Treatment to Enhance Cognition in Bipolar Disorder (TREC-BD)

Lewandowski, Kathryn E.; Sperry, Sarah H.; Cohen, Bruce M.; Norris, Lesley A.; Fitzmaurice, Garrett M.; Öngür, Döst; Keshavan, Matcheri S.

doi:10.4088/jcp.17m11476

Cited by 91 publications

(35 citation statements)

References 31 publications

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“…Repetition is the hallmark feature of CCT, and neuroplasticity is its theoretical foundation ( Siegle et al, 2007 ). Cognitive improvements, including EF, have been identified using BrainHQ or similar exercises ( Morimoto et al, 2014 ; Lewandowski et al, 2017 ), and these studies established the empirical basis for the selection of exercises. In addition, exercise selection was based on the provider’s description 1 .…”

Section: Methodsmentioning

confidence: 99%

Predictors of Long-Term Improvement Following Cognitive Remediation in a Sample With Elevated Depressive Symptoms

et al. 2020

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Objective: Cognitive remediation (CR) techniques (interventions to enhance cognitive functioning) have proven moderately effective in improving cognition and daily functioning in major depressive disorder (MDD). However, baseline predictors of treatment response are lacking. The present study aimed to identify factors influencing long-term CR outcomes in a sample with current or previous, mild or moderate MDD and with self-reported cognitive deficits. Methods: Forty-two completers of group-based CR (strategy learning or drill-andpractice), were pooled into one sample. Based on change scores from baseline to 6-month follow-up, participants were categorized as "improvers" or "non-improvers" using reliable change index calculations. Measures included a questionnaire of everyday executive functioning and a neuropsychological test of attention. Finally, improvers and non-improvers were compared in terms of various sociodemographic, psychological, illness-related, and neuropsychological baseline variables. Results: Seventeen participants improved reliably in everyday executive functioning, and fourteen demonstrated a reliable improvement in attention. No statistically significant differences emerged between improvers and non-improvers. Conclusion: No major predictors of CR were identified. Importantly, the current findings are insufficient to guide clinical decision-making. Large-scale studies with a priori hypotheses are needed to make advances in the future.

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Section: Methodsmentioning

confidence: 99%

Predictors of Long-Term Improvement Following Cognitive Remediation in a Sample With Elevated Depressive Symptoms

et al. 2020

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“…It is worth mentioning that these negative results might be explained by some methodological limitations of the trial, including the length of the intervention (too short) or the fact that patients were subsyndromic at study enrolment. Another study leaded by Lewandowski and colleagues (2017) assessed the efficacy of an internet-based cognitive remediation program in patients with BD compared with an active control group both in neurocognition and community functioning. After treatment, patients who received the internet-based program improved cognitive performance in processing speed, visual learning and memory domains, and the composite score.…”

Section: Restoring Psychosocial Functioning: Therapies That Have Imprmentioning

confidence: 99%

Improving Functioning, Quality of Life, and Well-being in Patients With Bipolar Disorder

Bonnín

Reinares

Martínez‐Arán

et al. 2019

International Journal of Neuropsychopharmacology

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People with bipolar disorder frequently experience persistent residual symptoms, problems in psychosocial functioning, cognitive impairment, and poor quality of life. In the last decade, the treatment target in clinical and research settings has focused not only on clinical remission, but also on functional recovery and, more lately, in personal recovery, taking into account patients’ well-being and quality of life. Hence, the trend in psychiatry and psychology is to treat bipolar disorder in an integrative and holistic manner. This literature review offers an overview regarding psychosocial functioning in bipolar disorder. First, a brief summary is provided regarding the definition of psychosocial functioning and the tools to measure it. Then, the most reported variables influencing the functional outcome in patients with bipolar disorder are listed. Thereafter, we include a section discussing therapies with proven efficacy at enhancing functional outcomes. Other possible therapies that could be useful to prevent functional decline and improve functioning are presented in another section. Finally, in the last part of this review, different interventions directed to improve patients’ well-being, quality of life, and personal recovery are briefly described.

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“…Consequently, clinical trials investigating the pro-cognitive effects of candidate cognition treatments have produced overall disappointing or only preliminary results [ 7 , 11 ]. However, evidence from a few small open-label, non-controlled studies suggests that cognitive remediation (CR) may have pro-cognitive effects in patients with BD [ 12 , 13 ], and recent findings from a larger randomized clinical trial of 70 h of computerized CR in remitted patients with BD type I showed improvements on processing speed, visual learning, and memory and a cognitive composite measure [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of action-based cognitive remediation on cognition and neural activity in bipolar disorder: study protocol for a randomized controlled trial

Ott

Vinberg

Bowie

et al. 2018

Trials

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BackgroundCognitive impairment is present in bipolar disorder (BD) during the acute and remitted phases and hampers functional recovery. However, there is currently no clinically available treatment with direct and lasting effects on cognitive impairment in BD. We will examine the effect of a novel form of cognitive remediation, action-based cognitive remediation (ABCR), on cognitive impairment in patients with BD, and explore the neural substrates of potential treatment efficacy on cognition.Methods/designThe trial has a randomized, controlled, parallel-group design. In total, 58 patients with BD in full or partial remission aged 18–55 years with objective cognitive impairment will be recruited. Participants are randomized to 10 weeks of ABCR or a control group. Assessments encompassing neuropsychological testing and mood ratings, and questionnaires on subjective cognitive complaints, psychosocial functioning, and quality of life are carried out at baseline, after 2 weeks of treatment, after the end of treatment, and at a six-month-follow-up after treatment completion. Functional magnetic resonance imaging scans are performed at baseline and 2 weeks into treatment. The primary outcome is a cognitive composite score spanning verbal memory, attention, and executive function. Two complete data sets for 52 patients will provide a power of 80% to detect a clinically relevant between-group difference on the primary outcome. Behavioral data will be analyzed using mixed models in SPSS while MRI data will be analyzed with the FMRIB Expert Analysis Tool (FEAT). Early treatment-related changes in neural activity from baseline to week 2 will be investigated for the dorsal prefrontal cortex and hippocampus as the regions of interest and with an exploratory whole-brain analysis.DiscussionThe results will provide insight into whether ABCR has beneficial effects on cognition and functioning in remitted patients with BD. The results will also provide insight into early changes in neural activity associated with improvement of cognition, which can aid future treatment development.Trial registrationClinicaltrials.gov, NCT03295305. Registered on 26 September 2017.Electronic supplementary materialThe online version of this article (10.1186/s13063-018-2860-8) contains supplementary material, which is available to authorized users.

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Treatment to Enhance Cognition in Bipolar Disorder (TREC-BD)

Abstract: ClinicalTrials.gov identifier: NCT01470781.

Cited by 91 publications

References 31 publications

Predictors of Long-Term Improvement Following Cognitive Remediation in a Sample With Elevated Depressive Symptoms

Predictors of Long-Term Improvement Following Cognitive Remediation in a Sample With Elevated Depressive Symptoms

Improving Functioning, Quality of Life, and Well-being in Patients With Bipolar Disorder

Effect of action-based cognitive remediation on cognition and neural activity in bipolar disorder: study protocol for a randomized controlled trial

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