Intensive Brain Training in Early Onset Schizophrenia & Schizoaffective Disorder

早发性精神分裂症的强化大脑训练

• 批准号: 7643039
• 负责人: Linmarie Sikich
• 金额: $ 34.65万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-06-01 至 2011-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7643039
• 关键词: 14 year old; Adolescent; Adult; Age; Anti-Cholinergics; Auditory; Biological Markers; Brain; Brain-Derived Neurotrophic Factor; Child; Client; Communities; Computers; Confidence Intervals; Consensus; Control Groups; Data; Development; Educational Intervention; Educational workshop; Enrollment; Evaluation; Exposure to; Feedback; Financial compensation; Focus Groups; Foundations; Future; Gender; Goals; Health; Hour; Individual; Intervention; Intervention Studies; Length; Link; Metric; National Institute of Mental Health; Neurocognition; Neurocognitive; Neurocognitive Deficit; Neurodevelopmental Disorder; Neurons; Neurosciences; Outcome; Outcome Measure; Participant; Pattern; Pilot Projects; Plastics; Problem Solving; Process; Race; Randomized; Recruitment Activity; Rewards; Sampling; Schizoaffective Disorders; Schizophrenia; Schools; Science; Services; Severities; Stimulus; Symptoms; Synapses; Testing; Time; Training; Training Programs; Translating; Youth; base; clinically significant; cognitive function; cognitive training; computerized; design; disability; disorder control; early onset; executive function; functional outcomes; group intervention; improved; information processing; neurocognitive test; novel; outcome forecast; payment; primary outcome; programs; response; satisfaction; skills; statistics; therapy design; visual process; visual processing; young adult

DESCRIPTION (provided by applicant): This R34 pilot proposal, entitled "Intensive Brain Training in Early Onset Schizophrenia & Schizoaffective Disorder" is submitted in response to RFA-MH-09-020 Novel Interventions for Neurodevelopmental Disorders. The overarching goal of this pilot study is to determine whether an intensive computerized intervention targeted on improving central auditory and visual processing as well as executive functioning improves neurocognition and overall functioning in youth with Early Onset Schizophrenia and Schizoaffective Disorders (EOSS), defined by onset prior to 18 years. Youth with EOSS have more pronounced neurocognitive deficits and generally poorer prognosis than individuals with adult onset schizophrenia. Since severity of neurocognitive deficits have been more strongly linked to functional outcome than severity of positive psychotic symptoms, interventions that improve neurocognition may be especially potent in reducing long term disability. Functional neurocognitive studies have demonstrated that individuals with schizophrenia tend to process information less efficiently than those without schizophrenia. Developmental neuroscientists have demonstrated that repeated exposure to synchronized and meaningful stimuli can led to structural changes in the brain that improve its processing efficiency. Although such plastic changes are possible even in adults, younger individuals generally have greater capacity to respond to such environmental training. This pilot study will randomly assign 40 youth (ages 10-18 years) to participate in a 90 hour Intensive neuroadaptive computerized Cognitive Training program conducted over 20 weeks (ICT group) or to spend the same amount of time engaged in commercially available computer games (EOSS control group). Changes in neurocognition (primary outcome measure), global functioning, psychiatric symptoms and Brain Derived Neurotrophic Factor (BDNF) will be assessed prior to beginning the interventions, at completion of the intervention (20 weeks) and 8 and 12 months following baseline. The same assessments will be performed in a group of 20 nonpsychiatrically ill youth matched for age, gender and race at the same time points to allow comparison of neurocognitive data and assess the typical extent of variability over time in neurocognitive functioning and BDNF levels. The results of this pilot study will allow refinement of the ICT program and inform the design of a more definitive test of neurocognitive interventions for youth with EOSS.

描述（由申请人提供）：本R34试点提案，题为“在早发性精神分裂症和分裂情感性障碍的强化大脑训练”，是为了响应RFA-MH-09-020神经发育障碍的新型干预措施而提交的。这项试点研究的总体目标是确定是否有针对性地改善中央听觉和视觉处理以及执行功能的强化计算机化干预，改善神经认知和整体功能的青年早发性精神分裂症和分裂情感障碍（EOSS），定义为发病前18年。青年EOSS有更明显的神经认知缺陷，一般预后差于成人发作的精神分裂症患者。由于神经认知缺陷的严重程度与功能结局的关系比阳性精神病症状的严重程度更密切，因此改善神经认知的干预措施在减少长期残疾方面可能特别有效。功能性神经认知研究表明，精神分裂症患者处理信息的效率往往低于非精神分裂症患者。发育神经科学家已经证明，重复暴露于同步和有意义的刺激可以导致大脑的结构变化，从而提高其处理效率。虽然这种可塑性变化即使在成年人中也是可能的，但年轻人通常对这种环境训练有更强的反应能力。这项试点研究将随机分配40名青少年（年龄10-18岁）参加为期20周的90小时的强化神经适应性计算机认知训练计划（ICT组）或花费相同的时间从事商业电脑游戏（EOSS对照组）。将在开始干预前、完成干预（20周）和基线后8个月和12个月评估神经认知（主要结局指标）、整体功能、精神症状和脑源性神经营养因子（BDNF）的变化。将在同一时间点对20名年龄、性别和种族相匹配的非精神病青年进行相同的评估，以比较神经认知数据，并评估神经认知功能和BDNF水平随时间变化的典型程度。这项试点研究的结果将允许完善的ICT计划，并告知设计一个更明确的测试与EOSS青少年的神经认知干预。