Computer-assisted cognitive remediation for schizophrenia: A randomized single-blind pilot study

Abstract

Cognitive impairment is a core symptom in schizophrenia that has a significant impact on psychosocial function, but shows a weak response to pharmacological treatment. Consequently, a variety of cognitive remediation strategies have been evaluated to improve cognitive function in schizophrenia. The efficacy of computer-based cognitive remediation as a stand-alone intervention on general measures of neuropsychological function remains unclear. We tested the effectiveness of biweekly training using computerized cognitive remediation programs on neuropsychological and event-related potential outcome measures. Schizophrenia patients were randomly assigned to cognitive remediation training (N=17), active control (TV-watching; N=17), or treatment as usual (N=10) groups for ten weeks and run in parallel. Functional, cognitive, and ERP measures revealed no differential improvement over time in the cognitive remediation group. Practice effects might explain change over time on several cognitive measures for all groups, consistent with studies indicating task-specific improvement. Computer-assisted cognitive remediation alone may not be sufficient for robust or generalized effects on cognitive and electrophysiological measures in schizophrenia patients.

Cognitive Remediation for Schizophrenia: A Review of Recent Findings

“…Two other studies [37,38] that were published before our publication period showed improved verbal memory and auditory neural responses (M100) after intensive auditory training. The MEG findings contradict Rass et al's study [36], but are in line with the original neuroplasticity-based studies from Fisher and colleagues [34,39], which reported significant improvements in verbal learning and memory and global cognition, and maintenance of treatment gains at 6- month follow-up. Thus, the limited data available for this review suggest neuroplasticity-based interventions likely impact functional brain changes associated with basic perceptual/cognitive processes.…”

“…One reported significant effects, in terms of normalized magnetoencephalography (MEG) sensory gating (M50 ratio) following neuroplasticity-based CR training [32]; in a separately published re-examination of the data, the researchers found normalized alpha desynchronization mediated the effects of improved auditory gating [35]. The other study concluded there were no gains in neurocognition and no changes in electroencephalogram (EEG) measures following 40 hours of BrainFitness training [36]. Two other studies [37,38] that were published before our publication period showed improved verbal memory and auditory neural responses (M100) after intensive auditory training.…”

Current Trends in the Empirical Study of Cognitive Remediation for Schizophrenia

“…Keefe et al 39 also reported nonsignificant results from the multisite Cognitive Remediation in the Schizophrenia Trials Network study, which used brain fitness training within the CR arm in a pilot efficacy RCT. Finally, Rass et al 40 found no significant improvement in cognitive or event-related potential outcome measures following the standard program package of brain fitness training.…”

Neuroplasticity-Based Auditory Training Via Laptop Computer Improves Cognition in Young Individuals With Recent Onset Schizophrenia

“…[9][10][11][12][13] Four other studies have investigated this form of training in schizophrenia, but methodologies and results have been inconsistent across studies. [14][15][16][17] While some of the findings have been promising, the discrepancies indicate the need for additional research.…”