study aims to investigate whether MDD patients in remission treated with selective serotonin reuptake inhibitors (SSRI) or dual serotonergic-noradrenergic reuptake inhibitors (SNRI) show cognitive deficits, to study whether the same patients suffer neuropsychological disturbances when they are unmedicated and in recovery phase, and if the previous pharmacological treatment used to achieve the remission of MDD clinical symptoms had any effect in the profile of these patients' cognitive performance in the recovery phase. METHODS: Thirty-six subjects with MDD treated with escitalopram and 37 depressed patients with duloxetine were compared both in remission phase and 24 weeks later, when they were unmedicated and in recovery phase. They were also compared, in both moments, to 37 healthy subjects. RESULTS: The control subjects showed a broader better cognitive performance than MDD patients in both measurement moments, but several cognitive functions improved over time. Also, the patients treated with SNRI performed better in memory tests than the SNRI-treated patients in remission phase, and in recovery phase. LIMITATIONS: Our sample size is somewhat small, and we followed our patients only for 6months after treatment. CONCLUSIONS: Cognitive functions improve over time in patients with MDD beyond the remission phase, and the antidepressant treatment class used in acute depressive phase could influence his/her memory improvement.