Effects of computerized cognitive correction therapy on cognitive function of schizophrenia

doi:10.3969/j.issn.1674-8115.2021.05.010

Abstract

Abstract: Objective

·To explore the effects of computerized cognitive correction therapy (CCRT) on the cognitive function of patients with chronic schizophrenia and the effects on plasma brain-derived nerve growth factor (BDNF) and tyrosine kinase receptors B (TrK-B) .

Methods

·162 patients with chronic schizophrenia from Shanghai Mental Health Center of Huangpu District were randomly divided into CCRT group and control group according to the random number table method. 81 patients in the control group were treated with the conventional antipsychotic drugs, and 81 patients in the CCRT group were given CCRT combined with the conventional antipsychotic treatment. The period of treatments is 12 weeks. The cognitive function by Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), detection of plasma BDNF and TrK-B expression levels by avidinbiotincomplex-Enzyme Linked Immune Sorbent Assay (ABC-ELISA) were assessed at the baseline and at the end of the 12th week. Paired sample t-test was applied to compare the cognitive function, plasma BDNF and TrK-B protein expression levels in the baseline between the two groups, and the repeated measurements variance analysis was used to compare the cognitive function and plasma BDNF and TrK-B protein expression levels between the two groups after treatment and change within the group. The correlation between the improvement of cognitive function and the change of protein expression levels used a general linear model.

Results

·The CCRT group and the control group actually completed 77 cases each. At the baseline, there was no statistically significant difference among cognitive function, BDNF and TrK-B between the two groups; after 12 weeks of treatment, cognitive function (P=0.000), BDNF (P=0.007) and TrK-B (P=0.015) expression level was statistically different between the CCRT and the control group; for CCRT group, cognitive function (P=0.000), BDNF (P=0.002) and TrK-B (P=0.000) expression level was significantly different after 12 weeks of treatment compared with the baseline, but not in the control group. The change of BDNF protein expression level is significantly correlated with the improvement of vocabulary learning (r²=1.598, P=0.019), story retelling (r²=1.495, P=0.038), digital breadth (r²=1.855, P=0.004), story recall (r²=1.459, P=0.047) and attention function (r²=1.673,P=0.012). The change of TrK-B protein expression level is significantly correlated with the improvement of picture naming (r²=1.582, P=0.034).

Conclusion

·The use of CCRT in the adjuvant treatment of antipsychotic treatment for schizophrenia patients has a significant effect on cognitive function. The improvement of some cognitive functions are significantly related to the changes in the plasma BDNF and its TrK-B expression levels.

Key words: schizophrenia, computerized cognitive remediation therapy, brain derived neurotrophic factor (BDNF), tyrosine kinase receptor B (TrK-B), cognitive function

CLC Number:

R749.302

Guo-qin HU, Cheng-qing YANG, Qin-yu LÜ, Jing ZHAO, Ming-huan ZHU, Zheng-hui YI, Xin-hai DAI. Effects of computerized cognitive correction therapy on cognitive function of schizophrenia[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(5): 622-627.

Figures/Tables 4

TrendMD

References 26

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Indicator	CCRT group (n=77)	HC group (n=77)	χ²/t value	df	P value
male/female/n	35/42	34/43	0.026	1	0.871
Age/year	34.14±7.41	36.23±7.18	-1.778	152	0.077
Duration/year	13.27±7.11	12.81±4.84	0.477	152	0.634
Education/year	9.05±2.43	9.36±2.53	-0.780	152	0.436
PANSS total/score	57.94±4.72	58.03±4.82	-0.118	152	0.906

Indicator	CCRT group (n=77)	HC group (n=77)	χ²/t value	df	P value
male/female/n	35/42	34/43	0.026	1	0.871
Age/year	34.14±7.41	36.23±7.18	-1.778	152	0.077
Duration/year	13.27±7.11	12.81±4.84	0.477	152	0.634
Education/year	9.05±2.43	9.36±2.53	-0.780	152	0.436
PANSS total/score	57.94±4.72	58.03±4.82	-0.118	152	0.906

Indicator	Baseline		12th week
Indicator	CCRT group (n=77)	HC group (n=77)	CCRT group (n=77)	HC group (n=77)
Vocabulary learning	8.32±4.84	8.14±4.37	22.38±6.49^①②	8.90±6.51
Story telling	4.38±3.55	4.45±3.63	11.87±4.70^①②	5.35±4.68
Graphic copy	12.13±5.49	12.43±5.53	18.55±1.71^①②	12.92±5.55
Line positioning	7.77±5.50	7.90±5.52	14.68±2.71^①②	8.12±5.69
Picture naming	7.29±2.54	7.42±2.57	9.04±1.06^①②	7.69±2.51
Semantic test	7.92±3.86	7.55±3.74	14.43±4.91^①②	7.68±3.82
Digital breadth	10.48±4.05	10.35±3.92	14.51±1.68^①②	10.53±4.11
Coding test	10.57±7.95	10.09±8.90	29.61±11.83^①②	11.48±10.23
Vocabulary recall	0.79±1.22	0.83±1.23	4.27±2.46^①②	1.16±1.94
Vocabulary recognition	10.83±5.66	10.16±6.00	18.44±1.73^①②	10.39±6.25
Story memory	1.56±2.04	1.71±2.10	6.66±3.20^①②	2.04±2.56
Graphic recognition	4.29±3.51	4.19±3.61	11.19±5.13^①②	4.65±4.50
Immediate memory	45.35±6.95	44.90±6.89	77.51±18.06^①②	48.29±15.97
Visual breadth	65.91±16.19	66.86±16.08	96.78±12.16^①②	69.14±18.24
Speech function	64.21±15.24	64.35±15.01	84.62±10.97^①②	66.60±14.17
Attention function	74.06±17.06	73.69±17.19	100.69±12.90^①②	75.56±18.06
Delay memory	48.62±9.91	48.14±9.08	87.64±17.41^①②	51.84±17.26
RBANS total score	298.16±48.23	297.94±47.95	447.19±49.15^①②	311.35±68.10
RBANS conversion points	53.13±7.77	53.09±7.61	85.96±12.10^①②	56.43±13.00

Indicator	Baseline		12th week
Indicator	CCRT group (n=77)	HC group (n=77)	CCRT group (n=77)	HC group (n=77)
Vocabulary learning	8.32±4.84	8.14±4.37	22.38±6.49^①②	8.90±6.51
Story telling	4.38±3.55	4.45±3.63	11.87±4.70^①②	5.35±4.68
Graphic copy	12.13±5.49	12.43±5.53	18.55±1.71^①②	12.92±5.55
Line positioning	7.77±5.50	7.90±5.52	14.68±2.71^①②	8.12±5.69
Picture naming	7.29±2.54	7.42±2.57	9.04±1.06^①②	7.69±2.51
Semantic test	7.92±3.86	7.55±3.74	14.43±4.91^①②	7.68±3.82
Digital breadth	10.48±4.05	10.35±3.92	14.51±1.68^①②	10.53±4.11
Coding test	10.57±7.95	10.09±8.90	29.61±11.83^①②	11.48±10.23
Vocabulary recall	0.79±1.22	0.83±1.23	4.27±2.46^①②	1.16±1.94
Vocabulary recognition	10.83±5.66	10.16±6.00	18.44±1.73^①②	10.39±6.25
Story memory	1.56±2.04	1.71±2.10	6.66±3.20^①②	2.04±2.56
Graphic recognition	4.29±3.51	4.19±3.61	11.19±5.13^①②	4.65±4.50
Immediate memory	45.35±6.95	44.90±6.89	77.51±18.06^①②	48.29±15.97
Visual breadth	65.91±16.19	66.86±16.08	96.78±12.16^①②	69.14±18.24
Speech function	64.21±15.24	64.35±15.01	84.62±10.97^①②	66.60±14.17
Attention function	74.06±17.06	73.69±17.19	100.69±12.90^①②	75.56±18.06
Delay memory	48.62±9.91	48.14±9.08	87.64±17.41^①②	51.84±17.26
RBANS total score	298.16±48.23	297.94±47.95	447.19±49.15^①②	311.35±68.10
RBANS conversion points	53.13±7.77	53.09±7.61	85.96±12.10^①②	56.43±13.00

Indicator	BDNF		TrK-B
Indicator	r²	P	r²	P
Vocabulary learning	1.598	0.019	0.959	0.594
Story telling	1.495	0.038	1.187	0.251
Graphic copy	1.144	0.280	1.017	0.494
Line positioning	1.271	0.144	1.095	0.369
Picture naming	1.439	0.053	1.582	0.034
Semantic test	1.310	0.115	0.862	0.762
Digital breadth	1.855	0.004	1.423	0.079
Coding test	1.397	0.069	1.192	0.246
Vocabulary recall	1.353	0.090	1.283	0.160
Vocabulary recognition	1.170	0.246	1.348	0.116
Story memory	1.459	0.047	1.077	0.396
Graphic recognition	1.366	0.083	1.052	0.435
Immediate memory	1.496	0.037	1.142	0.305
Visual breadth	1.077	0.380	0.971	0.572
Speech function	1.118	0.316	1.267	0.173
Attention function	1.673	0.012	1.469	0.062
Delay memory	1.174	0.241	0.926	0.652
RBANS total score	1.402	0.067	1.140	0.307
RBANS conversion points	1.306	0.118	1.053	0.434