Readiness to change: Exploring clinical, cognitive and neural predictors of treatment efficacy following virtual reality-based cognitive remediation in mood and schizophrenia spectrum disorders

Resumo original em inglês

O que aconteceu

Virtual reality-based cognitive remediation therapy (VR-CRT) offers an ecologically valid approach to enhance real-world cognitive functioning in mood disorders (MD) or schizophrenia spectrum disorders (SSD). This study investigated baseline cognitive, clinical, and neural predictors of VR-CRT response in MD and SSD.

Sixty-two MD and SSD participants were randomized to receive four-week VR-CRT or control with assessments at baseline, treatment completion (week 5), and follow-up (week 17). Univariate general linear models examined predictors of VR-CRT improvement on daily-life cognitive skills, assessed using the Cognition Assessment in Virtual Reality (CAVIR). Predictors included age, diagnosis, baseline cognition, IQ-cognition discrepancy, dorsal prefrontal cortex (dPFC) activation during a working memory task, functional connectivity within the dorsal attention (DAN) and salience (SAL) networks, subjective cognition, and technological acceptance.

O que encontraram

Higher IQ-cognition discrepancy at baseline (i.e., better cognitive performance than expected from premorbid IQ) predicted greater treatment efficacy at treatment completion (β = 0.17, p = 0.045) and follow-up (β = 0.21, p = 0.008), while baseline cognition was not associated with treatment response (ps ≥ 0.15). Higher baseline dPFC activity predicted more improvements at both times (β = 2.27 p = 0.03; β = 1.82; p = 0.048, respectively). Higher DAN-SAL connectivity predicted improvements at treatment completion (β = 2.81 p = 0.047), but not at follow-up (p = 0.38). Age, sex, diagnosis, subjective cognition, and technological acceptance were not associated with cognitive change.

Por que isso importa

Better cognitive performance than expected based on IQ, possibly reflecting higher cognitive fitness, and greater task-related engagement of dPFC may enhance VR-CRT responsiveness. This profile may indicate greater readiness for change and propensity to translate cognitive strategies into daily life.

Resumo publicado sob licença CC BY. A tradução para o português ainda não chegou a este estudo.