fMRI of Cognitive Remediation Therapy in Schizophrenia

精神分裂症认知矫正治疗的功能磁共振成像

• 批准号: 6922125
• 负责人: BRUCE E. WEXLER
• 金额: $ 16.37万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-07-16 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6922125
• 关键词: behavioral /social science research tag; brain imaging /visualization /scanning; clinical research; cognition disorders; cognitive behavior therapy; frontal lobe /cortex; functional magnetic resonance imaging; human subject; human therapy evaluation; image processing; mood disorders; patient oriented research; schizophrenia

DESCRIPTION (provided by applicant): Cognitive dysfunctions are major and debilitating features of schizophrenia and schizoaffective disorder (scz-sza). Even after clinical symptom remission, persistent cognitive deficits limit school and work performance and response to behavioral treatments. Some of the most prominent and problematic of these dysfunctions, those in working memory and certain types of problem solving, are thought to reflect frontal lobe dysfunction. Since frontal lobe dysfunction is central in current models of the pathophysiology of scz-sza, cognitive deficits are of relevance both to patient quality of life and to the pathophysiology of the illness. Because of this, new efforts to understand and treat the cognitive deficits of scz-sza are significant for both understanding and for treating the disorders. Most currently available treatments are of limited benefit for the cognitive deficits of scz-sza. One possible, promising exception are new behavioral treatments developed specifically to address the cognitive deficits with varying mixes of instructions and drill and practice. We have been leaders in the development and evaluation of these treatments, and have provided preliminary evidence of substantial and enduring improvements in cognitive function. At this early state in the research, there are several important questions about the relationship between the observed improvements in cognitive function and possible changes in underlying brain dysfunctions. Answers to these questions are important for understanding the nature of the treatments, optimizing further development of the treatments and assessing the potential of the treatments to fundamentally alter the course of illness. An R-0l funded evaluation of behavioral effects of cognitive treatment is ongoing in our laboratory. R-21 support is requested to support exploratory and developmental fMRI studies that will provide preliminary data on changes in regional brain activation associated with behavioral treatment of cognitive dysfunctions, and develop methods for fuller study of these changes.

描述(由申请人提供)：认知功能障碍是精神分裂症和分裂情感障碍(SCZ-SZA)的主要和衰弱特征。即使在临床症状缓解后，持续的认知缺陷也会限制学习和工作表现以及对行为治疗的反应。其中一些最突出、最有问题的功能障碍，即工作记忆和某些类型的解决问题的功能障碍，被认为反映了额叶功能障碍。由于额叶功能障碍是目前SCZ-SZA病理生理学模型的核心，认知缺陷与患者的生活质量和疾病的病理生理学都相关。正因为如此，了解和治疗SCZ-SZA认知缺陷的新努力对理解和治疗这些障碍都具有重要意义。目前可用的大多数治疗方法对SCZ-SZA的认知障碍的益处有限。一个可能的、有希望的例外是专门为解决认知缺陷而开发的新的行为疗法，它采用了不同的指导、训练和练习的组合。我们在这些治疗的开发和评估方面一直处于领先地位，并提供了认知功能显著和持久改善的初步证据。在这项研究的早期阶段，对于观察到的认知功能改善与潜在大脑功能障碍可能发生的变化之间的关系，存在几个重要的问题。对这些问题的回答对于了解治疗的性质、优化治疗的进一步发展以及评估治疗从根本上改变病程的潜力是重要的。R-01资助的认知治疗行为效果评估正在我们的实验室进行。要求R-21提供支持，以支持探索性和发展性功能磁共振研究，这些研究将提供与认知功能障碍的行为治疗相关的区域大脑激活变化的初步数据，并开发对这些变化进行更全面研究的方法。