Neuroplastic changes in patients with schizophrenia undergoingcognitive remediation: Triple-blind trial

• Published in: British journal of psychiatry Vol. 210; no. 3; pp. 216 - 222
• Main Authors: Ramsay, Ian S, Nienow, Tasha M, Marggraf, Matthew P, MacDonald, Angus W
• Format: Journal Article
• Language: English
• Published: London Cambridge University Press 01-03-2017
• Subjects: Changes; Cognition; Cognitive ability; Cortex; Functional status; Magnetic resonance imaging; Mental disorders; Mental task performance; Prefrontal cortex; Schizophrenia; Short term memory; Social functioning; Variants
• ISSN: 0007-1250; 1472-1465
• DOI: 10.1192/bjp.bp.115.171496

BackgroundPatients with schizophrenia have shown cognitive improvements followingcognitive remediation, but the neuroplastic changes that support theseprocesses are not fully understood.AimsTo use a triple-blind, placebo-controlled trial to examine neuralactivation before and after cognitive remediation or a computer skillstraining (CST) placebo (trial registration: NCT00995553)).MethodTwenty-seven participants underwent functional magnetic resonance imagingbefore and after being randomised to either cognitive remediationintervention or CST. Participants completed two variants of the N-backtask during scanning and were assessed on measures of cognition,functional capacity, community functioning and symptoms.ResultsWe observed a group × time interaction in the left prefrontal cortex,wherein the cognitive remediation group showed increased activation.These changes correlated with improved task accuracy within the cognitiveremediation group, whereas there was no relationship between changes inactivation in untrained cognitive measures. Significant changes were notobserved in other hypothesised areas for the cognitive remediationgroup.ConclusionsWe replicated the finding that cognitive remediation increases leftlateral prefrontal activation during a working memory task in patientswith schizophrenia, suggesting this may be an important neural target forthese types of interventions.