Digital therapeutic tool improved attention, cognitive function for adults with MDD

Use of a digital therapeutic tool by adults with major depressive disorder resulted in significant improvement in attention and cognitive functioning, according to a study published in the American Journal of Psychiatry.

“People with major depressive disorder report a range of difficulties with concentrating, making decisions, slowed thinking and forgetfulness,” Richard S.E. Keefe, PhD, of the department of psychiatry and behavioral sciences at Duke University Medical Center, and colleagues wrote. “These cognitive challenges can have a serious impact on patients’ daily activities, especially in education and work.”

Keefe and colleagues sought to evaluate AKL-T03, an investigational video game-based digital intervention that targets the fronto-parietal network to enhance attentional control.

The double-blind, randomized controlled study involved 37 adults aged 25 to 55 years, who presented with residual mild to moderate depression, were prescribed a stable antidepressant regimen and who displayed cognitive impairment. Participants were randomized in a 1:1 ratio either to AKL-T03 or an expectation-matched digital control letter-word video game and underwent baseline assessment and an additional assessment after completing their 6-week at-home intervention. Participants in the both the AKL-T03 and control groups were required to complete five sessions per day at least 5 days a week for 6 weeks, a total of 25 minutes of game play per day, after which the software locked. All enrollees were monitored remotely using an electronic dashboard made by Akili, the creator of AKL-T03.

Primary outcome was measurable changes in sustained attention, evaluated by the Test of Variables of Attention (TOVA). Following each intervention, all participants were required to complete five mental health-based questionnaires, including the PHQ-9.

Results showed a statistically significant medium-effect-size improvement in sustained attention compared with the control intervention on the TOVA primary outcome (partial eta-squared = 0.11). Additionally, a composite score derived from all cognitive measures revealed significant improvement with AKL-T03 compared with the control intervention. No serious adverse events were reported; however, two patients in the AKL-T03 group reported an intervention-related adverse event (headache).

“The digital nature of the intervention could help to increase access for patients who otherwise might not find a solution for their depression-related cognitive difficulties,” Keefe and colleagues wrote.