Kannampallil, ThomasAjilore, Olusola ALv, NanSmyth, Joshua MWittels, Nancy ERonneberg, Corina RKumar, VikasXiao, LanDosala, SusanthBarve, AmrutaZhang, AifengTan, Kevin CCao, Kevin PPatel, Charmi RGerber, Ben SJohnson, Jillian AKringle, Emily AMa, Jun2023-07-212023-07-212023-05-12Kannampallil T, Ajilore OA, Lv N, Smyth JM, Wittels NE, Ronneberg CR, Kumar V, Xiao L, Dosala S, Barve A, Zhang A, Tan KC, Cao KP, Patel CR, Gerber BS, Johnson JA, Kringle EA, Ma J. Effects of a virtual voice-based coach delivering problem-solving treatment on emotional distress and brain function: a pilot RCT in depression and anxiety. Transl Psychiatry. 2023 May 12;13(1):166. doi: 10.1038/s41398-023-02462-x. Erratum in: Transl Psychiatry. 2023 Jul 4;13(1):242. PMID: 37173334; PMCID: PMC10175049.2158-318810.1038/s41398-023-02462-x37173334https://hdl.handle.net/20.500.14038/52347Consumer-based voice assistants have the ability to deliver evidence-based treatment, but their therapeutic potential is largely unknown. In a pilot trial of a virtual voice-based coach, Lumen, delivering problem-solving treatment, adults with mild-to-moderate depression and/or anxiety were randomized to the Lumen intervention (n = 42) or waitlist control (n = 21). The main outcomes included changes in neural measures of emotional reactivity and cognitive control, and Hospital Anxiety and Depression Scale [HADS] symptom scores over 16 weeks. Participants were 37.8 years (SD = 12.4), 68% women, 25% Black, 24% Latino, and 11% Asian. Activation of the right dlPFC (neural region of interest in cognitive control) decreased in the intervention group but increased in the control group, with an effect size meeting the prespecified threshold for a meaningful effect (Cohen's d = 0.3). Between-group differences in the change in activation of the left dlPFC and bilateral amygdala were observed, but were of smaller magnitude (d = 0.2). Change in right dlPFC activation was also meaningfully associated (r ≥ 0.4) with changes in self-reported problem-solving ability and avoidance in the intervention. Lumen intervention also led to decreased HADS depression, anxiety, and overall psychological distress scores, with medium effect sizes (Cohen's d = 0.49, 0.51, and 0.55, respectively), compared with the waitlist control group. This pilot trial showed promising effects of a novel digital mental health intervention on cognitive control using neuroimaging and depression and anxiety symptoms, providing foundational evidence for a future confirmatory study.enOpen Access: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http:// creativecommons.org/licenses/by/4.0/. © The Author(s) 2023, corrected publication 2023Attribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/DepressionEpigenetics and behaviourJournal ArticleTranslational psychiatry