Active Ingredients in Digital Cognitive Interventions: Integrating Dismantling Designs With Mechanistic Neuroscience

Digital cognitive interventions (DCIs) have emerged as scalable approaches for treating cognitive dysfunction across psychiatric, neurological, and aging populations. Despite growing evidence of efficacy, little is known about which intervention components drive therapeutic effects or through which neurocognitive mechanisms they operate. As a result, null findings are often difficult to interpret, making it unclear whether interventions failed to engage their intended targets, or whether the targets themselves are not causally related to meaningful outcomes. This limits intervention refinement, comparative evaluation, and precision personalization. Here, we argue that DCI research should shift from broad efficacy testing toward mechanistic trials designed to identify active ingredients-the intervention components responsible for engaging prespecified neurocognitive targets and producing clinically meaningful benefits. We propose adapting dismantling design methodology from psychotherapy research in order to integrate Research Domain Criteria constructs, mechanistic neuroscience, and high-resolution digital behavioral data to identify factors driving cognitive and functional outcomes. This approach aligns with the National Institute of Mental Health experimental therapeutics framework by explicitly linking target specification and target engagement with downstream clinical and functional outcomes. Mechanistic dismantling trials can determine whether specific DCI features, including adaptive difficulty, reward schedules, feedback contingencies, task variability, cognitive targets, and human support, are necessary, sufficient, or synergistic for engaging neural circuitry and producing durable and clinically meaningful transfer. Beyond optimizing intervention design, such studies may transform null or negative trials into mechanistically interpretable findings, while clarifying disease mechanisms and supporting the development of personalized, optimized, and usable DCIs.