Development and analysis of computerized training framework for patients with neurocognitive deficits

Abstract

Cognition is the ability to think, decide and act. Many mental disorders are associated with deficits in cognition. Schizophrenia is a severe mental disorder which is characterized by the breakdown of thought process, abnormal behavior and huge cognitive deficits. Cognitive remediation is employed in psychiatric setups to ameliorate cognitive deficits in patients with schizophrenia. In India, paper pencil methods are largely used to impart cognitive remediation. In this work, a computer tablet based cognitive training program Cogbrain has been developed in collaboration with Department of Psychiatry, Government Medical College and Hospital, Sector 32, Chandigarh to facilitate clinicians in providing cognitive remediation to patients with cognitive deficit. The program has been tested through a 3 months Randomized Controlled Trial in which 29 patients participated and randomly allocated to Cognitive Training (CT) or Treatment as Usual (TAU) group. At both pre and post cognitive training, the clinical neuropsychological assessment was done using NIMHANS Neuropsychological Battery which includes tests for various cognitive functions. Electrophysiological (EEG) recordings were also obtained and analyzed under Passive (Rest) and Active (Cognitive activity) conditions. Following cognitive training on the developed program, the patients showed significant improvement in cognitive functions namely Speed of Processing, Sustained Attention, Auditory Verbal Learning Memory and Visual Learning and Memory-Immediate recall. The electrophysiological findings reveal schizophrenic patients exhibited higher dimensional and lower dynamical neural system complexities over time. The CT group also showed improvement over P300 Event-Related Potential abnormality in latency which further correlated with improved performances in the speed of processing following cognitive training. newline newline newline