Computerized cognitive training shows early promise in schizophrenia

Home-based computerized cognitive training has shown promise as a treatment for young people with schizophrenia, results of a randomized trial indicate.

In the study, individuals who completed 40 hours of training over an 8-week period showed significant improvements in global cognition, verbal memory, and problem solving, compared with a control group.

“Future studies must investigate whether cognitive training improves functioning and how best to integrate it into critical psychosocial interventions,” write Sophia Vinogradov (University of California, San Francisco, USA) and colleagues in Schizophrenia Bulletin.

Cognitive dysfunction is present early in the course of schizophrenia and is a strong predictor of later poor functioning. This trial assessed the value of cognitive remediation in adolescents and young adults who were within 5 years of illness onset.

A total of 86 individuals (mean age 21 years) were given laptop computers to take home. They were randomly assigned to perform 40 hours of cognitive training or 40 hours of commercial computer games over 8 weeks.

The training program consisted of computerized exercises designed to improve speed and accuracy of auditory information processing while engaging auditory and verbal working memory, explain the authors. In each session, participants worked through four of six exercises for 15 minutes per exercise, receiving points and animations for correctly completed exercises.

Between baseline and study end, participants given auditory training showed improvements in all measures of cognitive performance, although only changes in global cognition, verbal memory, and problem-solving were statistically significant.

By contrast, participants assigned to play computer games showed no significant improvements in any domain of cognition and even deteriorated in some domains.

Further analysis showed that, among people in the computerized training group, baseline reward anticipation was strongly associated with improvements in cognitive performance. Also in this group, auditory processing time declined significantly from baseline, indicating that participants became more efficient at rapid processing of successive auditory stimuli; again, this improvement was significantly associated with gains in global cognition.

“Early gains in auditory processing speed likely serve as an indirect measure of training-induced plasticity and increased efficiency in the neural systems subserving auditory encoding,” Vinogradov and co-authors remark.

They conclude: “In sum, results indicate that a neuroscience-informed approach to cognitive training in young individuals with schizophrenia, using a portable computer, can generate significant improvements in cognition, a finding with promising implications for the long-term course of illness.”

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