Randomized trial of self-adaptive computerized cognitive remediation in schizophrenia
4 affiliations
- 1Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University
- 2Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Capital Medical University
- 3Beijing Wispirit Technology Co., Ltd.
- 4Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
Abstract
Computerized, self-adaptive cognitive training has emerged as a promising digital therapeutic for cognitive impairment; however, its underlying training mechanisms in schizophrenia remain poorly understood. This double-blind, randomized trial compared self-adaptive difficulty (SAD) with fixed-difficulty (FD) computerized cognitive training program, evaluating both domain-specific cognitive and clinical outcomes, and exploring difficulty-performance coupling as a potential active therapeutic mechanism. Seventy-two patients with schizophrenia (SAD = 41, FD = 31) completed 4 weeks of training, and 40 patients (n = 20 per group) were assessed at week 8. Cognitive outcomes were measured using the Cognitive Index (CI) and MATRICS Consensus Cognitive Battery (MCCB), while clinical symptoms were also assessed. Linear mixed-effects models (LMMs) revealed significantly greater and faster cognitive improvements in the SAD compared with the FD group in attention and agility, with faster improvement also observed in thinking. Robust difficulty-performance coupling was observed across all cognitive domains. Additionally, positive symptoms improved significantly in the SAD group compared to the FD group at week 4. Self-adaptive cognitive training enhances and accelerates cognitive improvements in schizophrenia, particularly in attention and processing speed, and also benefits positive symptoms. Difficulty-performance coupling may reflect dynamic load calibration as a key therapeutic mechanism in digital cognitive training. Trial registration: Chictr.org.cn, number, ChiCTR2000040326, registered 2020-11-27.
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BibTeX
@article{ren2026randomized,
title = {{Randomized trial of self-adaptive computerized cognitive remediation in schizophrenia}},
author = {Yan-ping Ren and Li-na Wang and Shuo Lin and Wei-gang Pan and Xue-quan Zhu and Yi Liu and Han Wu and Dan-di Zhu and Si-yuan Lian and Wen Wang and Wen-qing Jin and Zhi-ming Bian and Zi-heng Zhang and Yi-lang Tang and Long-jun Cai and Gang Wang and Xin Ma},
journal = {npj Digital Medicine},
year = {2026},
month = jul,
doi = {10.1038/s41746-026-02949-z},
url = {https://doi.org/10.1038/s41746-026-02949-z},
note = {CC BY},
}
RIS
TY - JOUR
TI - Randomized trial of self-adaptive computerized cognitive remediation in schizophrenia
AU - Yan-ping Ren
AU - Li-na Wang
AU - Shuo Lin
AU - Wei-gang Pan
AU - Xue-quan Zhu
AU - Yi Liu
AU - Han Wu
AU - Dan-di Zhu
AU - Si-yuan Lian
AU - Wen Wang
AU - Wen-qing Jin
AU - Zhi-ming Bian
AU - Zi-heng Zhang
AU - Yi-lang Tang
AU - Long-jun Cai
AU - Gang Wang
AU - Xin Ma
PY - 2026
DA - 2026/07/01
JO - npj Digital Medicine
DO - 10.1038/s41746-026-02949-z
UR - https://doi.org/10.1038/s41746-026-02949-z
AB - Computerized, self-adaptive cognitive training has emerged as a promising digital therapeutic for cognitive impairment; however, its underlying training mechanisms in schizophrenia remain poorly understood. This double-blind, randomized trial compared self-adaptive difficulty (SAD) with fixed-difficulty (FD) computerized cognitive training program, evaluating both domain-specific cognitive and clinical outcomes, and exploring difficulty-performance coupling as a potential active therapeutic mechanism. Seventy-two patients with schizophrenia (SAD = 41, FD = 31) completed 4 weeks of training, and 40 patients (n = 20 per group) were assessed at week 8. Cognitive outcomes were measured using the Cognitive Index (CI) and MATRICS Consensus Cognitive Battery (MCCB), while clinical symptoms were also assessed. Linear mixed-effects models (LMMs) revealed significantly greater and faster cognitive improvements in the SAD compared with the FD group in attention and agility, with faster improvement also observed in thinking. Robust difficulty-performance coupling was observed across all cognitive domains. Additionally, positive symptoms improved significantly in the SAD group compared to the FD group at week 4. Self-adaptive cognitive training enhances and accelerates cognitive improvements in schizophrenia, particularly in attention and processing speed, and also benefits positive symptoms. Difficulty-performance coupling may reflect dynamic load calibration as a key therapeutic mechanism in digital cognitive training. Trial registration: Chictr.org.cn, number, ChiCTR2000040326, registered 2020-11-27.
SN - 2398-6352
ER -