Rachel Loewy1, Melissa Fisher2, Sisi Ma3,4, Cameron Carter5, J Daniel Ragland5, Tara A Niendam5, Barbara Stuart1, Danielle Schlosser1,6, Felix Amirfathi1, Seghel Yohannes7, Sophia Vinogradov2. 1. Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA. 2. Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA. 3. School of Medicine, Division of General Internal Medicine, University of Minnesota, Minneapolis, MN, USA. 4. Institute for Health Informatics, University of Minnesota, Minneapolis, MN, USA. 5. Department of Psychiatry, University of California, Davis, Davis, CA, USA. 6. Verily Life Sciences, South San Francisco, CA, USA. 7. Department of Public Health, University of California, Berkeley, Berkeley, CA, USA.
Abstract
OBJECTIVE: Cognitive impairment in schizophrenia predicts functional outcomes and is largely unresponsive to pharmacology or psychotherapy; it is thus a critical unmet treatment need. This article presents the impact of remotely completed, intensive, targeted auditory training (AT) vs control condition computer games (CG) in a double-blind randomized trial in young adults with recent-onset schizophrenia. METHOD: Participants (N = 147) were assessed for cognition, symptoms, and functioning at baseline, post-intervention, and at 6-month follow-up. All participants were provided with laptop computers and were instructed to complete 40 hours remotely of training or computer games. An intent-to-treat analysis (N = 145) was performed using linear mixed models with time modeled as a continuous variable. Planned contrasts tested the change from baseline to post-training, baseline to 6-month follow-up, and post-training to 6-month follow-up. RESULTS: Global Cognition, which had improved in the AT group relative to the CG group at post-training, showed durable gains at 6-month follow-up in an omnibus group-by-time interaction test (F(1,179) = 4.80, P = .030), as did Problem-Solving (F(1,179) = 5.13, P = .025), and Speed of Processing improved at trend level significance (F(1,170) = 3.80, P = .053). Furthermore, the AT group showed significantly greater improvement than the CG group in positive symptoms (F(1,179) = 4.06, P = .045). CONCLUSIONS: These results provide the first evidence of durable cognitive gains and symptom improvement at follow-up of cognitive training (CT) in early schizophrenia completed independently and remotely. While functioning did not show significant improvement, these findings suggest that intensive targeted CT of auditory processing is a promising component of early intervention to promote recovery from psychosis.
OBJECTIVE: Cognitive impairment in schizophrenia predicts functional outcomes and is largely unresponsive to pharmacology or psychotherapy; it is thus a critical unmet treatment need. This article presents the impact of remotely completed, intensive, targeted auditory training (AT) vs control condition computer games (CG) in a double-blind randomized trial in young adults with recent-onset schizophrenia. METHOD: Participants (N = 147) were assessed for cognition, symptoms, and functioning at baseline, post-intervention, and at 6-month follow-up. All participants were provided with laptop computers and were instructed to complete 40 hours remotely of training or computer games. An intent-to-treat analysis (N = 145) was performed using linear mixed models with time modeled as a continuous variable. Planned contrasts tested the change from baseline to post-training, baseline to 6-month follow-up, and post-training to 6-month follow-up. RESULTS: Global Cognition, which had improved in the AT group relative to the CG group at post-training, showed durable gains at 6-month follow-up in an omnibus group-by-time interaction test (F(1,179) = 4.80, P = .030), as did Problem-Solving (F(1,179) = 5.13, P = .025), and Speed of Processing improved at trend level significance (F(1,170) = 3.80, P = .053). Furthermore, the AT group showed significantly greater improvement than the CG group in positive symptoms (F(1,179) = 4.06, P = .045). CONCLUSIONS: These results provide the first evidence of durable cognitive gains and symptom improvement at follow-up of cognitive training (CT) in early schizophrenia completed independently and remotely. While functioning did not show significant improvement, these findings suggest that intensive targeted CT of auditory processing is a promising component of early intervention to promote recovery from psychosis.
Authors: Richard S E Keefe; Kolleen Hurley Fox; Philip D Harvey; Josephine Cucchiaro; Cynthia Siu; Antony Loebel Journal: Schizophr Res Date: 2010-12-31 Impact factor: 4.939
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Authors: A M Smerbeck; J Parrish; E A Yeh; M Hoogs; Lauren B Krupp; B Weinstock-Guttman; R H B Benedict Journal: Clin Neuropsychol Date: 2011-03-07 Impact factor: 3.535
Authors: Barbara A Cornblatt; Andrea M Auther; Tara Niendam; Christopher W Smith; Jamie Zinberg; Carrie E Bearden; Tyrone D Cannon Journal: Schizophr Bull Date: 2007-04-17 Impact factor: 9.306