Verbal learning deficits associated with increased anticholinergic burden are attenuated with targeted cognitive training in treatment refractory schizophrenia patients
Verbal learning deficits associated with increased anticholinergic burden are attenuated with targeted cognitive training in treatment refractory schizophrenia patients
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DOI：
10.1016/j.schres.2019.01.016
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发表时间：
2019-06-01
影响因子：
4.5
通讯作者：
Light, Gregory A.
中科院分区：
文献类型：
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作者：
Joshi, Yash B.;Thomas, Michael L.;Light, Gregory A.
有报道称，有针对性的认知训练(TCF)可以改善精神分裂症(SZ)患者的语言学习障碍。尽管有积极的发现，但尚不清楚人口统计学因素和临床特征是否有助于TCT的个体成功。药物相关的抗胆碱能负荷已被证明影响SZ门诊患者与TCT相关的言语学习成绩，但在治疗难治性SZ患者中，抗胆碱能药物负荷对TCF成绩的影响尚未被描述。在这项研究中，SZ患者被随机分配到锁定的住宅康复中心接受常规治疗(TAU；n=22)或TAU加TCT的疗程(n=24)。根据基线和随访时的用药数据，使用抗胆碱能认知负荷量表(ACB)计算抗胆碱能药物负荷。Matrics Consensus Cognitive Battery言语学习领域得分作为主要结果变量。在基线和随访时，TAU组和TCT组的ACB相匹配。虽然在两组中，基线ACB与语言学习没有关联，但在TAU组中，在研究过程中ACB的增加与语言学习的恶化显著相关(r=-0.51，p=0.02)。这在随机接受TCT治疗的受试者中没有发现(r=-0.13，p=0.62)。我们的结果表明，在严重残疾的SZ住院患者中，TCT可能会削弱与语言学习相关的抗胆碱能药物负担。(C)2019爱思唯尔B.V.保留所有权利。
Targeted cognitive training (TCF) has been reported to improve verbal learning deficits in patients with schizophrenia (SZ). Despite positive findings, it is not clear whether demographic factors and clinical characteristics contribute to the success of TCT on an individual basis. Medication-associated anticholinergic burden has been shown to impact TCT-associated verbal learning gains in SZ outpatients, but the role of anticholinergic medication burden on TCF gains in treatment refractory SZ patients has not been described. In this study, SZ patients mandated to a locked residential rehabilitation center were randomized to treatment as usual (TAU; n = 22) or a course of TAU augmented with TCT (n = 24). Anticholinergic medication burden was calculated from medication data at baseline and follow-up using the Anticholinergic Cognitive Burden (ACB) Scale. MATRICS Consensus Cognitive Battery Verbal Learning domain scores were used as the primary outcome variable. The TAU and TCT groups were matched in ACB at baseline and follow-up. While baseline ACB was not associated with verbal learning in either group, increases in ACB over the course of the study were significantly associated with deterioration of verbal learning in the TAU group (r = -0.51, p = 0.02). This was not seen in subjects randomized to TCT (r = -0.13, p = 0.62). Our results suggest that TCT may blunt anticholinergic medication burden associated reduction in verbal learning in severely disabled SZ inpatients. (C) 2019 Elsevier B.V. All rights reserved.