Christophe Delay , Peter Link , Jason Holden , Eric Granholm
{"title":"Using pupillometry to predict outcome in cognitive behavioral therapy for negative symptoms of schizophrenia","authors":"Christophe Delay , Peter Link , Jason Holden , Eric Granholm","doi":"10.1016/j.schres.2025.01.014","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Clinical trials of cognitive-behavioral therapy (CBT) for negative symptoms of schizophrenia have provided mixed results, perhaps because some patients are more likely to benefit than others. Patients likely to benefit may be those with greater pre-treatment motivation. To better examine the effects of motivation on treatment outcome, more objective measures of motivation are needed. Pupillary responses provide an objective biomarker of cognitive effort and motivation, with greater dilation associated with greater effort and motivation.</div></div><div><h3>Aims</h3><div>The current study examined whether pre-treatment baseline pupil dilation predicted motivation and pleasure (MAP) negative symptom reduction in an open clinical trial of CBT for individuals with schizophrenia.</div></div><div><h3>Methods</h3><div>Pupil dilation was recorded during the digit-span task at low (3 digits), moderate (6 digits) and high (9 digits) loads in participants with schizophrenia or schizoaffective disorder (<em>N</em> = 31) with persistent negative symptoms prior to delivery of mobile-assisted CBT for negative symptoms (mCBTn).</div></div><div><h3>Results</h3><div>Greater pre-treatment pupil dilation during low, but not moderate or high, loads of the digit-span task significantly predicted greater reduction in MAP negative symptoms. However, while MAP negative symptoms improved throughout treatment, pupil dilation did not significantly change throughout treatment for any digit-span loads.</div></div><div><h3>Implications</h3><div>Pupil dilation may provide a much-needed prognostic biomarker of patients most likely to benefit from CBT for MAP symptoms, but did not change with change in MAP symptoms.</div></div>","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":"276 ","pages":"Pages 135-142"},"PeriodicalIF":3.6000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Schizophrenia Research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0920996425000210","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Clinical trials of cognitive-behavioral therapy (CBT) for negative symptoms of schizophrenia have provided mixed results, perhaps because some patients are more likely to benefit than others. Patients likely to benefit may be those with greater pre-treatment motivation. To better examine the effects of motivation on treatment outcome, more objective measures of motivation are needed. Pupillary responses provide an objective biomarker of cognitive effort and motivation, with greater dilation associated with greater effort and motivation.
Aims
The current study examined whether pre-treatment baseline pupil dilation predicted motivation and pleasure (MAP) negative symptom reduction in an open clinical trial of CBT for individuals with schizophrenia.
Methods
Pupil dilation was recorded during the digit-span task at low (3 digits), moderate (6 digits) and high (9 digits) loads in participants with schizophrenia or schizoaffective disorder (N = 31) with persistent negative symptoms prior to delivery of mobile-assisted CBT for negative symptoms (mCBTn).
Results
Greater pre-treatment pupil dilation during low, but not moderate or high, loads of the digit-span task significantly predicted greater reduction in MAP negative symptoms. However, while MAP negative symptoms improved throughout treatment, pupil dilation did not significantly change throughout treatment for any digit-span loads.
Implications
Pupil dilation may provide a much-needed prognostic biomarker of patients most likely to benefit from CBT for MAP symptoms, but did not change with change in MAP symptoms.
期刊介绍:
As official journal of the Schizophrenia International Research Society (SIRS) Schizophrenia Research is THE journal of choice for international researchers and clinicians to share their work with the global schizophrenia research community. More than 6000 institutes have online or print (or both) access to this journal - the largest specialist journal in the field, with the largest readership!
Schizophrenia Research''s time to first decision is as fast as 6 weeks and its publishing speed is as fast as 4 weeks until online publication (corrected proof/Article in Press) after acceptance and 14 weeks from acceptance until publication in a printed issue.
The journal publishes novel papers that really contribute to understanding the biology and treatment of schizophrenic disorders; Schizophrenia Research brings together biological, clinical and psychological research in order to stimulate the synthesis of findings from all disciplines involved in improving patient outcomes in schizophrenia.