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Weinberg A, Dieterich R, Riesel A. Error-related brain activity in the age of RDoC: A review of the literature. Int J Psychophysiol 2015; 98:276-299. [PMID: 25746725 DOI: 10.1016/j.ijpsycho.2015.02.029] [Citation(s) in RCA: 134] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 02/24/2015] [Accepted: 02/26/2015] [Indexed: 12/28/2022]
Abstract
The ability to detect and respond to errors is critical to successful adaptation to a changing environment. The error-related negativity (ERN), an event-related potential (ERP) component, is a well-validated neural response to errors and reflects the error monitoring activity of the anterior cingulate cortex (ACC). Additionally, the ERN is implicated in several processes key to adaptive functioning. Abnormalities in error-related brain activity have been linked to multiple forms of psychopathology and individual differences. As such, the component is likely to be useful in NIMH's Research Domain Criteria (RDoC) initiative to establish biologically-meaningful dimensions of psychological dysfunction, and currently appears as a unit of measurement in three RDoC domains: Positive Valence Systems, Negative Valence Systems, and Cognitive Systems. In this review paper, we introduce the ERN and discuss evidence related to its psychometric properties, as well as important task differences. Following this, we discuss evidence linking the ERN to clinically diverse forms of psychopathology, as well as the implications of one unit of measurement appearing in multiple RDoC dimensions. And finally, we discuss important future directions, as well as research pathways by which the ERN might be leveraged to track the ways in which dysfunctions in multiple neural systems interact to influence psychological well-being.
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Affiliation(s)
- Anna Weinberg
- Department of Psychology, University of Illinois at Chicago, United States.
| | - Raoul Dieterich
- Clinical Psychology, Humboldt-Universität zu Berlin, Germany
| | - Anja Riesel
- Clinical Psychology, Humboldt-Universität zu Berlin, Germany
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Fisher M, Loewy R, Carter C, Lee A, Ragland JD, Niendam T, Schlosser D, Pham L, Miskovich T, Vinogradov S. Neuroplasticity-based auditory training via laptop computer improves cognition in young individuals with recent onset schizophrenia. Schizophr Bull 2015; 41:250-8. [PMID: 24444862 PMCID: PMC4266283 DOI: 10.1093/schbul/sbt232] [Citation(s) in RCA: 138] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Cognitive deficits that characterize schizophrenia are present in the prodrome, worsen with illness onset, and predict functional outcome. Cognitive dysfunction is thus a critical target for early intervention in young individuals with recent onset schizophrenia. METHOD This 2-site double-blind randomized controlled trial investigated cognitive training of auditory processing/verbal learning in 86 subjects with recent onset schizophrenia (mean age of 21 years). Subjects were given laptop computers to take home and were asked to perform 40 hours of training or 40 hours of commercial computer games over 8 weeks. We examined cognitive measures recommended by the Measurement and Treatment Research to Improve Cognition in Schizophrenia initiative (MATRICS), symptoms, and functioning. We also assessed baseline reward anticipation to index motivational system functioning and measured changes in auditory processing speed after 20 hours of training to assess target engagement. RESULTS Auditory training subjects demonstrated significant improvements in global cognition, verbal memory, and problem solving compared with those of computer games control subjects. Both groups showed a slight but significant decrease in symptoms and no change in functional outcome measures. Training-induced cognitive gains at posttraining showed significant associations with reward anticipation at baseline and with improvement in auditory processing speed at 20 hours. CONCLUSION Neuroscience-informed cognitive training via laptop computer represents a promising treatment approach for cognitive dysfunction in early schizophrenia. An individual's baseline motivational system functioning (reward anticipation), and ability to engage in auditory processing speed improvement, may represent important predictors of treatment outcome. Future studies must investigate whether cognitive training improves functioning and how best to integrate it into critical psychosocial interventions.
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Affiliation(s)
- Melissa Fisher
- Department of Psychiatry, University of California, San Francisco, CA;,Department of Psychiatry, San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA
| | - Rachel Loewy
- Department of Psychiatry, University of California, San Francisco, CA
| | - Cameron Carter
- Department of Psychiatry, University of California, Davis, CA
| | - Ashley Lee
- Department of Psychiatry, University of California, San Francisco, CA
| | | | - Tara Niendam
- Department of Psychiatry, University of California, Davis, CA
| | | | - Lien Pham
- Department of Psychiatry, University of California, Davis, CA
| | - Tara Miskovich
- Department of Psychiatry, University of California, Davis, CA
| | - Sophia Vinogradov
- Department of Psychiatry, University of California, San Francisco, CA; Department of Psychiatry, San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA;
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The effect of cognitive training on evoked potentials in schizophrenia. SCHIZOPHRENIA RESEARCH-COGNITION 2014; 1:180-186. [PMID: 29379751 PMCID: PMC5779133 DOI: 10.1016/j.scog.2014.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 07/09/2014] [Accepted: 07/21/2014] [Indexed: 11/22/2022]
Abstract
Electrophysiological indices are sensitive to cognitive dysfunction in schizophrenia but have rarely been used to assess benefits of cognitive remediation. Our aim was to evaluate the effect of specific cognitive training approaches on event-related potentials. Forty-six patients with schizophrenia underwent either auditory (AUD) or visuo-spatial (VIS) cognitive training or treatment-as-usual (TAU). Cognitive training was computer-assisted and administered for 10 sessions within two weeks. Event-related potentials during an active odd-ball paradigm together with clinical and neuropsychological variables were assessed before and after training and again at a two-month follow-up. Compared to the TAU group both the AUD and VIS training groups showed decreased P2 latency following training. At follow-up, the P2-latency reduction was stable in the VIS group but the AUD group experienced a relapse. Training resulted in improved digit-span backward among neuropsychological variables. Increased P2 amplitude was related to more positive symptoms and lower social-occupational functioning and longer P2 latency was associated with greater severity of stereotyped thinking. The more general visuo-spatial training appears to have a longer-lasting effect on P2 latency than the specific auditory training. Alternatively, there may be specific auditory discrimination deficits in schizophrenia requiring more extensive training for a stable change.
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Popova P, Popov TG, Wienbruch C, Carolus AM, Miller GA, Rockstroh BS. Changing facial affect recognition in schizophrenia: effects of training on brain dynamics. NEUROIMAGE-CLINICAL 2014; 6:156-65. [PMID: 25379427 PMCID: PMC4215531 DOI: 10.1016/j.nicl.2014.08.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 08/17/2014] [Accepted: 08/31/2014] [Indexed: 11/17/2022]
Abstract
Deficits in social cognition including facial affect recognition and their detrimental effects on functional outcome are well established in schizophrenia. Structured training can have substantial effects on social cognitive measures including facial affect recognition. Elucidating training effects on cortical mechanisms involved in facial affect recognition may identify causes of dysfunctional facial affect recognition in schizophrenia and foster remediation strategies. In the present study, 57 schizophrenia patients were randomly assigned to (a) computer-based facial affect training that focused on affect discrimination and working memory in 20 daily 1-hour sessions, (b) similarly intense, targeted cognitive training on auditory-verbal discrimination and working memory, or (c) treatment as usual. Neuromagnetic activity was measured before and after training during a dynamic facial affect recognition task (5 s videos showing human faces gradually changing from neutral to fear or to happy expressions). Effects on 10–13 Hz (alpha) power during the transition from neutral to emotional expressions were assessed via MEG based on previous findings that alpha power increase is related to facial affect recognition and is smaller in schizophrenia than in healthy subjects. Targeted affect training improved overt performance on the training tasks. Moreover, alpha power increase during the dynamic facial affect recognition task was larger after affect training than after treatment-as-usual, though similar to that after targeted perceptual–cognitive training, indicating somewhat nonspecific benefits. Alpha power modulation was unrelated to general neuropsychological test performance, which improved in all groups. Results suggest that specific neural processes supporting facial affect recognition, evident in oscillatory phenomena, are modifiable. This should be considered when developing remediation strategies targeting social cognition in schizophrenia.
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Affiliation(s)
- Petia Popova
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Tzvetan G. Popov
- Department of Psychology, University of Konstanz, Konstanz, Germany
- Corresponding author: Department of Psychology, University of Konstanz, P.O. Box 905, Konstanz D-78457, Germany.
| | | | - Almut M. Carolus
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Gregory A. Miller
- Departments of Psychology & Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
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55
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Merzenich MM, Van Vleet TM, Nahum M. Brain plasticity-based therapeutics. Front Hum Neurosci 2014; 8:385. [PMID: 25018719 PMCID: PMC4072971 DOI: 10.3389/fnhum.2014.00385] [Citation(s) in RCA: 105] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 05/15/2014] [Indexed: 11/30/2022] Open
Abstract
The primary objective of this review article is to summarize how the neuroscience of brain plasticity, exploiting new findings in fundamental, integrative and cognitive neuroscience, is changing the therapeutic landscape for professional communities addressing brain-based disorders and disease. After considering the neurological bases of training-driven neuroplasticity, we shall describe how this neuroscience-guided perspective distinguishes this new approach from (a) the more-behavioral, traditional clinical strategies of professional therapy practitioners, and (b) an even more widely applied pharmaceutical treatment model for neurological and psychiatric treatment domains. With that background, we shall argue that neuroplasticity-based treatments will be an important part of future best-treatment practices in neurological and psychiatric medicine.
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Affiliation(s)
| | - Thomas M Van Vleet
- Posit Science Corporation San Francisco, CA, USA ; Medical Research, Department of Veteran Affairs Martinez, CA, USA
| | - Mor Nahum
- Posit Science Corporation San Francisco, CA, USA ; Department of Optometry, University of California at Berkeley Berkeley, CA, USA
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56
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Paquin K, Wilson AL, Cellard C, Lecomte T, Potvin S. A systematic review on improving cognition in schizophrenia: which is the more commonly used type of training, practice or strategy learning? BMC Psychiatry 2014; 14:139. [PMID: 24885300 PMCID: PMC4055167 DOI: 10.1186/1471-244x-14-139] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 04/28/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this article was to conduct a review of the types of training offered to people with schizophrenia in order to help them develop strategies to cope with or compensate for neurocognitive or sociocognitive deficits. METHODS We conducted a search of the literature using keywords such as "schizophrenia", "training", and "cognition" with the most popular databases of peer-reviewed journals. RESULTS We reviewed 99 controlled studies in total (though nine did not have a control condition). We found that drill and practice training is used more often to retrain neurocognitive deficits while drill and strategy training is used more frequently in the context of sociocognitive remediation. CONCLUSIONS Hypotheses are suggested to better understand those results and future research is recommended to compare drill and strategy with drill and practice training for both social and neurocognitive deficits in schizophrenia.
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Affiliation(s)
- Karine Paquin
- Psychology Department, University of Montreal, Montreal, Canada.
| | | | | | - Tania Lecomte
- Psychology Department, University of Montreal, Montreal, Canada
| | - Stéphane Potvin
- Psychology Department, University of Montreal, Montreal, Canada
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57
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Thorsen AL, Johansson K, Løberg EM. Neurobiology of cognitive remediation therapy for schizophrenia: a systematic review. Front Psychiatry 2014; 5:103. [PMID: 25177300 PMCID: PMC4133649 DOI: 10.3389/fpsyt.2014.00103] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 08/01/2014] [Indexed: 12/13/2022] Open
Abstract
Cognitive impairment is an important aspect of schizophrenia, where cognitive remediation therapy (CRT) is a promising treatment for improving cognitive functioning. While neurobiological dysfunction in schizophrenia has been the target of much research, the neural substrate of cognitive remediation and recovery has not been thoroughly examined. The aim of the present article is to systematically review the evidence for neural changes after CRT for schizophrenia. The reviewed studies indicate that CRT affects several brain regions and circuits, including prefrontal, parietal, and limbic areas, both in terms of activity and structure. Changes in prefrontal areas are the most reported finding, fitting to previous evidence of dysfunction in this region. Two limitations of the current research are the few studies and the lack of knowledge on the mechanisms underlying neural and cognitive changes after treatment. Despite these limitations, the current evidence suggests that CRT is associated with both neurobiological and cognitive improvement. The evidence from these findings may shed light on both the neural substrate of cognitive impairment in schizophrenia, and how better treatment can be developed and applied.
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Affiliation(s)
| | - Kyrre Johansson
- Department of Psychosocial Science, University of Bergen , Bergen , Norway
| | - Else-Marie Løberg
- Division of Psychiatry, Haukeland University Hospital , Bergen , Norway ; Department of Biological and Medical Psychology, University of Bergen , Bergen , Norway
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58
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Crocker LD, Heller W, Warren SL, O'Hare AJ, Infantolino ZP, Miller GA. Relationships among cognition, emotion, and motivation: implications for intervention and neuroplasticity in psychopathology. Front Hum Neurosci 2013; 7:261. [PMID: 23781184 PMCID: PMC3678097 DOI: 10.3389/fnhum.2013.00261] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 05/23/2013] [Indexed: 01/16/2023] Open
Abstract
Emotion-cognition and motivation-cognition relationships and related brain mechanisms are receiving increasing attention in the clinical research literature as a means of understanding diverse types of psychopathology and improving biological and psychological treatments. This paper reviews and integrates some of the growing evidence for cognitive biases and deficits in depression and anxiety, how these disruptions interact with emotional and motivational processes, and what brain mechanisms appear to be involved. This integration sets the stage for understanding the role of neuroplasticity in implementing change in cognitive, emotional, and motivational processes in psychopathology as a function of intervention.
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Affiliation(s)
- Laura D. Crocker
- Department of Psychology, University of Illinois at Urbana-ChampaignChampaign, IL, USA
| | - Wendy Heller
- Department of Psychology, University of Illinois at Urbana-ChampaignChampaign, IL, USA
| | - Stacie L. Warren
- Department of Mental Health, St. Louis VA Medical CenterSt. Louis, MO, USA
| | - Aminda J. O'Hare
- Department of Psychology, University of Massachusetts DartmouthNorth Dartmouth, MA, USA
| | | | - Gregory A. Miller
- Department of Psychology, University of Illinois at Urbana-ChampaignChampaign, IL, USA
- Department of Psychology, University of DelawareNewark, DE, USA
- Department of Psychology, University of KonstanzKonstanz, Germany
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Early sensory processing deficits predict sensitivity to distraction in schizophrenia. Schizophr Res 2013; 147:196-200. [PMID: 23590872 PMCID: PMC3650096 DOI: 10.1016/j.schres.2013.03.025] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 03/14/2013] [Accepted: 03/20/2013] [Indexed: 11/21/2022]
Abstract
Patients with schizophrenia frequently report difficulties paying attention during important tasks, because they are distracted by noise in the environment. The neurobiological mechanism underlying this problem is, however, poorly understood. The goal of this study was to determine if early sensory processing deficits contribute to sensitivity to distracting noise in schizophrenia. To that end, we examined the effect of environmentally relevant distracting noise on performance of an attention task in 19 patients with schizophrenia and 22 age and gender-matched healthy comparison subjects. Using electroencephalography, P50 auditory gating ratios also were measured in the same subjects and were examined for their relationship to noise-induced changes in performance on the attention task. Positive symptoms also were evaluated in patients. Distracting noise caused a greater increase in reaction time in patients, relative to comparison subjects, on the attention task. Higher P50 auditory gating ratios also were observed in patients. P50 gating ratio significantly correlated with the magnitude of noise-induced increase in reaction time. Noise-induced increase in reaction time was associated with delusional thoughts in patients. P50 ratios were associated with delusional thoughts and hallucinations in patients. In conclusion, the observation of noise effects on attention in patients is consistent with subjective reports from patients. The observed relationship between noise effects on reaction time and P50 auditory gating supports the hypothesis that early inhibitory processing deficits may contribute to susceptibility to distraction in the illness.
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60
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Vinogradov S, Fisher M, Nagarajan S. Cognitive training in schizophrenia: golden age or wild west? Biol Psychiatry 2013; 73:935-7. [PMID: 23628236 DOI: 10.1016/j.biopsych.2013.03.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 03/21/2013] [Indexed: 11/18/2022]
Affiliation(s)
- Sophia Vinogradov
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA 94121, USA.
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61
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Smucny J, Rojas DC, Eichman LC, Tregellas JR. Neural effects of auditory distraction on visual attention in schizophrenia. PLoS One 2013; 8:e60606. [PMID: 23560100 PMCID: PMC3613360 DOI: 10.1371/journal.pone.0060606] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Accepted: 02/28/2013] [Indexed: 11/19/2022] Open
Abstract
Sensory flooding, particularly during auditory stimulation, is a common problem for patients with schizophrenia. The functional consequences of this impairment during cross-modal attention tasks, however, are unclear. The purpose of this study was to examine how auditory distraction differentially affects task-associated response during visual attention in patients and healthy controls. To that end, 21 outpatients with schizophrenia and 23 healthy comparison subjects performed a visual attention task in the presence or absence of distracting, environmentally relevant "urban" noise while undergoing functional magnetic resonance imaging at 3T. The task had two conditions (difficult and easy); task-related neural activity was defined as difficult - easy. During task performance, a significant distraction (noise or silence) by group (patient or control) interaction was observed in the left dorsolateral prefrontal cortex, right hippocampus, left temporoparietal junction, and right fusiform gyrus, with patients showing relative hypoactivation during noise compared to controls. In patients, the ability to recruit the dorsolateral prefrontal cortex during the task in noise was negatively correlated with the effect of noise on reaction time. Clinically, the ability to recruit the fusiform gyrus during the task in noise was negatively correlated with SANS affective flattening score, and hippocampal recruitment during the task in noise was positively correlated with global functioning. In conclusion, schizophrenia may be associated with abnormalities in neural response during visual attention tasks in the presence of cross-modal noise distraction. These response differences may predict global functioning in the illness, and may serve as a biomarker for therapeutic development.
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Affiliation(s)
- Jason Smucny
- Neuroscience Program, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
| | - Donald C. Rojas
- Neuroscience Program, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
- Research Service, Denver VA Medical Center, Denver, Colorado, United States of America
| | - Lindsay C. Eichman
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
- Research Service, Denver VA Medical Center, Denver, Colorado, United States of America
| | - Jason R. Tregellas
- Neuroscience Program, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
- Research Service, Denver VA Medical Center, Denver, Colorado, United States of America
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62
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Affiliation(s)
- Gregory A. Miller
- Department of Psychology, University of Delaware, Newark, Delaware 19716;
- Zukunftskolleg, University of Konstanz, 78457 Konstanz, Germany
- Department of Psychology and Beckman Institute, University of Illinois at Urbana-Champaign, Illinois 61820
| | - Brigitte Rockstroh
- Department of Psychology, University of Konstanz, 78457 Konstanz, Germany;
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63
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Fisher M, Loewy R, Hardy K, Schlosser D, Vinogradov S. Cognitive interventions targeting brain plasticity in the prodromal and early phases of schizophrenia. Annu Rev Clin Psychol 2013; 9:435-63. [PMID: 23297786 PMCID: PMC4745413 DOI: 10.1146/annurev-clinpsy-032511-143134] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Several important paradigm shifts have occurred in the field of schizophrenia treatment, including an increased focus on early detection, the development of preemptive interventions, and the view of schizophrenia as a neurodevelopmental disease characterized by decreased efficiency and abnormal connectivity in cortical and subcortical neural networks. In this review, we briefly describe some of the neural impairments that contribute to the development of schizophrenia, with an emphasis on the impact of stress and trauma on cognitively vulnerable neural systems. We then present current data on two behavioral interventions that target these critical risk factors and that aim to preempt the onset of schizophrenia in vulnerable individuals or improve the clinical course in recent-onset schizophrenia: cognitive therapy and computerized cognitive training.
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Affiliation(s)
- Melissa Fisher
- Department of Psychiatry, University of California, San Francisco; San Francisco, CA
- San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA
| | - Rachel Loewy
- Department of Psychiatry, University of California, San Francisco; San Francisco, CA
| | - Kate Hardy
- Department of Psychiatry, University of California, San Francisco; San Francisco, CA
| | - Danielle Schlosser
- Department of Psychiatry, University of California, San Francisco; San Francisco, CA
- San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA
| | - Sophia Vinogradov
- Department of Psychiatry, University of California, San Francisco; San Francisco, CA
- San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA
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64
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Biagianti B, Vinogradov S. Computerized cognitive training targeting brain plasticity in schizophrenia. PROGRESS IN BRAIN RESEARCH 2013; 207:301-26. [PMID: 24309260 DOI: 10.1016/b978-0-444-63327-9.00011-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Two important paradigm shifts have occurred recently in the field of schizophrenia research. First, we now understand schizophrenia to be a neurodevelopmental disorder, one that is characterized by aberrant patterns of activation and connectivity in cortical and subcortical neural networks that are present before illness onset and that worsen as an individual progresses into later stages of the disease. Second, we now understand that these abnormalities are not immutable and fixed, but instead can respond to interventions targeting brain plasticity, particularly when delivered in the prodromal and early phases of schizophrenia. In this chapter, we will first describe some of the neurocognitive impairments that characterize schizophrenia, highlighting the developmental course of the illness. We will then briefly review salient features of currently available computerized cognitive training programs that target these impairments. Next, we will present an overview of current research findings regarding neurobiological effects of computerized cognitive training in schizophrenia and how these results shed light on the critical neuroplasticity mechanisms that support successful training. Finally, we will present recommendations for future research to optimize computerized cognitive training programs, with an aim to promoting functional recovery.
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Affiliation(s)
- Bruno Biagianti
- San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA, USA; Department of Psychiatry, University of California, San Francisco, CA, USA
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65
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Qi XL, Constantinidis C. Neural changes after training to perform cognitive tasks. Behav Brain Res 2012; 241:235-43. [PMID: 23261872 DOI: 10.1016/j.bbr.2012.12.017] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 12/10/2012] [Accepted: 12/11/2012] [Indexed: 11/29/2022]
Abstract
Cognitive operations requiring working memory rely on the activity of neurons in areas of the association cortex, most prominently the lateral prefrontal cortex. Human imaging and animal neurophysiological studies indicate that this activity is shaped by learning, though much is unknown about how much training alters neural activity and cortical organization. Results from non-human primates demonstrate that prior to any training in cognitive tasks, prefrontal neurons respond to stimuli, exhibit persistent activity after their offset, and differentiate between matching and non-matching stimuli presented in sequence. A number of important changes also occur after training in a working memory task. More neurons are recruited by the stimuli and exhibit higher firing rates, particularly during the delay period. Operant stimuli that need to be recognized in order to perform the task elicit higher overall rates of responses, while the variability of individual discharges and correlation of discharges between neurons decrease after training. New information is incorporated in the activity of a small population of neurons highly specialized for the task and in a larger population of neurons that exhibit modest task related information, while information about other aspects of stimuli remains present in neuronal activity. Despite such changes, the relative selectivity of the dorsal and ventral aspect of the lateral prefrontal cortex is not radically altered with regard to spatial and non-spatial stimuli after training. Collectively, these results provide insights on the nature and limits of cortical plasticity mediating cognitive tasks.
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Affiliation(s)
- Xue-Lian Qi
- Department of Neurobiology & Anatomy, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
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66
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Abstract
OBJECTIVE To investigate the effects of transcranial direct current stimulation (tDCS) applied over the prefrontal cortex on the improvement of verbal, visuospatial working memory and naming in healthy adults. METHOD Thirty two healthy adults (15 males and 17 females, mean age 37.3±13.0 years) were enrolled in this study. The subjects were divided into four groups randomly. They underwent sham or anodal tDCS over the left or right prefrontal cortex, for 20 minutes at a direct current of 1 mA. Before and immediately after tDCS, the subjects performed the Korean version of the mini-mental state exam (K-MMSE) and stroop test (color/word/interference) for the screening of cognitive function. For working memory and language evaluation, the digit span test (forward/backward), the visuospatial attention test in computer assisted cognitive program (CogPack®) and the Korean-Boston Naming Test (K-BNT) were assessed before tDCS, immediately after tDCS, and 2 weeks after tDCS. RESULTS The stroop test (word/interference), backward digit span test and K-BNT were improved in the left prefrontal tDCS group compared with that of the sham group (p<0.05). The stroop test (interference) and visuospatial attention test were in the right prefrontal tDCS group compared with that of the sham group (p<0.05). Their improvement lasted for 2 weeks after stimulation. CONCLUSION tDCS can induce verbal working memory improvement and naming facilitation by stimulating the left prefrontal cortex. It can also improve the visuospatial working memory by stimulating the right prefrontal cortex. Further studies which are lesion and symptom specific tDCS treatment for rehabilitation of stroke can be carried out.
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Affiliation(s)
- Seo Young Jeon
- Department of Rehabilitation Medicine, School of Medicine, Ewha Womans University, Seoul 158-710, Korea
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67
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Edgar JC, Hunter MA, Huang M, Smith AK, Chen Y, Sadek J, Lu BY, Miller GA, Cañive JM. Temporal and frontal cortical thickness associations with M100 auditory activity and attention in healthy controls and individuals with schizophrenia. Schizophr Res 2012; 140:250-7. [PMID: 22766129 PMCID: PMC3423523 DOI: 10.1016/j.schres.2012.06.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Revised: 06/05/2012] [Accepted: 06/06/2012] [Indexed: 12/17/2022]
Abstract
BACKGROUND Although gray matter (GM) abnormalities are frequently observed in individuals with schizophrenia (SCZ), the functional consequences of these structural abnormalities are not yet understood. The present study sought to better understand GM abnormalities in SCZ by examining associations between GM and two putative functional SCZ biomarkers: weak 100 ms (M100) auditory responses and impairment on tests of attention. METHODS Data were available from 103 subjects (healthy controls=52, SCZ=51). GM cortical thickness measures were obtained for superior temporal gyrus (STG) and prefrontal cortex (PFC). Magnetoencephalography (MEG) provided measures of left and right STG M100 source strength. Subjects were administered the Trail Making Test A and the Connors' Continuous Performance Test to assess attention. RESULTS A strong trend indicated less GM cortical thickness in SCZ than controls in both regions and in both hemispheres (p=0.06). Individuals with SCZ had weaker M100 responses than controls bilaterally, and individuals with SCZ performed more poorly than controls on tests of attention. Across groups, left STG GM was positively associated with left M00 source strength. In SCZ only, less left and right STG and PFC GM predicted poorer performance on tests of attention. After removing variance in attention associated with age, associations between GM and attention remained significant only in left and right STG. CONCLUSIONS Reduced GM cortical thickness may serve as a common substrate for multiple functional abnormalities in SCZ, with structural-functional abnormalities in STG GM especially prominent. As suggested by others, functional abnormalities in SCZ may be a consequence of elimination of the neuropil (dendritic arbors and associated synaptic infrastructure) between neuron bodies.
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Affiliation(s)
- J. Christopher Edgar
- The Children’s Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, USA,Corresponding Author: J. Christopher Edgar, Children’s Hospital of Philadelphia, 34 and Civic Center Blvd, Department of Neuroradiology, Wood Building (Room 2115), Philadelphia, PA 19104, 215-590-3573,
| | - Michael A. Hunter
- The University of New Mexico, Department of Psychology, Albuquerque, NM, USA,New Mexico Raymond G. Murphy VA Healthcare System, Psychiatry Research, Behavioral Health Care Line, Albuquerque, NM, USA,The University of New Mexico School of Medicine, Department of Psychiatry, Albuquerque, NM, USA
| | - Mingxiong Huang
- San Diego VA Healthcare System, Department of Radiology, San Diego, CA, USA,The University of California, Department of Radiology, San Diego, CA, USA
| | - Ashley K. Smith
- The University of Colorado, Department of Psychology and Neuroscience, Boulder, CO, USA
| | - Yuhan Chen
- New Mexico Raymond G. Murphy VA Healthcare System, Psychiatry Research, Behavioral Health Care Line, Albuquerque, NM, USA,The University of New Mexico School of Medicine, Department of Psychiatry, Albuquerque, NM, USA
| | - Joseph Sadek
- New Mexico Raymond G. Murphy VA Healthcare System, Psychiatry Research, Behavioral Health Care Line, Albuquerque, NM, USA,The University of New Mexico School of Medicine, Department of Psychiatry, Albuquerque, NM, USA
| | - Brett Y Lu
- The University of Hawaii, Department of Psychiatry, Honolulu, HI, USA
| | - Gregory A. Miller
- The University of Illinois at Urbana-Champaign, Department of Psychology, USA, and the University of Delaware, Department of Psychology, USA
| | - José M. Cañive
- The University of New Mexico, Department of Psychology, Albuquerque, NM, USA,New Mexico Raymond G. Murphy VA Healthcare System, Psychiatry Research, Behavioral Health Care Line, Albuquerque, NM, USA
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Harvey PD, Bowie CR. Cognitive enhancement in schizophrenia: pharmacological and cognitive remediation approaches. Psychiatr Clin North Am 2012; 35:683-98. [PMID: 22929873 PMCID: PMC3430871 DOI: 10.1016/j.psc.2012.06.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This article discusses the measurement of cognition in schizophrenia, its role as a determinant of disability, and treatment efforts to date, including pharmacological and behavioral interventions as well as effective treatments that lead to improved outcomes. The measurement of functioning when patients with schizophrenia receive treatment in the office is addressed. The review focuses on new developments in the creation and adoption of a consensus method for the assessment of cognitive functioning in treatment studies, on the increased appreciation for assessment of functional skills in the prediction of everyday outcomes, and on developments in the basic neuroscience of cognition.
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Affiliation(s)
- Philip D Harvey
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1120 North West 14th Street, Suite 1450, Miami, FL 33136, USA.
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69
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Popov T, Rockstroh B, Weisz N, Elbert T, Miller GA. Adjusting brain dynamics in schizophrenia by means of perceptual and cognitive training. PLoS One 2012; 7:e39051. [PMID: 22815697 PMCID: PMC3399837 DOI: 10.1371/journal.pone.0039051] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Accepted: 05/14/2012] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND In a previous report we showed that cognitive training fostering auditory-verbal discrimination and working memory normalized magnetoencephalographic (MEG) M50 gating ratio in schizophrenia patients. The present analysis addressed whether training effects on M50 ratio and task performance are mediated by changes in brain oscillatory activity. Such evidence should improve understanding of the role of oscillatory activity in phenomena such as M50 ratio, the role of dysfunctional oscillatory activity in processing abnormalities in schizophrenia, and mechanisms of action of cognitive training. METHODOLOGY/PRINCIPAL FINDINGS Time-locked and non-time-locked oscillatory activity was measured together with M50 ratio in a paired-click design before and after a 4-week training of 36 patients randomly assigned to specific cognitive exercises (CE) or standard (comparison) cognitive training (CP). Patient data were compared to those of 15 healthy controls who participated in two MEG measurements 4 weeks apart without training. Training led to more time-locked gamma-band response and more non-time-locked alpha-band desynchronization, moreso after CE than after CP. Only after CE, increased alpha desynchronization was associated with normalized M50 ratio and with improved verbal memory performance. Thus, both types of cognitive training normalized gamma activity, associated with improved stimulus encoding. More targeted training of auditory-verbal discrimination and memory additionally normalized alpha desynchronization, associated with improved elaborative processing. The latter presumably contributes to improved auditory gating and cognitive function. CONCLUSIONS/SIGNIFICANCE Results suggest that dysfunctional interplay of ocillatory activity that may contribute to auditory processing disruption in schizophrenia can be modified by targeted training.
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Affiliation(s)
- Tzvetan Popov
- Department of Psychology, University of Konstanz, Konstanz, Germany.
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70
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Surti TS, Corbera S, Bella MD, Wexler BE. Successful computer-based visual training specifically predicts visual memory enhancement over verbal memory improvement in schizophrenia. Schizophr Res 2011; 132:131-4. [PMID: 21795025 PMCID: PMC3195942 DOI: 10.1016/j.schres.2011.06.031] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Revised: 06/28/2011] [Accepted: 06/30/2011] [Indexed: 10/17/2022]
Abstract
We investigated whether improved early visual processing on cognitive remediation (CR) exercises generalizes to visual and auditory learning and information manipulation in schizophrenia. Fourteen participants received neuropsychological testing before and after CR consisting of visual, auditory and cognitive control training. Achievement on visual training exercises was strongly and significantly correlated with improved visual learning, but not improved verbal learning or increased ability to manipulate visual information. Improvement in training, not training time, predicted cognitive gain. Implications for improving cognitive outcomes from CR include ensuring the trained task is learned and providing exercises of multiple modalities.
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Affiliation(s)
- Toral S. Surti
- Yale University, Department of Psychiatry and the Connecticut Mental Health Center, New Haven, CT, United States,Corresponding Author, Toral S. Surti, Connecticut Mental Health Center, 5th Floor, 34 Park Street, New Haven, CT 06519, Telephone: 1-203-974-7538, Fax: 1-203-974-7881,
| | - Silvia Corbera
- Yale University, Department of Psychiatry and the Connecticut Mental Health Center, New Haven, CT, United States
| | - Morris D. Bella
- Yale University, Department of Psychiatry and the Connecticut Mental Health Center, New Haven, CT, United States,VA Connecticut Healthcare System, Psychology Service 116B, VACHS 950 Campbell Avenue, West Haven, CT, United States
| | - Bruce E. Wexler
- Yale University, Department of Psychiatry and the Connecticut Mental Health Center, New Haven, CT, United States
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71
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Gating in schizophrenia: from genes to cognition (to real world function?). Biol Psychiatry 2011; 69:395-6. [PMID: 21316513 DOI: 10.1016/j.biopsych.2011.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2010] [Accepted: 01/03/2011] [Indexed: 11/24/2022]
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72
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Popov T, Jordanov T, Weisz N, Elbert T, Rockstroh B, Miller GA. Evoked and induced oscillatory activity contributes to abnormal auditory sensory gating in schizophrenia. Neuroimage 2011; 56:307-14. [PMID: 21316464 DOI: 10.1016/j.neuroimage.2011.02.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2010] [Revised: 02/02/2011] [Accepted: 02/03/2011] [Indexed: 11/26/2022] Open
Abstract
The ratio of magnetoencephalogram-recorded brain responses occurring 50ms after paired clicks (S2-evoked M50/S1-evoked M50) serves as a measure of sensory gating. An abnormally large ratio is commonly found in schizophrenia. Whether this abnormality indicates impaired gating is debated. Using event-related oscillations the present study sought to elucidate processes contributing to the phenomenon of altered M50 gating ratio. Schizophrenia inpatients (n=50) showed the expected large M50 gating ratio relative to 48 healthy controls, which correlated with less induced frontally generated activity in the 10-15Hz frequency band starting 200ms before the onset of S2. Patients also produced smaller alpha (8-12Hz) and gamma (60-80Hz) responses to S1. Results suggest that the deviant gating ratio in schizophrenia is a consequence of a complex alteration in the processing of incoming information that cannot be attributed to impaired gating alone.
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Affiliation(s)
- Tzvetan Popov
- Department of Psychology, University of Konstanz, Germany.
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Abstract
We systematically mistreat psychological phenomena, both logically and clinically. This article explores three contentions: that the dominant discourse in modern cognitive, affective, and clinical neuroscience assumes that we know how psychology/biology causation works when we do not; that there are serious intellectual, clinical, and policy costs to pretending we do know; and that crucial scientific and clinical progress will be stymied as long as we frame psychology, biology, and their relationship in currently dominant ways. The arguments are developed with emphasis on misguided attempts to localize psychological function via neuroimaging, misunderstandings about the role of genetics in psychopathology, and untoward constraints on health-care policy and clinical service delivery. A particular challenge, articulated but not resolved in this article, is determining what constitutes adequate explanation in the relationship between psychology and biology.
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Affiliation(s)
- Gregory A Miller
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, and Zukunfstkolleg, University of Konstanz, Konstanz, Germany
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