Enhancing Cognitive Training through Exercise after a First Schizophrenia Episode

第一次精神分裂症发作后通过锻炼加强认知训练

• 批准号: 8776334
• 负责人: KEITH H NUECHTERLEIN
• 金额: $ 34.81万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-12-01 至 2016-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8776334
• 关键词: Address; Adverse effects; Aerobic Exercise; Applications Grants; Biological; Brain; Brain-Derived Neurotrophic Factor; Chronic; Cognition; Cognitive; Cognitive deficits; Cognitive remediation; Communities; Data; Deterioration; Disease; Educational Intervention; Educational process of instructing; Exercise; Goals; Growth Factor; Health; Impaired cognition; Impairment; Independent Living; Individual; Intervention; Intervention Studies; Intervention Trial; Lead; Measures; Meta-Analysis; Metabolic syndrome; National Institute of Mental Health; Neuronal Plasticity; Outcome Measure; Outpatients; Persons; Pharmaceutical Preparations; Public Health; Randomized; Randomized Controlled Clinical Trials; Randomized Controlled Trials; Relative (related person); Risk; Schizophrenia; Staging; Strategic Planning; Training Programs; base; cognitive function; cognitive training; computerized; cost; design; disability; efficacy testing; efficacy trial; first episode schizophrenia; functional improvement; functional outcomes; improved; innovation; neurotrophic factor; neurotropin; novel; physical conditioning; prevent; primary outcome; programs; remediation; secondary outcome; severe mental illness; skills; treatment duration

DESCRIPTION (provided by applicant): This R34 application is designed to move our innovative treatment approach to improving cognition in schizophrenia from the feasibility stage to the pilot intervention trial stage. We propose a randomized controlled 6-month trial of the efficacy of a novel intervention combining neuroplasticity-based cognitive training with neurotrophin-releasing aerobic exercise, compared to the same cognitive training alone. Both of these treatments address the NIMH Strategic Plan and NIMH Director Tom Insel's request to create innovative interventions that can be "disseminated broadly" and "readily taught to the existing workforce with minimal cost." The primary treatment targets are overall cognitive deficit level and impairment in independent living skills. A secondary outcome variable will be a key neurotrophic growth factor, brain-derived neurotrophic factor (BDNF). We hypothesize that combining neuroplasticity-based computerized cognitive training and neurotrophin-enhancing physical exercise will produce large cognitive and functional improvements, even relative to cognitive training alone. Based on theoretical considerations and our initial pilot data, the new cognitive training plus aerobic exercise intervention has the potential to make a real difference in the lives of individuals with severe mental illness. Adding aerobic exercise to our cognitive training program will have the additional benefit of helping to ameliorate medication side effects, reduce the risk for developing metabolic syndrome, and help to prevent the deterioration in physical health that usually follows the onset of schizophrenia and its pharmacologic treatment. Cognitive deficits in persons with schizophrenia present an enormous challenge when helping them to return to functioning in the community. Cognitive remediation and physical exercise have each been shown separately to have promise for improving cognitive deficits in schizophrenia, but used separately yield moderate effects. Our initial pilot data suggest that integrating these two interventions produces larger cognitive gains than the cognitive training alone. We posit that the increases in neurotrophic factors associated with regular aerobic exercise provide a platform which allows neuroplasticity-based cognitive training to impact cognition to a greater degree than is typically observed in studies of cognitive training alone. We target the period shortly after a first episode of schizophrenia to maximize the generalization of cognitive improvement to functional outcome, before chronic disability is established.

描述（由申请人提供）：该R34申请旨在将我们改善精神分裂症认知的创新治疗方法从可行性阶段推向试点干预试验阶段。我们建议进行一项为期6个月的随机对照试验，比较基于神经可塑性的认知训练与释放神经营养素的有氧运动相结合的新型干预措施与单独进行相同的认知训练的效果。这两种治疗方法都符合NIMH战略计划和NIMH主任Tom Insel的要求，即创造创新的干预措施，可以“广泛传播”，并“以最小的成本随时教授给现有的员工”。主要治疗目标是整体认知缺陷水平和独立生活能力的损害。次要结果变量将是关键的神经营养生长因子，脑源性神经营养因子（BDNF）。我们假设，结合基于神经可塑性的计算机认知训练和增强神经营养素的体育锻炼将产生巨大的认知和功能改善，甚至相对于单独的认知训练。基于理论考虑和我们的初步试验数据，新的认知训练加上有氧运动干预有可能对严重精神疾病患者的生活产生真正的影响。在我们的认知训练计划中加入有氧运动将有助于减轻药物副作用，