M106. VIRTUAL-REALITY COGNITIVE TRAINING AND ASSESSMENT IN SCHIZOPHRENIA

Abstract

BackgroundIt is widely accepted that neurocognitive performance is linked to functional outcomes in schizophrenia (Green, Kern, Braff, & Mintz, 2000). Research, however, shows that this relationship is likely to be mediated by other factors such as social competence (Brekke, Kay, Lee, & Green, 2005). Indeed, performance on cognitive tasks only explain 20% of the variance in work related skills (Bowie et al., 2008). Furthermore, the composite score generated by the gold standard neurocognitive measure, the MATRICS Consensus Cognitive Battery (MCCB), fails to predict work or education related functioning and independent living (August, Kiwanuka, McMahon, & Gold, 2012). To address these limitations, we developed a novel and ecologically valid virtual reality (VR) task with the aim to simultaneously measure cognition and functional capacity in schizophrenia. The assessment is set in a minimarket environment where participants are required to buy selected items from a shopping list. In this study, our objective was to establish the construct validity of the VR task in relation to the MCCB, and test whether it can predict functional outcomes. In addition, we tested whether app-based cognitive training can improve cognition and/or functional outcomes at follow-up as an exploratory objective.MethodsThirty patients with a diagnosis of schizophrenia or schizoaffective disorder were recruited from South London. At baseline, participants completed the VR task and MCCB, the Positive and Negative Syndrome Scale (PANSS), and various functional capacity/outcome measures including the Global Assessment of Functioning (GAF), Social and Occupational Functioning Assessment Scale (SOFAS), UCSD Performance-Based Skills Assessment-Brief (UPSA-B), and World Health Organization Disability Assessment Schedule II (WHODAS-II). A subset of participants was randomly allocated to receive a 4-week long, app-based training; either playing with an immersive or a 2D spatial memory training game. Those who completed the training were invited back for a follow-up visit. Construct validity of the VR task will be assessed through a series of bivariate correlations. The predictive ability of the VR task for functional outcomes will be tested through linear regression models. Finally, the efficacy of spatial memory training will be assessed using repeated measures ANOVA.ResultsData analysis is currently ongoing, and results will be presented at the conference.DiscussionThis study will provide the first indication whether VR can be employed to test cognition and functional capacity simultaneously in patients with schizophrenia. Given the current lack of reliable and ecologically valid functional outcome measures, new assessments that are sensitive to clinically meaningful cognitive improvements are desperately needed.