Patients receiving REHACOP showed improvements in several cognitive domains. This preliminary study thus provides evidence supporting the efficacy of this integrative group-based cognitive rehabilitation intervention in MS. Future research should confirm these findings, examine the impact of the treatment on everyday life functioning and explore the presence of brain changes associated with cognitive rehabilitation. Implications for rehabilitation This study provides initial evidence for integrative group-based cognitive rehabilitation efficacy in MS patients through the implementation of the REHACOP cognitive rehabilitation programme. Patients received cognitive rehabilitation for three months (3 one-hour-sessions per week) focused on training attention, learning and memory, language, executive functioning, and social cognition. Patients attending REHACOP sessions showed medium to large and statistically significant improvements in processing speed, working memory, verbal memory, and executive functioning.
ObjectiveTo obtain two equivalent short forms of the “Situational Feature Recognition Test, Version 2,” a social perception test, and their psychometric properties.MethodsPatients with schizophrenia (n = 101) were assessed at two different times. Statistical analyses were performed as follows: (1) Cronbach's alpha was used to assess reliability; (2) Spearman correlations, Wilcoxon signed‐rank test, and a 2 (form) × 2 (time) repeated measures multivariate analysis of variance were used to analyse interform equivalence; (3) Sensitivity to change was studied by a 2 (group) × 2 (time) repeated measures multivariate analysis of variance; (4) Spearman correlations were employed to assess test–retest reliability, convergent and discriminant validity, and relationship with functionality and symptoms.ResultsThe short forms showed good internal consistency at both times. Significant and moderate correlation between forms was found along with no statistically significant form x time interaction. Hits and false positives of both forms were moderately correlated at both times. Group x time interaction was significant especially for hits when assessing sensitivity to change. Both forms were significantly correlated with other social cognition domains and with functionality.ConclusionsResults of this study support the use of short forms of the Situational Feature Recognition Test, Version 2 especially in clinical trials and longitudinal studies among patients with schizophrenia.
This study analyzed the effectiveness of an integrative cognitive remediation program (REHACOP) in improving neurocognition, social cognition, creativity, functional outcome, and clinical symptoms in patients with schizophrenia. In addition, possible mediators predicting improvement in functional outcomes were explored. The program combined cognitive remediation with social cognitive training and social and functional skill training over 20 weeks. The sample included 94 patients, 47 in the REHACOP group and 47 in the active control group (occupational activities). Significant differences were found between the two groups in change scores of processing speed, working memory, verbal memory (VM), inhibition, theory of mind, emotion processing (EP), figural creative strengths, functional competence, disorganization, excitement, and primary negative symptoms. A mediational analysis revealed that changes in VM, inhibition, and EP partially explained the effect of cognitive remediation on functional competence improvement. This study provides initial evidence of the effect of integrative cognitive remediation on primary negative symptoms and creativity.
Background
White matter (WM) alterations are well documented in schizophrenia. Abnormalities in interhemispheric fibers appear to account for altered WM asymmetry in the illness. However, the regional specificity (e.g., frontal versus occipital) of these alterations and their potential contribution to cognitive dysfunction in schizophrenia remain unknown.
Methods
Forty one patients with schizophrenia and 21 healthy controls (HC) underwent diffusion-weighted imaging on a 3 Tesla MRI machine. Tract-based spatial statistic (FSL) was used to assess whole brain differences in WM. Probabilistic tractography was performed in order to separately measure frontal and occipital WM tracts. Participants also completed tests of verbal memory and processing speed. Repeated measures analyses of covariance and Pearson correlation analyses were performed.
Results
A significant group x cerebral hemisphere interaction was found for fractional anisotropy (FA) (
F
(1,17)
= 7.03;
p
= .017;
η
p
2
= 0.29) and radial diffusivity (RD)
(F
(1,17)
= 4.84;
p
= .042;
η
p
2
= 0.22) in the frontal tract of patients versus HC. Healthy controls showed higher mean FA and lower mean RD in the left frontal tract compared to patients, who showed the opposite pattern. In patients with schizophrenia, mean FA and RD in the right frontal tract correlated with verbal memory (
r
= −0.68,
p
= .046;
r
= 0.77,
p
= .015).
Conclusions
Asymmetric WM alterations were found in a frontal tract of patients with schizophrenia. Higher mean FA in the right frontal tract correlated with worse verbal memory performance, suggesting a possible contribution these brain changes to cognitive impairment in schizophrenia.
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