Intensive Auditory Cognitive Training Improves Verbal Memory in Adolescents and Young Adults at Clinical High Risk for Psychosis
Intensive Auditory Cognitive Training Improves Verbal Memory in Adolescents and Young Adults at Clinical High Risk for Psychosis
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DOI：
10.1093/schbul/sbw009
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发表时间：
2016-07-01
影响因子：
6.6
通讯作者：
Vinogradov, Sophia
中科院分区：
文献类型：
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作者：
Loewy, Rachel;Fisher, Melissa;Vinogradov, Sophia
目的：精神病临床高风险（CHR）个体表现出认知障碍，预测后来的精神病转变和现实世界功能。认知训练已显示出对精神分裂症的益处，但尚未在CHR人群中进行充分的测试。方法：在这项双盲随机对照试验中，83名CHR个体（N = 83）被给予笔记本电脑，并在家中进行40小时的听觉处理训练，旨在针对言语学习和记忆操作，或电脑游戏（CG）。参与者通过基于改善精神分裂症认知的测量和治疗研究（matrix）电池的神经认知测试进行评估，并对症状和功能进行评分。考虑到高的研究损失率（42%），使用限制最大似然估计的混合效应模型对各组训练前后进行比较。结果：与CG组相比，目标认知训练组的参与者在言语记忆方面表现出显著的改善（效应值= 0.61）。随着时间的推移，两组的阳性症状和总症状均有所改善。结论：CHR个体在言语记忆方面表现出训练诱导的认知改善模式，与先前对精神分裂症的观察结果一致。对于有精神病风险的个体来说，这是一个特别脆弱的领域，它预示着后来的功能和精神病的转变。该队列的持续随访将评估培训对CHR个体效果的持久性，以及随着时间的推移对症状和功能的潜在影响。临床试验编号：NCT00655239。URL: https://clinicaltrials.gov/ct2/show/NCT00655239?term=vinogradov&rank=5。
Objective: Individuals at clinical high risk (CHR) for psychosis demonstrate cognitive impairments that predict later psychotic transition and real-world functioning. Cognitive training has shown benefits in schizophrenia, but has not yet been adequately tested in the CHR population. Methods: In this double-blind randomized controlled trial, CHR individuals (N = 83) were given laptop computers and trained at home on 40 hours of auditory processing-based exercises designed to target verbal learning and memory operations, or on computer games (CG). Participants were assessed with neurocognitive tests based on the Measurement and Treatment Research to Improve Cognition in Schizophrenia initiative (MATRICS) battery and rated on symptoms and functioning. Groups were compared before and after training using a mixed-effects model with restricted maximum likelihood estimation, given the high study attrition rate (42%). Results: Participants in the targeted cognitive training group showed a significant improvement in Verbal Memory compared to CG participants (effect size = 0.61). Positive and Total symptoms improved in both groups over time. Conclusions: CHR individuals showed patterns of training-induced cognitive improvement in verbal memory consistent with prior observations in schizophrenia. This is a particularly vulnerable domain in individuals at-risk for psychosis that predicts later functioning and psychotic transition. Ongoing follow-up of this cohort will assess the durability of training effects in CHR individuals, as well as the potential impact on symptoms and functioning over time. Clinical Trials Number: NCT00655239. URL: https://clinicaltrials.gov/ct2/show/NCT00655239?term=vinogradov&rank=5.