Enhancing Neuroplasticity to Augment Cognitive Remediation in Schizophrenia.
Enhancing Neuroplasticity to Augment Cognitive Remediation in Schizophrenia.
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DOI：
10.3389/fpsyt.2017.00191
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发表时间：
2017
影响因子：
4.7
通讯作者：
Green MF
中科院分区：
文献类型：
--
作者：
Jahshan C;Rassovsky Y;Green MF
有一个新兴的需要创新的治疗策略，以改善精神分裂症的认知缺陷。认知矫正（CR）在组水平上是有效的，但治疗反应的变异性很大。考虑到CR可能依赖于完整的神经可塑性来产生认知增益，将其与利用患者神经可塑性潜力的策略联合收割机相结合是合理的。在这篇综述中，我们讨论了两种非药物的方法，可以增强神经可塑性，并可能增加CR在精神分裂症的影响：体育锻炼和经颅直流电刺激（tDCS）。大量证据支持体育锻炼对认知的有益影响，少数精神分裂症研究表明，体育锻炼与CR相结合对认知的影响比单独CR更大。体育锻炼被认为是通过调节中枢生长因子来刺激神经可塑性，目前的证据表明脑源性神经营养因子是体育锻炼可能增强CR有效性的潜在潜在机制。tDCS已经成为认知增强的潜在工具，并且似乎影响涉及长时程增强（LTP）的细胞机制。一些报告已经证明了将tDCS与CR整合治疗精神分裂症的可行性，但没有足够的数据来确定这种多模式方法是否会导致患者的表现增加。更大规模的随机对照试验对于了解联合tDCS-CR干预的机制是必要的。未来的研究应该利用神经可塑性范式的新发展来研究这些干预措施对LTP的影响。
There is a burgeoning need for innovative treatment strategies to improve the cognitive deficits in schizophrenia. Cognitive remediation (CR) is effective at the group level, but the variability in treatment response is large. Given that CR may depend on intact neuroplasticity to produce cognitive gains, it is reasonable to combine it with strategies that harness patients’ neuroplastic potential. In this review, we discuss two non-pharmacological approaches that can enhance neuroplasticity and possibly augment the effects of CR in schizophrenia: physical exercise and transcranial direct current stimulation (tDCS). Substantial body of evidence supports the beneficial effect of physical exercise on cognition, and a handful of studies in schizophrenia have shown that physical exercise in conjunction with CR has a larger impact on cognition than CR alone. Physical exercise is thought to stimulate neuroplasticity through the regulation of central growth factors, and current evidence points to brain-derived neurotrophic factor as the potential underlying mechanism through which physical exercise might enhance the effectiveness of CR. tDCS has emerged as a potential tool for cognitive enhancement and seems to affect the cellular mechanisms involved in long-term potentiation (LTP). A few reports have demonstrated the feasibility of integrating tDCS with CR in schizophrenia, but there are insufficient data to determine if this multimodal approach leads to incremental performance gain in patients. Larger randomized controlled trials are necessary to understand the mechanisms of the combined tDCS–CR intervention. Future research should take advantage of new developments in neuroplasticity paradigms to examine the effects of these interventions on LTP.
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影响因子：
3.8
作者：
Bhatia T;Mazumdar S;Wood J;He F;Gur RE;Gur RC;Nimgaonkar VL;Deshpande SN
通讯作者：
Deshpande SN
DOI：
10.1016/j.pbb.2010.11.009
发表时间：
2011-08
期刊：
Pharmacology, biochemistry, and behavior
影响因子：
--
作者：
Goff DC;Hill M;Barch D
通讯作者：
Barch D
影响因子：
6.6
作者：
Firth J;Stubbs B;Rosenbaum S;Vancampfort D;Malchow B;Schuch F;Elliott R;Nuechterlein KH;Yung AR
通讯作者：
Yung AR
影响因子：
4.5
作者：
Dunn, Walter;Rassovsky, Yuri;Green, Michael F.
通讯作者：
Green, Michael F.
影响因子：
6.6
作者：
Buchanan, Robert W.;Keefe, Richard S. E.;Marder, Stephen R.
通讯作者：
Marder, Stephen R.