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Efficacy and specificity of computer-assisted cognitive remediation in schizophrenia: a meta-analytical study

Published online by Cambridge University Press:  12 April 2010

O. Grynszpan ,
S. Perbal ,
A. Pelissolo ,
P. Fossati ,
R. Jouvent ,
S. Dubal  and
F. Perez-Diaz
O. Grynszpan*
Affiliation:
Centre Emotion, CNRS USR 3246, Hôpital de La Salpêtrière, Paris, France Pierre et Marie Curie University, Paris, France
S. Perbal
Affiliation:
Centre Emotion, CNRS USR 3246, Hôpital de La Salpêtrière, Paris, France
A. Pelissolo
Affiliation:
Centre Emotion, CNRS USR 3246, Hôpital de La Salpêtrière, Paris, France
P. Fossati
Affiliation:
Centre Emotion, CNRS USR 3246, Hôpital de La Salpêtrière, Paris, France Pierre et Marie Curie University, Paris, France
R. Jouvent
Affiliation:
Centre Emotion, CNRS USR 3246, Hôpital de La Salpêtrière, Paris, France Pierre et Marie Curie University, Paris, France
S. Dubal
Affiliation:
Centre Emotion, CNRS USR 3246, Hôpital de La Salpêtrière, Paris, France
F. Perez-Diaz
Affiliation:
Centre Emotion, CNRS USR 3246, Hôpital de La Salpêtrière, Paris, France
*
*Address for correspondence: Dr O. Grynszpan, CNRS USR 3246, Service du Professeur Roland Jouvent, Pavillon Clérambault, Bâtiment de La Force, Hôpital de La Salpêtrière, 47 Bd de l'Hôpital, F-75013Paris, France. (Email: ouriel.grynszpan@upmc.fr)
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Abstract

Background

Cognitive remediation is frequently based on computerized training methods that target different cognitive deficits. The aim of this article was to assess the efficacy of computer-assisted cognitive remediation (CACR) in schizophrenia and to determine whether CACR enables selective treatment of specific cognitive domains.

Method

A meta-analysis was performed on 16 randomized controlled trials evaluating CACR. The effect sizes of differences between CACR and control groups were computed and classified according to the cognitive domain assessed. The possible influences of four potential moderator variables were examined: participants' age, treatment duration, weekly frequency, and control condition type. To test the domain-specific effect, the intended goal of each study was determined and the effect sizes were sorted accordingly. The effect sizes of the cognitive domains explicitly targeted by the interventions were then compared with those that were not.

Results

CACR enhanced general cognition with a mean effect size of 0.38 [confidence interval (CI) 0.20–0.55]. A significant medium effect size of 0.64 (CI 0.29–0.99) was found for Social Cognition. Improvements were also significant in Verbal Memory, Working Memory, Attention/Vigilance and Speed of Processing with small effect sizes. Cognitive domains that were specifically targeted by the interventions did not yield higher effects than those that were not.

Conclusions

The results lend support to the efficacy of CACR with particular emphasis on Social Cognition. The difficulty in targeting specific domains suggests a ‘non-specific’ effect of CACR. These results are discussed in the light of the possible bias in remediation tasks due to computer interface design paradigms.

Keywords

Human computer interfaceneuropsychologyrehabilitationsocial cognitiontraining
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 1 , January 2011 , pp. 163 - 173
Copyright
Copyright © Cambridge University Press 2010

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