Cognitive intervention in early psychosis — preserving abilities versus remediating deficits

Brain change trajectories that differentiate the major psychoses

“…, the changes observed are apparent across the whole cortex in relation to controls, however only frontal regions show a significant difference. We have previously suggested that brain maturation may be an important mediating variable to explain these findings . We suggest that stage of brain maturation mediates the impact of the illness on brain structure.…”

“…This suggested that in SZ, the changes are more global; it was speculated that frontal regions reached significance because these regions are the areas showing the most dynamic maturational changes in later adolescence and early adulthood. That is, the significant findings in the frontal regions can be understood by placing the findings within a neurodevelopmental context as has also been observed with neurocognitive data . It is unclear whether this is also relevant to BP, although studies that examine trajectories of structural and functional brain changes from childhood to adulthood may be informative (see below).…”

Deterioration of visuospatial associative memory following a first psychotic episode: a long-term follow-up study

“…Deterioration in visuospatial associative memory challenges the 'dominant' notion of stable cognitive deficits in schizophrenia (Bora & Murray 2013), and highlights that different areas of cognition may have different trajectories over the course of psychotic illness. That is, while some cognitive domains are impaired at the earliest stages of the illness, other areas of cognition are preserved at illness onset and deteriorate only as the illness progresses (Pantelis, Wannan, Bartholomeusz, Allott, & McGorry, 2015). In order to understand these differing trajectories, it is important to consider individual cognitive tasks within the context of normal development, while also taking into account the brain changes that have been found to occur in the period following illness onset (Pantelis et al, 2005;Pantelis, Yucel, et al, 2009;Pantelis, Wannan, Bartholomeusz, Allott, & McGorry, 2015).…”

Drugs, games, and devices for enhancing cognition: implications for work and society

“…However, to date, most of the studies were conducted using chronically ill patients with relatively severe cognitive deficits. There are reasons to believe that with earlier treatment the development of cognitive impairments can be stopped or even reversed, which might be easier to achieve than to repair damage that has already occurred . In addition, the lack of consistent results could be explained by the neurobiological heterogeneity of schizophrenia as a diagnostic category; with neurobiological criteria for subcategories, treatment responders to specific and different cognitive treatments might be identified.…”