While the psychotic symptoms of schizophrenia are reasonably treated by current medications, patients are still left with debilitating cognitive impairments, including in their memory, and so are frequently unable to return to school or work, the researchers said.
They added that while there are no medications to improve cognitive function for people with schizophrenia, there is increasing evidence that computer-assisted training can help them overcome some of their symptoms, with better outcomes in daily functioning and their lives.
In a study published in the Philosophical Transactions of the Royal Society B, a team of researchers led by Professor Barbara Sahakian from the Department of Psychiatry at Cambridge describe how they developed and tested Wizard, an iPad game aimed at improving episodic memory.
Episodic memory is the type of memory required when you have to remember where you parked your car in a multi-story parking garage after going shopping for several hours or where you left your keys several hours ago, for example. It is one of the facets of cognitive functioning affected in patients with schizophrenia, the researchers said.
The game is the result of a nine-month collaboration between psychologists, neuroscientists, a professional game developer, and people with schizophrenia. It is intended to be fun, attention-grabbing, motivating and easy to understand, while at the same time improving the player’s episodic memory.
The memory task was woven into a narrative in which the player is allowed to choose their own character and name. The game rewards progress with additional in-game activities to provide the user with a sense of progression independent of the cognitive training process, the researchers explain.
For the study, the researchers recruited 22 people diagnosed with schizophrenia. They were then randomly assigned to either the cognitive training group or a control group.
Those in the training group played the memory game for a total of eight hours over a four-week period, while those in the control group continued their treatment as usual.
At the end of the four weeks, the researchers tested all participants’ episodic memory using the Cambridge Neuropsychological Test Automated Battery (CANTAB) PAL, as well as their level of enjoyment and motivation, and their score on the Global Assessment of Functioning (GAF) scale, which doctors use to rate the social, occupational, and psychological functioning of adults.
The researchers found that the patients who had played the memory game made significantly fewer errors and needed significantly fewer attempts to remember the location of different patterns in the CANTAB PAL test relative to the control group. In addition, patients in the cognitive training group saw an increase in their score on the GAF scale.
Those in the training group indicated that they enjoyed the game and were motivated to continue playing across the eight hours of cognitive training. In fact, the researchers found that those who were most motivated also performed best at the game. This is important, as lack of motivation is another common facet of schizophrenia.
“We need a way of treating the cognitive symptoms of schizophrenia, such as problems with episodic memory, but slow progress is being made towards developing a drug treatment,” Sahakian said. “So this proof-of-concept study is important because it demonstrates that the memory game can help where drugs have so far failed. Because the game is interesting, even those patients with a general lack of motivation are spurred on to continue the training.”
In April 2015, the researchers began a collaboration with the team behind the brain training app Peak to produce scientifically-tested cognitive training modules. The collaboration has resulted in the launch of the Cambridge University & Peak Advanced Training Plan, a memory game available within Peak’s iOS app, designed to train visual and episodic memory while promoting learning.
The training module is based on the Wizard memory game, developed by Sahakian and colleague Tom Piercy at the Department of Psychiatry at the University of Cambridge. Rights to the game were licensed to Peak by Cambridge Enterprise, the university’s commercialization company.
“This new app will allow the Wizard memory game to become widely available, inexpensively,” Sahakian said. “State-of-the-art neuroscience at the University of Cambridge, combined with the innovative approach at Peak, will help bring the games industry to a new level and promote the benefits of cognitive enhancement.”
The game is built for four weeks of training and is priced at $14.99/£10.99.
Source: University of Cambridge