Sensory-enhanced system for enhancing neuroplasticity and preventing and treating fundamental sensory, perceptual, and higher-level executive cognitive impairments

Abstract

The invention relates to a system developed for preventing schizophrenia (schizophrenia-SZ) in at-risk individuals before its onset, treating existing schizophrenia, treating delusions (audio-verbal hallucinations) and auditory-verbal paranoid symptoms (such as thought insertion and thought broadcasting), which constitute the positive symptoms experienced in schizophrenia, and for remediating 0 and enhancing cognition in cases of various neurocognitive impairments observed in the brains of schizophrenia patients.

Description

[0001] SENSORY-ENHANCED SYSTEM FOR ENHANCING NEUROPLASTICITY AND PREVENTING AND TREATING FUNDAMENTAL SENSORY, PERCEPTUAL, AND HIGHER-LEVEL EXECUTIVE COGNITIVE IMPAIRMENTS

[0002] TECHNICAL FIELD

[0003] The invention pertains to a system designed to be used for preventing schizophrenia (schizophrenia-SZ) in individuals at risk before its onset, treating schizophrenia that has already manifested, and addressing the restoration and cognitive enhancement of various neurocognitive impairments observed in the brains of schizophrenia patients, as well as positive symptoms consisting of delusions (audio-verbal hallucinations) and auditory-verbal paranoid symptoms (such as thought insertion and thought broadcasting).

[0004] PRIOR ART

[0005] Schizophrenia (SZ) is associated with impairment and decline in a wide range of higher-level executive cognitive domains, leading to positive symptoms such as hallucinations and delusions, and negative symptoms such as apathy and withdrawal. SZ affects approximately 1 % of the global population and significantly impacts functionality. Individuals with SZ have lower employment and marriage rates, reduced physical health and quality of life, lower educational attainment, and considerably shorter life expectancy.

[0006] It is supported by data from hundreds of studies and thousands of individuals that SZ is associated with impairment in many basic sensory, perceptual and higher- order executive cognitive domains. Unfortunately, in children who are later diagnosed with SZ, cognitive decline manifests itself long before any overt symptoms. Among the most disruptive abnormal cognitive processes in SZ are verbal learning and memory. Poor social functioning and poor response to psychosocial rehabilitation programs are associated with impaired auditory-verbal functioning.

[0007] Auditory-Verbal Hallucinations (AVH) are another common condition in SZ that causes individuals discomfort and prevents them from going about their daily lives. AVH is one of the most common symptoms of SZ, affecting 64 to 80 percent of people with SZ. Auditory-verbal hallucinations are the most common hallucinatory phenomenon and have a lifetime prevalence higher than all other forms of hallucinations combined (visual 23-31 %, tactile 9-19%, olfactory 6-10%).

[0008] Despite their moderate to severe side effects, the effects of antipsychotics on negative symptoms, cognitive decline or long-term loss of functioning have been found to be quite low.

[0009] Although antipsychotics are very successful in reducing positive symptoms such as hallucinations from early onset, it has been reported that they may not help with auditory-verbal hallucinations in 25-30% of SZ cases. Antipsychotics alone may not be sufficient to prevent cognitive decline, promote cognitive recovery or eliminate AVHs. Therefore, it is recommended that medication management be supported by cognitive training modules, cognitive behavioral therapies and other psychosocial therapies to improve cognitive functioning and functionality in the treatment of SZ.

[0010] Over the last 20 years, a range of evidence-based cognitive and psychosocial therapies have been established to help people with SZ manage their symptoms, improve their social functioning, maintain a healthy lifestyle and find meaningful employment despite having a chronic mental illness. Individuals with SZ can be identified when they are at risk. Sometimes interventions are initiated after the first psychosis and the support system can continue afterwards. Cognitive Behavioral Therapy (CBT) helps with medication adherence, coping with auditory hallucinations and other psychotic symptoms, coping with stress, developing social skills, improving PTSD and maintaining employment. Social interventions also target occupational problems, sociability, family psychoeducation and prevention of traumatization. CBT and other social interventions mostly focus on auditory-verbal and social-cognitive rehabilitation. Disturbances caused by hallucinations are often targeted. There is also a shift in the treatment of SZ from a focus on neurodegeneration to neuroplasticity and cognitive rehabilitation. Cognitive remediation / training are computer or human-based methods that aim to restore cognitive abilities and help manage negative and positive symptoms using the principles of neuroplasticity. They have been found to be effective for cognitive and behavioral remediation in SZ, new-onset SZ and high-risk individuals. Interventions mostly focus on auditory-verbal and socio-cognitive domains, which are considered the most impaired areas. However, these interventions are difficult to access in clinical settings for a variety of reasons, including the scarcity of practitioners trained in these methodologies, lack of funding for psychological interventions, and, where available, low attendance and retention in treatments. To compensate for this, as technology has advanced, online, social media and / or mobile technology interventions, virtual / augmented reality and brain / computer interfaces, computerized cognitive auditory training modules, computerized social cognition training, neurofeedback training and similar applications have taken their place in the prior art.

[0011] However, most interventions are clinic-based, costly, involve expensive equipment, are implemented for a limited period of time and are not available to everyone. There are also some problems with participation, volunteering, dropout and the intrusive nature of some interventions. Mobile-based interventions have proven to be quite practical, but sustainability depends on commitment and may not be lifelong. Perhaps the most lasting effects achieved in CBT are social interventions such as family psychoeducation, stressor reduction and employment. Unfortunately, there are few follow-up studies on neuroplasticity interventions, and existing cognitive training follow-up studies suggest that gains may be diminishing.

[0012] In summary, cost, availability and sustainability are important problems in psychosocial and cognitive intervention programs. The shortage of qualified experts and therefore limited access to clinical practices is one of the most fundamental technical problems.

[0013] BRIEF DESCRIPTION OF THE INVENTION

[0014] The invention relates to a system for preventing and remediating cognitive impairments by sensory enhancement and sensory substitution administered through sensory substitution devices for enhancing neuroplasticity, Schizophrenia (SZ) prevention, cognitive rehabilitation, remediation, reduction of auditory-verbal hallucinations (AVH), and relief of positive and negative symptoms.

[0015] Here, an intervention method that improves cognitive impairments in SZ, eliminates disturbing symptoms such as auditory-verbal hallucinations (AVH) and reduces functional losses caused by negative and positive symptoms, is cost- effective, lifelong, non-invasive, non-intrusive, easily adaptable, engaging, sustainable rehabilitative, therapeutic and preventive of the development of SZ in individuals at risk becomes applicable without the need for a qualified specialist with our invention.

[0016] DETAILED DESCRIPTION OF THE INVENTION

[0017] The invention relates to a system for preventing and remediating cognitive impairments by sensory enhancement and sensory substitution administered via sensory substitution devices for enhancing neuroplasticity, Schizophrenia (SZ) prevention, cognitive rehabilitation, remediation, reduction of auditory-verbal hallucinations (AVH), and relief of positive and negative symptoms.

[0018] As defined in the prior art, sensory substitution (SS) is the process of transmitting sensory data to the brain via a different sensory organ / module. For example, in order to provide visual assistance to the visually impaired, visual information obtained from video-graphic data (from a camera) is converted into tactile data by vibration on the skin, tactile data by electricity on the tongue or audio data through the ear. In another example, sensory substitution devices were also created to assist the hearing impaired by converting sound data into tactile data.

[0019] Sensory substitution tools in the prior art have been developed and tested for a variety of methods. Balance sensory data has been converted into tactile data to help people with posture and balance problems. Tactile data has been converted back to tactile data to help people with nerve damage due to diseases such as leprosy, or to help people with prosthetic limbs experience somatosensation. Sensory enhancement (SE) and sensory substitution (SS) mechanisms have also been used to improve the performance of archers and athletes, or to add another sense, such as global orientation (compass heading information) or stock market information, to subjects through tactile perception.

[0020] Within the scope of the technical problems that our invention aims to solve, there is no system targeting the effectiveness of sensory substitution devices (SSD) sensory enhancement (SE) and sensory substitution (SS) in enhancing learning and skill development for SZ. There are also no known techniques for utilizing sensory substitution devices (SSD), sensory enhancement (SE) and sensory substitution (SS) for cognitive rehabilitation and restoration in SZ. There are also no known techniques for the use of sensory substitution devices (SSD), sensory enhancement (SE) and sensory substitution (SS) for the management of positive and negative symptoms in SZ. There are also no known techniques to utilize sensory substitution devices (SSD), sensory enhancement (SE) and sensory substitution (SS) to prevent the development of SZ in individuals at risk for SZ.

[0021] The inventive system comprises the regular lifelong (or over a long period of time) use of at least one of Sensory Substitution Devices (SSD) or Sensory Enhancement Devices (SED) that convert auditory data into tactile sensory data (auditory to tactile) for the prevention of the occurrence of SZ, for cognitive enhancement and cognitive remediation, and for the relief of positive symptoms and negative symptoms. For the purposes of this methodology, SSD and SED devices that convert auditory data into tactile data include any device and fabric technology that can convert any type of auditory data, including verbal data, into tactile data in a variety of ways, including vibration or electronic stimulation and signaling on the tongue, on the skin, on the body, on the wrist.

[0022] The mechanisms by which auditory to tactile sensory enhancement and substitution intervention in SZ helps prevent the onset of SZ, cognitive remediation and cognitive enhancement, and relief of positive symptoms and negative symptoms are outlined below:

[0023] Preventing the onset of SZ: Cognitive remediation and enhancement interventions for young, high-risk individuals during the schizophrenia risk period will prevent the risk of developing schizophrenia. The inventive system provides an inexpensive, lifelong, non-invasive, easy to implement, impressive and sustainable solution for the prevention and rehabilitation of schizophrenia (SZ) by using at least one of the SSD and SED devices that convert sound waves into tactile data.

[0024] Providing cognitive remediation and cognitive enhancement: With the system subject to our invention, which is provided by using at least one of the SSD and SED devices that convert sound waves into tactile data, the functions of improving hearing regions and increasing crossmodal processing, increasing functional connections in certain brain regions, increasing physiological activity in certain brain regions, increasing neuroplasticity, neuroplasticity in sensory and perceptual functions and treatment and protection against SZ are provided. SZ is fundementally a cognitive disorder and some cognitive / perceptual / sensory functions that are reduced in SZ are more developed especially in people with congenital / early visual impairment. Improvements in these cognitive / perceptual / sensory functions prevent people from developing SZ. Cognitive rehabilitation of SZ requires an emphasis on sensory adaptation, accuracy of sensory representations, perceptual organization, multisensory integration, and the development of controlled processing, including the integration of bottom-up auditory sensory data with stored information. People with SZ who receive tactile feedback begin to resemble healthy individuals in their response times to auditory and visual stimuli. In this context, sound-to-touch sensory enhancement and substitution intervention is expected to improve auditory adaptation, accuracy of auditory representations, auditory organization, multisensory integration, and bottom-up matching of auditory data with other parts of the brain. In this context, with the use of the inventive system, auditory and tactile sensory and perceptual training is provided by imitating the neuroplasticity process that occurs in visually impaired people with sensory enhancement and sensory substitution intervention from sound to touch. In this way, it leads to a decrease in positive and negative symptoms and an increase in cognitive functions.

[0025] Treatment of positive symptoms: The inventive system provides sensory enhancement and substitution intervention from sound to touch to improve some delusions (auditory hallucinations) and some hallucinations (thought insertion, thought propagation) seen in SZ. The inventive system provides this technical effect by providing synchronization through the use of at least one of the SSD and SED devices that convert sound waves into tactile data, teaching implicit and explicit sound discrimination, improving cognitive impairments in the auditory region and developing auditory regions.

[0026] - Treatment of Auditory Verbal Hallucinations: Tinnitus and chronic auditory- verbal hallucinations (AVH) share some phenomenologically similarfeatures. Some types of AVH, such as tinnitus, are thought to have a neurological cause and may be associated with chronic deafferentation of the auditory cortex. In this condition, the brain tries to compensate for the loss of sensory auditory information and becomes more sensitive to subtle stimuli. These compensatory mechanisms cause some types of AVH or tinnitus, giving the impression of real perception. In the inventive system, by using at least one of the SSD and SED devices that convert sound waves into tactile data, two sensory modules (sound and touch) that convert sounds into sensory data with vibrations in the wrist by focusing on speech sounds by converting sound into tactile perception, reduce AVHs caused by the difficulty in auditory perception and discrimination of SZ patients. Thus, the treatment of auditory verbal hallucinations is realized.

[0027] - - Treatment of delusions: According to the self-monitoring model, poor reality discrimination and hallucinations are caused by the inability to identify the original source (inside or outside) of perceptions and sensations. In studies conducted in the known technique, auditory-verbal hallucinations (AVHs) and delusions of control in SZ are thought to be caused by a deficit in the self / real ity monitoring system. Accordingly, as a result of all these, individuals in SZ are able to attribute their internal perceptions and experiences to external forces. A wide range of problems in SZ, from psychotic experiences to cognitive dysfunctions, can be caused by errors in the coordination of locally specialized systems in the brain. Synchronization problems observed in the brains of individuals with SZ prior to self-initiated movements, such as talking or pressing a button, indicate that patients with SZ are out of sync even with the most basic cognitive tasks. It is argued that this synchronization problem in the brain can lead to internal ideas or sensations being perceived as external, which can ultimately result in positive symptoms such as auditory hallucinations and thought insertion / thought broadcasting delusions. It is argued that in normal individuals, when a sound (beep) and / or an image (flash) occurs shortly after a motor movement (e.g. raising a hand), the brain is more likely to claim ownership of these sensory consequences. According to Parsons et al. (2013), expectations based on sensory feedback, and hence perception, can be modulated in specific ways by our motor movements. For example, the brain calibrates the timing of various modalities by sending a motor movement (such as snapping one's fingers) and then analyzing the sensory feedback it receives in return, such as sensation, vision and sound. Here, it is thought that the return of auditory stimuli as haptic feedback will act like motor movement and help calibrate the timing of these modalities by analyzing the accompanying sensations such as sensation-vision- sound by the brain. In one study, when visual and auditory stimuli were combined with tactile stimuli in SZ patients, the reaction times of the patients were found to be shorter and closer to the reaction times of control subjects without SZ. By using at least one of the SSD and SED devices that convert sound waves into tactile data in the inventive system, the reaction times of SZ patients will also improve when the auditory stimuli they are exposed to in daily life are accompanied by tactile stimuli through SSD and SEDs. Thus, training with the sensory substitution and enhancement tool (SSD and SED) used in the inventive system will potentially create an experiential change resulting in the ability to distinguish external objects through reality-monitoring processes. Through these mechanisms created with the inventive system, auditory-verbal paranoid symptoms such as thought broadcasting / thought insertion are improved by means of SSDs and SEDs that convert auditory data into tactile data. For these reasons, the use of at least one of the sensory substitution and enhancement tools (SSD and SED) from audio to tactile data within the scope of the inventive system will help the source monitoring process by helping to correct desynchronization through continuous auditory to tactile feedback, thus reducing positive symptoms such as auditory-verbal hallucinations (AVHs) and auditory- verbal paranoid symptoms such as thought insertion / broadcasting delusions. In addition, since motor movements help synchronization / calibration in the brain, the tactile data will increase the synchronization of local systems in the brain, resulting in improved cognitive coordination, cognitive functions and reaction times.

[0028] Treatment of Negative Symptoms: The treatment of negative symptoms is secondary to improvements in brain structure (sensory enhancement, cognitive remediation and enhancement) and improvements in positive symptoms with the use of the inventive system. These improvements lead to a decrease in negative symptoms by increasing reward sensitivity, executive functions, motivation and selfconfidence in individuals with schizophrenia.

[0029] For enhancing neuroplasticity, schizophrenia (SZ) prevention, cognitive rehabilitation, remediation, reduction of auditory-verbal hallucinations (AVH), relief of positive and negative symptoms, The technical problems experienced in the known technique are solved by means of new technical effects that are not in the known technique, which are formed by the use of at least one of the SSD and SED devices that convert sound waves into tactile data, as we have explained above with examples with the system of preventing and eliminating cognitive impairments with sensory enhancement and sensory substitution applied through sensory substitution devices. Here are all the technical effects of the invention we have described above; auditory improvement, crossmodal processing, timing synchronization, neuroplasticity, 24 / 7 cognitive remediation, cognitive enhancement and rehabilitation, internal-external source management and discrimination (source monitoring), P100 in EEG measurements, N100 can be summarized as sensory gating, improvement in MMN regions, normalization of reaction time through motor / tactile feedback accompanying auditory data, implicit learning, and classical conditioning.

[0030] The system described in the invention can be implemented using all devices, fabrics, and wearable technologies that convert sound waves or speech into any tactile sensation (e.g., on the tongue, skin, or wrist) through vibration, electrical signals, or any transmission method, either simultaneously or with minimal delay.

Claims

CLAIMS1. A system for preventing and treating cognitive impairments through sensory enhancement and substitution, utilizing sensory substitution devices to enhance neuroplasticity, prevent schizophrenia (SZ), enable cognitive rehabilitation and remediation, reduce auditory-verbal hallucinations (AVH), and treat positive and negative symptoms, characterized by the inclusion of at least one sensory substitution or sensory enhancement device that transforms auditory perception into tactile sensation.

2. The sensory substitution devices and sensory enhancement devices as claimed in claim 1 , characterized in that they include a unit which converts the sounds, especially speech sounds, into sensory data through vibrations applied to the wrist and transmits this data to the brain.

3. The sensory substitution devices and sensory enhancement devices as claimed in Claim 1 , characterized in that they comprise at least one of the following: a device, fabric, or wearable device designed to convert speech into tactile sensations with simultaneous or minimal delay, using at least one of the following: vibration or electrical signal transmission pathways.