Cognitive Remediation in Schizophrenia
2
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
Cognitive deficits in schizophrenia are pervasive, severe, and largely independent of the positive and negative symptoms of the illness. These deficits are increasingly considered to be core features of schizophrenia with evidence that the extent of cognitive impairment is the most salient predictor of daily functioning. Unfortunately, current schizophrenia treatment has been limited in addressing the cognitive deficits of the illness. Alterations in neuroplasticity are hypothesized to underpin these cognitive deficits, though preserved neuroplasticity may offer an avenue towards cognitive remediation. Key neuroplastic principles to consider in designing remediation interventions include ensuring sufficient intensity and duration of remediation programs,"bottom-up" training that proceeds from simple to complex cognitive processes, and individual tailoring of remediation regimens. We discuss several cognitive remediation programs, including cognitive enhancement therapy, which embrace these principles to target neurocognitive and social cognitive improvements and which havebeen demonstrated to be effective in schizophrenia. Future directions in cognitive remediation research include potential synergy with pharmacologic treatment, non-invasive stimulation techniques, and psychosocial interventions, identification of patient characteristics that predict outcome with cognitive remediation, and increasing the access to these interventions in front-line settings.
Abstract
Cognitive deficits in schizophrenia are pervasive, severe, and largely independent of the positive and negative symptoms of the illness. These deficits are increasingly considered to be core features of schizophrenia with evidence that the extent of cognitive impairment is the most salient predictor of daily functioning. Unfortunately, current schizophrenia treatment has been limited in addressing the cognitive deficits of the illness. Alterations in neuroplasticity are hypothesized to underpin these cognitive deficits, though preserved neuroplasticity may offer an avenue towards cognitive remediation. Key neuroplastic principles to consider in designing remediation interventions include ensuring sufficient intensity and duration of remediation programs,"bottom-up" training that proceeds from simple to complex cognitive processes, and individual tailoring of remediation regimens. We discuss several cognitive remediation programs, including cognitive enhancement therapy, which embrace these principles to target neurocognitive and social cognitive improvements and which havebeen demonstrated to be effective in schizophrenia. Future directions in cognitive remediation research include potential synergy with pharmacologic treatment, non-invasive stimulation techniques, and psychosocial interventions, identification of patient characteristics that predict outcome with cognitive remediation, and increasing the access to these interventions in front-line settings.
참고문헌 (118)
- Hyman SE, "What are the right targets for psychopharmacology?", Science, 299, pp.350~351 (2003)
- Keefe RS, "How should DSM-V criteria for schizophrenia include cognitive impairment?", Schizophr Bull, 33, pp.912~920 (2007)
- Heinrichs RW, "Neurocognitive deficit in schizophrenia: a quantitative review of the evidence", Neuropsychology, 12, pp.426~445 (1998)
- Saykin AJ, "Neuropsychological deficits in neuroleptic naive patients with first-episode schizophrenia", Arch Gen Psychiatry, 51, pp.124~131 (1994)
- Wilk CM, "Brief cognitive assessment in schizophrenia: normative data for the Repeatable Battery for the Assessment of Neuropsychological Status", Schizophr Res, 70, pp.175~186 (2004)
- Keefe RS, "Defining a cognitive function decrement in schizophrenia", Biol Psychiatry, 57, pp.688~691 (2005)
- Hoff AL, "Ten year longitudinal study of neuropsychological functioning subsequent to a first episode of schizophrenia", Schizophr Res, 78, pp.27~34 (2005)
- Keefe RS, "Baseline neurocognitive deficits in the CATIE schizophrenia trial", Neuropsychopharmacology, 31, pp.2033~2046 (2006)
- Bilder RM, "Neuropsychology of first-episode schizophrenia: initial characterization and clinical correlates", Am J Psychiatry, 157, pp.549~559 (2000)
- Goldberg TE, "Contrasts between patients with affective disorders and patients with schizophrenia on a neuropsychological test battery", Am J Psychiatry, 150, pp.1355~1362 (1993)
- Mohamed S, "Generalized cognitive deficits in schizophrenia: a study of first-episode patients", Arch Gen Psychiatry, 56, pp.749~754 (1999)
- Finkelstein JR, "Attentional dysfunctions in neuroleptic-naive and neuroleptic- withdrawn schizophrenic patients and their siblings", J Abnorm Psychol, 106, pp.203~212 (1997)
- Green MF, "Approaching a consensus cognitive battery for clinical trials in schizophrenia: the NIMHMATRICS conference to select cognitive domains and test criteria", Biol Psychiatry, 56, pp.301~307 (2004)
- Cannon TD, "Neuropsychological functioning in siblings discordant for schizophrenia and healthy volunteers", Arch Gen Psychiatry, 51, pp.651~661 (1994)
- Heydebrand G., "Cognitive deficits in the families of patients with schizophrenia", Curr Opin Psychiatry, 19, pp.277~281 (2006)
- Nuechterlein KH, "Identification of separable cognitive factors in schizophrenia", Schizophr Res, 72, pp.29~39 (2004)
- Buchanan RW, "A summary of the FDA-NIMH-MATRICS workshop on clinical trial design for neurocognitive drugs for schizophrenia", Schizophr Bull, 31, pp.5~19 (2005)
- Krabbendam L, "Cognitive functioning in patients with schizophrenia and bipolar disorder: a quantitative review", Schizophr Res, 80, pp.137~149 (2005)
- Harvey PD, "Cognitive deficits and thought disorder: II. An 8-month followup study", Schizophr Bull, 16, pp.147~156 (1990)
- Keefe RS, "Cognitive deficits in patients with schizophrenia: effects and treatment", J Clin Psychiatry, 68(Suppl 14), pp.8~13 (2007)
- Cannon M, "Evidence for early-childhood, pandevelopmental impairment specific to schizophreniform disorder: results from a longitudinal birth cohort", Arch Gen Psychiatry, 59, pp.449~456 (2002)
- Sasson NJ, "The benefit of directly comparing autism and schizophrenia for revealing mechanisms of social cognitive impairment", J Neurodev Disord, 3, pp.87~100 (2011)
- Eack SM, "Cognitive enhancement therapy improves emotional intelligence in early course schizophrenia: preliminary effects", Schizophr Res, 89, pp.308~311 (2007)
- Fett AK, "The relationship between neurocognition and social cognition with functional outcomes in schizophrenia: a meta-analysis", Neurosci Biobehav Rev, 35, pp.573~588 (2011)
- Green MF, "Should schizophrenia be treated as a neurocognitive disorder?", Schizophr Bull, 25, pp.309~319 (1999)
- Green MF, "Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the “right stuff”?", Schizophr Bull, 26, pp.119~136 (2000)
- Gold JM, "Cognitive correlates of job tenure among patients with severe mental illness", Am J Psychiatry, 159, pp.1395~1402 (2002)
- Hill SK, "Effect of second-generation antipsychotics on cognition: current issues and future challenges", Expert Rev Neurother, 10, pp.43~57 (2010)
- Mishara AL, "A meta-analysis and critical review of the effects of conventional neuroleptic treatment on cognition in schizophrenia: opening a closed book", Biol Psychiatry, 55, pp.1013~1022 (2004)
- Davidson M, "Cognitive effects of antipsychotic drugs in first-episode schizophrenia and schizophreniform disorder: a randomized, open-label clinical trial (EUFEST)", Am J Psychiatry, 166, pp.675~682 (2009)
- Keefe RS, "CATIE Investigators; Neurocognitive Working Group. Neurocognitive effects of antipsychotic medications in patients with chronic schizophrenia in the CATIE Trial", Arch Gen Psychiatry, 64, pp.633~647 (2007)
- Hebb DO., "The organization of behavior: A neuropsychological theory" (1949), Wiley
- Bliss TV, "A synaptic model of memory: long-term potentiation in the hippocampus", Nature, 361, pp.31~39 (1993)
- Citri A, "Synaptic plasticity: multiple forms, functions, and mechanisms", Neuropsychopharmacology, 33, pp.18~41 (2008)
- Friston KJ., "The disconnection hypothesis", Schizophr Res, 30, pp.115~125 (1998)
- Stephan KE, "Synaptic plasticity and dysconnection in schizophrenia", Biol Psychiatry, 59, pp.929~939 (2006)
- Daskalakis ZJ, "Dysfunctional neural plasticity in patients with schizophrenia", Arch Gen Psychiatry, 65, pp.378~385 (2008)
- Mears RP, "Electrophysiological assessment of auditory stimulus-specific plasticity in schizophrenia", Biol Psychiatry, 71, pp.503~511 (2012)
- Domino EF, "N-methyl-D-aspartate antagonists as drug models of schizophrenia: a surprising link to tobacco smoking", Prog Neuropsychopharmacol Biol Psychiatry, 28, pp.801~811 (2004)
- Harrison PJ, "Schizophrenia genes, gene expression, and neuropathology: on the matter of their convergence", Mol Psychiatry, 10, pp.40~68 (2005)
- Balu DT, "Neuroplasticity signaling pathways linked to the pathophysiology of schizophrenia", Neurosci Biobehav Rev, 35, pp.848~870 (2011)
- Komitova M, "On neural plasticity, new neurons and the postischemic milieu: an integrated view on experimental rehabilitation", Exp Neurol, 199, pp.42~55 (2006)
- Will B, "Recovery from brain injury in animals: relative efficacy of environmental enrichment, physical exercise or formal training (1990-2002)", Prog Neurobiol, 72, pp.167~182 (2004)
- Cramer SC, "Harnessing neuroplasticity for clinical applications", Brain, 134, pp.1591~1609 (2011)
- Buma FE, "Functional neuroimaging studies of early upper limb recovery after stroke: a systematic review of the literature", Neurorehabil Neural Repair, 24, pp.589~608 (2010)
- Carey JR,., "Analysis of fMRI and finger tracking training in subjects with chronic stroke", Brain, 125, pp.773~788 (2002)
- Chen P., "Inosine induces axonal rewiring and improves behavioral outcome after stroke", Proc Natl Acad Sci U S A, 99, pp.9031~9036 (2002)
- Gauthier LV, "Remodeling the brain: plastic structural brain changes produced by different motor therapies after stroke", Stroke, 39, pp.1520~1525 (2008)
- Sawaki L, "Constraint-induced movement therapy results in increased motor map area in subjects 3 to 9 months after stroke", Neurorehabil Neural Repair, 22, pp.505~513 (2008)
- Halperin JM, "The influences of environmental enrichment, cognitive enhancement, and physical exercise on brain development: can we alter the developmental trajectory of ADHD?", Neurosci Biobehav Rev, 35, pp.621~634 (2011)
- Tardif S, "Cognitive stimulation programs in healthy elderly: a review", Int J Alzheimers Dis, 2011, pp.378934~ (2011)
- Eack SM, "Mechanisms of functional improvement in a 2-year trial of cognitive enhancement therapy for early schizophrenia", Psychol Med, 41, pp.1253~1261 (2011)
- Wykes T, "A meta-analysis of cognitive remediation for schizophrenia: methodology and effect sizes", Am J Psychiatry, 168, pp.472~485 (2011)
- Muller D, "LTP, memory and structural plasticity", Curr Mol Med, 2, pp.605~611 (2002)
- Malinow R, "AMPA receptor trafficking and synaptic plasticity", Annu Rev Neurosci, 25, pp.103~126 (2002)
- Barria A, "Regulatory phosphorylation of AMPA-type glutamate receptors by CaM-KII during long-term potentiation", Science, 276, pp.2042~2045 (1997)
- Dayan E, "Neuroplasticity subserving motor skill learning", Neuron, 72, pp.443~454 (2011)
- Vinogradov S, "Cognitive training for impaired neural systems in neuropsychiatric illness", Neuropsychopharmacology, 37, pp.43~76 (2012)
- Classen J, "Rapid plasticity of human cortical movement representation induced by practice", J Neurophysiol, 79, pp.1117~1123 (1998)
- Floyer-Lea A, "Distinguishable brain activation networks for short- and long-term motor skill learning", J Neurophysiol, 94, pp.512~518 (2005)
- Sakai K, "Presupplementary motor area activation during sequence learning reflects visuo-motor association", J Neurosci, 19, pp.RC1~ (1999)
- Fox MD, "The human brain is intrinsically organized into dynamic, anticorrelated functional networks", Proc Natl Acad Sci U S A, 102, pp.9673~9678 (2005)
- Buchs PA, "Induction of long-term potentiation is associated with major ultrastructural changes of activated synapses", Proc Natl Acad Sci U S A, 93, pp.8040~8045 (1996)
- Bolshakov VY, "Recruitment of new sites of synaptic transmission during the cAMP-dependent late phase of LTP at CA3-CA1 synapses in the hippocampus", Neuron, 19, pp.635~651 (1997)
- Tominaga-Yoshino K, "Repetitive induction of late-phase LTP produces long-lasting synaptic enhancement accompanied by synaptogenesis in cultured hippocampal slices", Hippocampus, 18, pp.281~293 (2008)
- Petersen SE, "The effects of practice on the functional anatomy of task performance", Proc Natl Acad Sci U S A, 95, pp.853~860 (1998)
- Kelly AM, "Human functional neuroimaging of brain changes associated with practice", Cereb Cortex, 15, pp.1089~1102 (2005)
- Debaere F, "Changes in brain activation during the acquisition of a new bimanual coodination task", Neuropsychologia, 42, pp.855~867 (2004)
- Frutiger SA, "Multivariate predictive relationship between kinematic and functional activation patterns in a PET study of visuomotor learning", Neuroimage, 12, pp.515~527 (2000)
- Bü~chel C, "The predictive value of changes in effective connectivity for human learning", Science, 283, pp.1538~1541 (1999)
- McGurk SR, "A meta-analysis of cognitive remediation in schizophrenia", Am J Psychiatry, 164, pp.1791~1802 (2007)
- Sweller J., "Cognitive load during problem solving: Effects on learning", Cognitive Science, 12, pp.257~285 (1988)
- van Merrië~nboer J, "Cognitive load theory and complex learning: Recent developments and future directions", Educ Psychol Rev, 17, pp.147~177 (2005)
- Kugler BT, "Phoneme discrimination in schizophrenia", Br J Psychiatry, 142, pp.53~59 (1983)
- Leitman DI, "Sensory contributions to impaired prosodic processing in schizophrenia", Biol Psychiatry, 58, pp.56~61 (2005)
- Dale CL, "Timing is everything: neural response dynamics during syllable processing and its relation to higher-order cognition in schizophrenia and healthy comparison subjects", Int J Psychophysiol, 75, pp.183~193 (2010)
- Adcock RA, "When top-down meets bottom-up: auditory training enhances verbal memory in schizophrenia", Schizophr Bull, 35, pp.1132~1141 (2009)
- Javitt DC, "Panmodal processing imprecision as a basis for dysfunction of transient memory storage systems in schizophrenia", Schizophr Bull, 25, pp.763~775 (1999)
- Berry AS, "The influence of perceptual training on working memory in older adults", PLoS One, 5, pp.e11537~ (2010)
- Roberts DL, "Social cognition and interaction training (SCIT) for outpatients with schizophrenia: a preliminary study", Psychiatry Res, 166, pp.141~147 (2009)
- Csikszentmihalyi M., "Flow: the psychology of optimal experience" (1990), Harper and Row
- Mahncke HW, "Memory enhancement in healthy older adults using a brain plasticity-based training program: a randomized, controlled study", Proc Natl Acad Sci U S A, 103, pp.12523~12528 (2006)
- Klingberg T, "Computerized training of working memory in children with ADHD--a randomized, controlled trial", J Am Acad Child Adolesc Psychiatry, 44, pp.177~186 (2005)
- Danion JM, "Intact implicit learning in schizophrenia", Am J Psychiatry, 158, pp.944~948 (2001)
- Siegert RJ, "Is implicit sequence learning impaired in schizophrenia? A meta-analysis", Brain Cogn, 67, pp.351~359 (2008)
- Mulholland CC, "Errorless learning and memory performance in schizophrenia", Psychiatry Res, 159, pp.180~188 (2008)
- Kern RS, "Errorless learning for training individuals with schizophrenia at a community mental health setting providing work experience", Schizophr Bull, 35, pp.807~815 (2009)
- McGaugh JL, "The amygdala modulates the consolidation of memories of emotionally arousing experiences", Annu Rev Neurosci, 27, pp.1~28 (2004)
- Phelps EA, "How (and why) emotion enhances the subjective sense of recollection", Curr Dir Psychol Sci, 17, pp.147~152 (2008)
- Draper ML, "Cognitive adaptation training for outpatients with schizophrenia", J Clin Psychol, 65, pp.842~853 (2009)
- Wagner B., "The training of attending and abstracting responses in chronic schizophrenics", J Exper Res Personal, 3, pp.77~88 (1968)
- Spaulding WD, "Applications of experimental psychopathology in psychiatric rehabilitation", Schizophr Bull, 12, pp.560~577 (1986)
- Choi J, "Expectancy-value theory in persistence of learning effects in schizophrenia: role of task value and perceived competency", Schizophr Bull, 36, pp.957~965 (2010)
- Eack SM, "Cognitive enhancement therapy for early-course schizophrenia: effects of a two-year randomized controlled trial", Psychiatr Serv, 60, pp.1468~1476 (2009)
- Hogarty GE, "Cognitive enhancement therapy for schizophrenia: effects of a 2-year randomized trial on cognition and behavior", Arch Gen Psychiatry, 61, pp.866~876 (2004)
- Hogarty GE, "Durability and mechanism of effects of cognitive enhancement therapy", Psychiatr Serv, 57, pp.1751~1757 (2006)
- Eack SM, "One-year durability of the effects of cognitive enhancement therapy on functional outcome in early schizophrenia", Schizophr Res, 120, pp.210~216 (2010)
- Eack SM, "Neuroprotective effects of cognitive enhancement therapy against gray matter loss in early schizophrenia: results from a 2-year randomized controlled trial", Arch Gen Psychiatry, 67, pp.674~682 (2010)
- Keshavan MS, "A broad cortical reserve accelerates response to cognitive enhancement therapy in early course schizophrenia", Schizophr Res, 130, pp.123~129 (2011)
- Nuechterlein KH, "The MATRICS Consensus Cognitive Battery, part 1: test selection, reliability, and validity", Am J Psychiatry, 165, pp.203~213 (2008)
- Gray JA, "Molecular targets for treating cognitive dysfunction in schizophrenia", Schizophr Bull, 33, pp.1100~1119 (2007)
- Goff DC, "The treatment of cognitive impairment in schizophrenia", Pharmacol Biochem Behav, 99, pp.245~253 (2011)
- Haydar SN, "Neuronal nicotinic acetylcholine receptors - targets for the development of drugs to treat cognitive impairment associated with schizophrenia and Alzheimer's disease", Curr Top Med Chem, 10, pp.144~152 (2010)
- Olincy A, "Proof-of-concept trial of an alpha7 nicotinic agonist in schizophrenia", Arch Gen Psychiatry, 63, pp.630~638 (2006)
- Kantrowitz JT, "High dose D-serine in the treatment of schizophrenia", Schizophr Res, 121, pp.125~130 (2010)
- Buchanan RW, "A randomized clinical trial of MK-0777 for the treatment of cognitive impairments in people with schizophrenia", Biol Psychiatry, 69, pp.442~449 (2011)
- Minzenberg MJ, "Modafinil: a review of neurochemical actions and effects on cognition", Neuropsychopharmacology, 33, pp.1477~1502 (2008)
- Barch DM, "Amphetamine improves cognitive function in medicated individuals with schizophrenia and in healthy volunteers", Schizophr Res, 77, pp.43~58 (2005)
- Daskalakis ZJ, "Transcranial magnetic stimulation: a new investigational and treatment tool in psychiatry", J Neuropsychiatry Clin Neurosci, 14, pp.406~415 (2002)
- Minzenberg MJ, "Developing treatments for impaired cognition in schizophrenia", Trends Cogn Sci, 16, pp.35~42 (2012)
- Levkovitz Y, "Deep transcranial magnetic stimulation add-on for treatment of negative symptoms and cognitive deficits of schizophrenia: a feasibility study", Int J Neuropsychopharmacol, 14, pp.991~996 (2011)
- Vercammen A, "Transcranial direct current stimulation influences probabilistic association learning in schizophrenia", Schizophr Res, 131, pp.198~205 (2011)
- Mulquiney PG, "Improving working memory: exploring the effect of transcranial random noise stimulation and transcranial direct current stimulation on the dorsolateral prefrontal cortex", Clin Neurophysiol, 122, pp.2384~2389 (2011)
- Raffard S, "Learning potential and cognitive remediation in schizophrenia", Encephale, 35, pp.353~360 (2009)
- Medalia A, "What predicts a good response to cognitive remediation interventions?", Schizophr Bull, 31, pp.942~953 (2005)
- Kurtz MM, "Predictors of change in life skills in schizophrenia after cognitive remediation", Schizophr Res, 107, pp.267~274 (2009)
- Bosia M, "Influence of catechol-O-methyltransferase Val158Met polymorphism on neuropsychological and functional outcomes of classical rehabilitation and cognitive remediation in schizophrenia", Neurosci Lett, 417, pp.271~274 (2007)
- Greenwood K, "No association between the Catechol-O-Methyltransferase (COMT) val158met polymorphism and cognitive improvement following cognitive remediation therapy (CRT) in schizophrenia", Neurosci Lett, 496, pp.65~69 (2011)
