Когнитивная ремедиация улучшила работу мозга и снизила симптомы у пациентов со шизофренией

TOPLINE Cognitive remediation therapy (CRT) given over 12 weeks was associated with significantly improved brain function in individuals with schizophrenia compared with control individuals, a trial showed. Participants receiving CRT also showed improvements in working memory and emotion regulation, alongside reductions in symptom severity and autonomic reactivity to negative emotional stimuli. METHODOLOGY - A randomized controlled trial included adults with schizophrenia in Istanbul, Türkiye, with 26 participants in the CRT group and 22 in the control group. - The CRT group received 24 individual, face-to-face CRT sessions delivered twice weekly over 12 weeks, each lasting approximately 60 minutes, targeting attention, working memory, executive function, and emotion regulation. The control group received treatment as usual. - The primary outcome was change in P300 amplitude (a brain wave marker of attention and cognitive processing) from baseline to post-intervention, measured via EEG during a visual oddball task. - Secondary outcomes included N200 amplitude, frontal midline theta power, skin conductance responses (SCR) to emotional stimuli, and working memory performance (2-back task accuracy and reaction time). - Psychometric outcomes included changes in the Positive and Negative Syndrome Scale (PANSS), Montreal Cognitive Assessment (MoCA), Difficulties in Emotion Regulation Scale (DERS), Brief Assessment of Cognition in Schizophrenia (BACS), and Quality of Life Scale (QLS). TAKEAWAY - A significant group × time interaction was observed for P300 amplitude (P < .001); the CRT group showed increased mean P300 amplitude from baseline to post-intervention (6.8 µV to 9.3 µV), while the control group remained stable (6.6 µV to 6.9 µV). - N200 amplitude at fronto-central electrodes showed a significant group × time interaction (P = .002). Frontal midline theta power during the 2-back task showed a significant group × time interaction (P < .001). SCR to negative emotional stimuli showed a significant group × time interaction (P = .004), with the CRT group showing reduced autonomic reactivity post-intervention, while baseline skin conductance level remained stable across groups. - Working memory accuracy on the 2-back task improved significantly in the CRT group (group × time: P < .001), as did backward digit span performance (P = .002) and facial emotion recognition (P = .009). PANSS total scores showed a significant group × time interaction (P = .004), with reductions observed across PANSS positive (P = .012), negative (P = .005), and general psychopathology subscale (P = .010). - MoCA scores (P = .002), DERS scores (P = .002), BACS composite scores (P < .001), and QLS scores (P = .007) all showed significant group × time interactions favoring CRT. IN PRACTICE "The findings provide mechanistic evidence that CRT can modify core cognitive-control systems in schizophrenia, with measurable downstream effects on emotional and functional outcomes. These results support the integration of structured, strategy-based cognitive remediation into routine outpatient care and highlight electrophysiological markers as valuable indices of treatment-related neuroplastic change," the authors wrote. SOURCE The study was led by Metin Çınaroğlu, Faculty of Administrative, Business and Social Sciences, İstanbul Nişantaşı University, Istanbul, Türkiye. It was published online on August 17 in BMC Psychiatry. LIMITATIONS The analysis was conducted on a per-protocol sample, potentially introducing bias. The study's modest sample size and multiple outcome measures increased the risk for type I error across secondary endpoints. The absence of an active control condition matched for therapist contact limited the ability to isolate intervention-specific effects from nonspecific influences such as expectancy and structured engagement. Neurophysiological measures were context-dependent. Generalizability was limited to clinically stable outpatients, and medication effects were not formally modeled, representing a potential confounding factor. DISCLOSURES The study received no specific funding. The authors reported having no conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.