Psychosis Clinical Trial
Official title:
Elucidating the Efficacy and Response to Social Cognitive Training (SCT) in Recent Onset Psychosis (ROP)
Participants with recent onset psychosis (ROP) experience delusions, hallucinations, and
impairment in social, cognitive and emotional functioning. Although symptoms often improve
following pharmacological intervention, the marked cognitive deficits, that often precede the
onset of symptoms, continue to persist despite current treatment methods. Computerized
neurocognitive interventions (NCI) are a promising therapeutic approach in participants with
chronic schizophrenia and individuals at risk for psychosis. Specifically, focus has shifted
to social cognitive training (SCT) as treating social cognition have been shown to provide
improvements not only in general cognitive deficits but is also related to improvements in
functional outcome (occupational and social). NCIs include non-invasive computerized tasks
that are done on a tablet. This intervention can be conducted in a clinical setting, as well
as out of the comfort of one's home. Additionally, research has shown that NCIs have the
potential to elicit neuroplastic effects on the brain.
The purpose of this study is to explore the efficacy of a 10-hour SCT in improving the
primary outcome measure, global cognition, and secondary outcome measure, global functioning,
in ROP participants. It is hypothesized that participants receiving the intervention will
show gains in global cognition, as well as the subdomains of social cognition, processing
speed, and working memory. Additionally, participants undergoing active intervention are
expected to show gains in functional connectivity primarily between the prefrontal cortex and
amygdala and other brain areas, that are engaged in social cognition.
Furthermore, machine learning approach will be used(support vector classification) to
investigate how the decision scores of the resting state classifier, indicating health vs.
disease proneness, change in response to the training.
In this randomized controlled trial, participants with a ROP receive a 4-6-week treatment
with 10 hours of SCT, with 30-minute sessions 4-5 times per week or treatment as usual (TAU)
control condition. Baseline and follow-up (6 weeks after the baseline assessment) assessments
include clinical diagnostic and symptom assessment, standard neuropsychological testing, and
structural and functional imaging.
The already recruited part of the ROP sample counts 27 participants in SCT and 27 in the TAU
arm. The power analysis recommends to recruit at least 6 more participants in both study
arms.
For the purpose of machine learning part of the analysis an independent psychosis
(ROP)-healthy population (HC) classifier will be used, which takes the data from the
naturalistic multi-center european study, Personalized Prognostic Tools for Early Psychosis
Management, in order to be able to track the decision scores of the intervention SCT sample
without risk of overfitting.
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