Eye-Movement Intervention for Cognitive Impairment Across Schizophrenia Spectrum

This study is a stratified, randomized, active‐controlled, assessor‐blinded clinicaltrial designed to evaluate the effects of a gamified eye‐movement intervention oncognitive function across the schizophrenia spectrum, including clinical high‐riskindividuals, first‐episode schizophrenia patients, chronic schizophrenia patients, andhealthy controls.Cognitive impairment is a core feature of schizophrenia‐spectrum disorders and isassociated with poor functional outcomes across illness stages. Eye movements are closelylinked to cognitive processes such as attention, working memory, and executive control,suggesting that eye‐movement‐based training may have potential as a cognitiveintervention.Participants will be stratified by illness stage and randomly assigned in a 1:1 ratio toeither an eye‐movement intervention group or an active control group receiving matchedfinger‐controlled game training. The intervention targets core oculomotor functions,including fixation control, smooth pursuit, and saccadic eye movements, throughstructured gamified training tasks. The intervention lasts 4 weeks, with 3‐4 sessions perweek.The primary outcome is change in cognitive performance assessed using the MATRICSConsensus Cognitive Battery (MCCB), including composite and domain‐specific T‐scores frombaseline to week 4. Secondary outcomes include changes in oculomotor functions and visualexploration patterns assessed using standardized eye‐tracking tasks, including fixationstability, smooth pursuit, antisaccade, and free‐viewing paradigms. Clinical symptomseverity will be assessed using the Scale of Psychosis‐Risk Symptoms (SOPS) for clinicalhigh‐risk participants and the Positive and Negative Syndrome Scale (PANSS) forschizophrenia participants.Statistical analyses will evaluate intervention effects on cognitive, eye‐movement, andclinical outcomes, including group‐by‐time interactions across illness stages.