Clinical research

Effects of computerized cognitive correction therapy on cognitive function of schizophrenia

  • Guo-qin HU ,
  • Cheng-qing YANG ,
  • Qin-yu Lü ,
  • Jing ZHAO ,
  • Ming-huan ZHU ,
  • Zheng-hui YI ,
  • Xin-hai DAI
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  • 1.Department of Psychiatry, Shanghai Mental Health Center of Huangpu District, Shanghai 200011, China
    2.Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
    3.Department of Psychiatry, Shanghai Mental Health Center of Pudong District, Shanghai 200122, China

Online published: 2021-05-27

Supported by

Shanghai Huangpu District Science and Technology Commission Scientific Research Project(HKQ201813);Shanghai Huangpu District Health and Family Planning Professional Talent Echelon Training Plan(2019GG11);Scientific Research Project of Shanghai Municipal Health Committee(20194Y0406)

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.

Cite this article

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 Jiao Tong University (Medical Science), 2021 , 41(5) : 622 -627 . DOI: 10.3969/j.issn.1674-8115.2021.05.010

References

1 Turetsky BI, Bilker WB, Siegel SJ, et al. Profile of auditory information-processing deficits in schizophrenia[J]. Psychiatry Res, 2009, 165(1/2): 27-37.
2 Levin ED, Rezvani AH. Nicotinic interactions with antipsychotic drugs, models of schizophrenia and impacts on cognitive function[J]. Biochem Pharmacol, 2007, 74(8): 1182-1191.
3 Iimori T, Nakajima S, Miyazaki T, et al. Effectiveness of the prefrontal repetitive transcranial magnetic stimulation on cognitive profiles in depression, schizophrenia, and Alzheimer's disease: a systematic review[J]. Prog Neuro - Psychopharmacol Biol Psychiatry, 2019, 88: 31-40.
4 Rector NA, Beck AT. Cognitive behavioral therapy for schizophrenia: an empirical review[J]. J Nerv Ment Dis, 2012, 200(10): 832-839.
5 屈英, 肖广荣, 马永珩, 等. 认知矫正治疗对慢性精神分裂症患者临床症状和社会功能的影响[J]. 中国组织工程研究与临床康复, 2007, 11(52): 10553-10556.
6 谭淑平, 邹义壮, 王健, 等. 认知矫正治疗慢性精神分裂症患者认知功能缺陷的随机对照研究[J]. 中华精神科杂志, 2010, 43(3): 140-145.
7 Tan SP, Liu DT. A review of the Chinese literature on cognitive remediation in psychosis[J]. Asian J Psychiatry, 2016, 22: 129-134.
8 Fernandez-Gonzalo S, Turon M, Jodar M, et al. A new computerized cognitive and social cognition training specifically designed for patients with schizophrenia/schizoaffective disorder in early stages of illness: a pilot study[J]. Psychiatry Res, 2015, 228(3): 501-509.
9 Hogarty GE, Flesher S, Ulrich R, et al. Cognitive enhancement therapy for schizophrenia: effects of a 2-year randomized trial on cognition and behavior[J]. Arch Gen Psychiatry, 2004, 61(9): 866-876.
10 Dickinson D, Tenhula W, Morris S, et al. A randomized, controlled trial of computer-assisted cognitive remediation for schizophrenia[J]. Am J Psychiatry, 2010, 167(2): 170-180.
11 Ibrahim I, Tobar S, Fathi W, et al. Randomized controlled trial of adjunctive Valproate for cognitive remediation in early course schizophrenia[J]. J Psychiatr Res, 2019, 118: 66-72.
12 王健, 邹义壮, 崔界峰, 等. 韦氏成人智力量表第四版中文版的信度和结构效度[J]. 中国心理卫生杂志, 2013, 27(9): 692-697.
13 Morice R, Delahunty A. Frontal/executive impairments in schizophrenia[J]. Schizophr Bull, 1996, 22(1): 125-137.
14 Randolph C, Tierney MC, Mohr E, et al. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS): preliminary clinical validity[J]. J Clin Exp Neuropsychol, 1998, 20(3): 310-319.
15 张保华, 谭云龙, 张五芳, 等. 重复性成套神经心理状态测验的信度、效度分析[J]. 中国心理卫生杂志, 2008, 22(12): 865-869.
16 Wilk CM, Gold JM, Bartko JJ, et al. Test-retest stability of the Repeatable Battery for the Assessment of Neuropsychological Status in schizophrenia[J]. Am J Psychiatry, 2002, 159(5): 838-844.
17 刘燕, 沈辉, 邓红玉, 等. 精神分裂症认知矫正治疗新进展[J]. 神经疾病与精神卫生, 2018, 18(7): 515-519.
18 Reser MP, Slikboer R, Rossell SL. A systematic review of factors that influence the efficacy of cognitive remediation therapy in schizophrenia[J]. Aust N Z J Psychiatry, 2019, 53(7): 624-641.
19 Gomar JJ, Valls E, Radua J, et al. A multisite, randomized controlled clinical trial of computerized cognitive remediation therapy for schizophrenia[J]. Schizophr Bull, 2015, 41(6):1387-1396.
20 Ramsay IS, MacDonald AW 3rd. Brain correlates of cognitive remediation in schizophrenia: activation likelihood analysis shows preliminary evidence of neural target engagement[J]. Schizophr Bull, 2015, 41(6): 1276-1284.
21 Barch DM, Ceaser A. Cognition in schizophrenia: core psychological and neural mechanisms[J]. Trends Cogn Sci, 2012, 16(1): 27-34.
22 Eisenberg DP, Berman KF. Executive function, neural circuitry, and genetic mechanisms in schizophrenia[J]. Neuropsychopharmacology, 2010, 35(1): 258-277.
23 Habtemariam S. The brain-derived neurotrophic factor in neuronal plasticity and neuroregeneration: new pharmacological concepts for old and new drugs[J]. Neural Regen Res, 2018, 13(6): 983-984.
24 Wang Q, Shao F, Wang WW. Region-dependent alterations in cognitive function and ERK1/2 signaling in the PFC in rats after social defeat stress[J]. Neural Plast, 2018, 2018: 9870985.
25 Pillai A, Kale A, Joshi S, et al. Decreased BDNF levels in CSF of drug-naive first-episode psychotic subjects: correlation with plasma BDNF and psychopathology[J]. Int J Neuropsychopharmacol, 2010, 13(4): 535-539.
26 Klein AB, Williamson R, Santini MA, et al. Blood BDNF concentrations reflect brain-tissue BDNF levels across species[J]. Int J Neuropsychopharmacol, 2011, 14(3): 347-353.
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