Abstract:Context
Cognitive rehabilitation has shown efficacy for improving cognition in patients with schizophrenia, but the underlying neurobiologic changes that occur during these treatments and support cognitive improvement are not well known.
Objective
To examine differential changes in brain morphology in early schizophrenia during cognitive rehabilitation versus supportive therapy.
Design
A 2-year, randomized-controlled trial with annual structural magnetic resonance imaging and cognitive assessments.
Setti… Show more
“…52) Over the course of two years, schizophrenia patients receiving CET had greater preservation of gray matter volume in the left hippocampus, parahippocampal gyrus, and fusiform gyrus, and significantly greater gray matter increases in the left amygdala compared with those who received enriched supportive therapy. 98) Gray matter preservation in the left parahippocampal and fusiform gyrus and greater gray matter increases in the left amygdala were significantly related to improved cognition. 98) These structural changes are likely mediated by neuroplasticity in the relevant signaling networks and may be the mechanism by which the beneficial cognitive effects of CET occur.…”
“…98) Gray matter preservation in the left parahippocampal and fusiform gyrus and greater gray matter increases in the left amygdala were significantly related to improved cognition. 98) These structural changes are likely mediated by neuroplasticity in the relevant signaling networks and may be the mechanism by which the beneficial cognitive effects of CET occur. Interestingly, pre-treatment whole brain cortical surface area and gray matter volume ("cortical reserve") significantly moderated the effects of CET on social cognition, though not on neurocognition.…”
“…52) Over the course of two years, schizophrenia patients receiving CET had greater preservation of gray matter volume in the left hippocampus, parahippocampal gyrus, and fusiform gyrus, and significantly greater gray matter increases in the left amygdala compared with those who received enriched supportive therapy. 98) Gray matter preservation in the left parahippocampal and fusiform gyrus and greater gray matter increases in the left amygdala were significantly related to improved cognition. 98) These structural changes are likely mediated by neuroplasticity in the relevant signaling networks and may be the mechanism by which the beneficial cognitive effects of CET occur.…”
“…98) Gray matter preservation in the left parahippocampal and fusiform gyrus and greater gray matter increases in the left amygdala were significantly related to improved cognition. 98) These structural changes are likely mediated by neuroplasticity in the relevant signaling networks and may be the mechanism by which the beneficial cognitive effects of CET occur. Interestingly, pre-treatment whole brain cortical surface area and gray matter volume ("cortical reserve") significantly moderated the effects of CET on social cognition, though not on neurocognition.…”
“…As a result, morphometric changes may not be directly related to the genetic liability for disease expression. But as the tissue loss is related to neural plasticity, reversal of these structural deficits is possible 65 . Identification of individuals at risk of more severe forms of psychosis, and offering treatments that reduce or delay progressive synaptic changes at early stages may have a true disease-modifying effect.…”
Section: Predictions Limitations and Further Questionsmentioning
“…Improvements have been noted not just in cognitive functions that the training methods targeted, but also in cognitive domains that were not directly targeted as well as measures of global cognitive abilities. Not surprisingly, the response to cognitive training response is associated with structural and functional changes in prefrontal area of the brain [10,11]. The gains of cognitive training are likely to be durable for several months beyond the training period [12,13].…”
Section: Cognitive Training In Schizophreniamentioning
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