The CORTEX Project: A Pre–Post Randomized Controlled Feasibility Trial Evaluating the Efficacy of a Computerized Cognitive Remediation Therapy Program for Adult Inpatients with Anorexia Nervosa

Background/Objectives: Anorexia nervosa (AN) is marked by cognitive deficits, particularly reduced mental flexibility and weak central coherence, which may sustain the core psychopathological symptoms. While cognitive remediation therapy (CRT) has shown efficacy in improving these cognitive processes in AN, evidence on computer-based CRT remains limited. This study aims to evaluate the feasibility and efficacy of integrating computer-assisted cognitive remediation therapy (CA-CRT) into standard nutritional rehabilitation (treatment as usual, TAU) to improve the targeted cognitive and psychological parameters among inpatients with AN in a more personalized and scalable way. Methods: A multicenter randomized controlled trial (RCT) will be conducted. At least 54 participants with a diagnosis of AN will be recruited at each site and randomized into either the experimental or control group after initial screening. The intervention will last five weeks and include 15 individual CA-CRT sessions alongside 10 individual CR sessions, delivered in addition to standard care. The primary and secondary outcomes will be assessed at the end of the intervention to evaluate the changes in cognitive flexibility, central coherence, and psychological functioning. Results: Participants receiving CA-CRT are expected to develop more flexible and integrated thinking styles and achieve greater improvements in clinical outcomes compared to those receiving standard care alone, supporting a more personalized therapeutic approach. Conclusions: These findings would underscore the feasibility and clinical value of incorporating CA-CRT into standard inpatient treatment for AN. By specifically targeting cognitive inflexibility and poor central coherence in a scalable, individualized format, CA-CRT may enhance treatment effectiveness and support the development of patient-centered interventions tailored to the cognitive profiles of individuals with AN.