Digital Therapeutics to Enhance Cognition in Major Depression: How Can We Make the Cognitive Gains Translate Into Functional Improvements?

Harvey, Philip D.

doi:10.1176/appi.ajp.20220441

Cited by 7 publications

(4 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In turn, daily functioning could be affected by encouraging efforts to deploy those improved cognitive skills. In a recent commentary, Harvey [ 48 ] notes this as potentially very important, given that improvement in objective cognitive performance and subjective assessments of performance are associated with improvements in everyday functioning [ 49 ]. Thus, important future directions include (1) increasing the enjoyability of digital cognitive training interventions and (2) providing interventions, such as metacognitive training, that might increase participants’ insights into cognitive improvements and encouragement of the use of these improvements in daily functioning.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Remote Cognitive Training Combined With a Mobile App Intervention on Psychosis: Double-Blind Randomized Controlled Trial

Fisher,

Etter,

Murray

et al. 2023

J Med Internet Res

View full text Add to dashboard Cite

Background Impairments in cognition and motivation are core features of psychosis and strong predictors of social and occupational functioning. Accumulating evidence indicates that cognitive deficits in psychosis can be improved by computer-based cognitive training programs; however, barriers include access and adherence to cognitive training exercises. Limited evidence-based methods have been established to enhance motivated behavior. In this study, we tested the effects of web-based targeted cognitive and social cognitive training (TCT) delivered in conjunction with an innovative digital smartphone app called Personalized Real-Time Intervention for Motivational Enhancement (PRIME). The PRIME app provides users with a motivational coach to set personalized goals and secure social networking for peer support. Objective This study investigated whether deficits in cognition and motivation in people with a psychosis spectrum disorder (N=100) can be successfully addressed with 30 hours of TCT+PRIME as compared with 30 hours of a computer games control condition (CG) plus PRIME (CG+PRIME). Here, we describe our study procedures, the feasibility and acceptability of the intervention, and the results on all primary outcomes. Methods In this double-blind randomized controlled trial, English-speaking participants completed all cognitive training, PRIME activities, and assessments remotely. Participants completed a diagnostic interview and remote cognitive, clinical, and self-report measures at baseline, posttraining, and at a 6-month follow-up. Results This study included participants from 27 states across the United States and 8 countries worldwide. The study population was 58% (58/100) female, with a mean age of 33.77 (SD 10.70) years. On average, participants completed more than half of the cognitive training regimen (mean 18.58, SD 12.47 hours of training), and logged into the PRIME app 4.71 (SD 1.58) times per week. The attrition rate of 22% (22/100) was lower than that reported in our previous studies on remote cognitive training. The total sample showed significant gains in global cognition (P=.03) and attention (P<.001). The TCT+PRIME participants showed significantly greater gains in emotion recognition (P<.001) and global cognition at the trend level (P=.09), although this was not statistically significant, relative to the CG+PRIME participants. The total sample also showed significant improvements on multiple indices of motivation (P=.02-0.05), in depression (P=.04), in positive symptoms (P=.04), and in negative symptoms at a trend level (P=.09), although this was not statistically significant. Satisfaction with the PRIME app was rated at 7.74 (SD 2.05) on a scale of 1 to 10, with higher values indicating more satisfaction. Conclusions These results demonstrate the feasibility and acceptability of remote cognitive training combined with the PRIME app and that this intervention can improve cognition, motivation, and symptoms in individuals with psychosis. TCT+PRIME appeared more effective in improving emotion recognition and global cognition than CG+PRIME. Future analyses will test the relationship between hours of cognitive training completed; PRIME use; and changes in cognition, motivation, symptoms, and functioning. Trial Registration ClinicalTrials.gov NCT02782442; https://clinicaltrials.gov/study/NCT02782442

show abstract

Section: Discussionmentioning

confidence: 99%

The Effects of Remote Cognitive Training Combined With a Mobile App Intervention on Psychosis: Double-Blind Randomized Controlled Trial

Fisher,

Etter,

Murray

et al. 2023

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…DTx have shown promise in various disease areas including psychiatric, [36][37][38] cardiovascular, 29,39 metabolism, 40 gastrointestinal, 41 neurodevelopmental, 33,42 and neurological diseases, 43,44 among others. With such a broad application, DTx hold great potential in translatability and treatment across different disease areas among the general population.…”

Section: Mechanism Of Action Potential and Applications Of Dtxmentioning

confidence: 99%

“… 27 , 28 The software can be further divided into subtypes such as mobile applications, 29 web applications, 30 , 31 virtual reality (VR), 32 AI, 33 , 34 video games, 35 and approved devices, among others. DTx have shown promise in various disease areas including psychiatric, 36 , 37 , 38 cardiovascular, 29 , 39 metabolism, 40 gastrointestinal, 41 neurodevelopmental, 33 , 42 and neurological diseases, 43 , 44 among others. With such a broad application, DTx hold great potential in translatability and treatment across different disease areas among the general population.…”

Section: Mechanism Of Action Potential and Applications Of Dt ...mentioning

confidence: 99%

Digital therapeutics in the clinic

Phan

Mitragotri

Zhao

2023

Bioengineering & Transla Med

View full text Add to dashboard Cite

Digital therapeutics are emerging as a new form of therapeutic interventions. Unlike conventional therapeutics, digital therapeutics deliver interventions directly to patients using an evidence‐based, clinically evaluated software to treat, manage, or prevent diseases. Digital therapeutics manifest in diverse forms such as web‐based applications, mobile applications on smart devices, virtual reality, and video games. As its own product category for FDA approval, digital therapeutics can function as stand‐alone treatments or in combination with conventional therapeutics to improve adherence and/or efficacy. Here, we review the clinical landscape of digital therapeutics. We summarize FDA‐approved products and their clinical use, overview >300 ongoing clinical trials, and discuss challenges for their clinical translation and strategies to overcome the same.

show abstract

“…Depending on the characteristics of the service or product to be applied, the variable of TAM is often expanded. In the DTx context, perceived enjoyment is often considered as a compelling variable, and it has been proved that it does affect the intention to use [51]. In this regard, successful digital treatment requires users to perceive the product as easy to use and recognize that the program is beneficial to them.…”

Section: Hci Factorsmentioning

confidence: 99%

Cutting-Edge Technologies for Digital Therapeutics: A Review and Architecture Proposals for Future Directions

2023

View full text Add to dashboard Cite

Digital therapeutics, evidence-based treatments delivered through software programs, are revolutionizing healthcare by utilizing cutting-edge computing technologies. Unlike conventional medical treatment methods, digital therapeutics are based on multiple information technologies, from data collection to analysis algorithms, and treatment support approaches. In this research, we provide a comprehensive overview of the latest technologies involved in the development of digital therapeutics and highlight specific technologies necessary for the future growth of the rapidly evolving digital therapeutics market. Furthermore, we present a system design of digital therapeutics for depression, currently being developed by our research team, to provide a detailed explanation of the technical process. Digital therapeutics require various technical supports, such as collecting user data in a security-enhanced medical environment, processing and analyzing the collected data, and providing personalized treatment methods to the user. The findings from this research will enable digital therapeutic companies to enhance their product performance, consequently bolstering their market competitiveness. Additionally, the research can be further extended to explore applicable methodologies at different stages of digital therapeutic environments.

show abstract

Digital Therapeutics to Enhance Cognition in Major Depression: How Can We Make the Cognitive Gains Translate Into Functional Improvements?

Cited by 7 publications

References 10 publications

The Effects of Remote Cognitive Training Combined With a Mobile App Intervention on Psychosis: Double-Blind Randomized Controlled Trial

The Effects of Remote Cognitive Training Combined With a Mobile App Intervention on Psychosis: Double-Blind Randomized Controlled Trial

Digital therapeutics in the clinic

Cutting-Edge Technologies for Digital Therapeutics: A Review and Architecture Proposals for Future Directions

Contact Info

Product

Resources

About