Department of Psychiatry, Nara Medical University School of Medicine, Nara, Japan; Department of Psychiatry, Teikyo University School of Medicine, Tokyo, Japan.
Psychiatry Clin Neurosci. 2014 Jun;68(6):425-31. doi: 10.1111/pcn.12147. Epub 2014 Feb 10.
Methods to improve neurocognitive impairments are of important research interest. This study sought to examine the synergistic effects of neurocognitive rehabilitation and antipsychotics for schizophrenia.
Subjects were 43 patients diagnosed with schizophrenia or schizoaffective disorder in a randomized trial of the effects of neurocognitive rehabilitation or a quasi-randomized experimental trial of supported employment with neurocognitive rehabilitation. We compared the effects of risperidone and aripiprazole in neurocognitive rehabilitation for schizophrenia. Subjects were divided into the following groups: (i) the control-risperidone group (CR group) (n = 13); (ii) the rehabilitation-risperidone group (RR group) (n = 9); (iii) the control-aripiprazole group (CA group) (n = 10); and (iv) the rehabilitation-aripiprazole group (RA group) (n = 11). Subjects in the rehabilitation group were engaged in computer-based cognitive exercises (24 sessions) with bridging group (12 sessions) over 12 weeks. Psychiatric symptoms, neurocognitive functioning and social functioning assessments were evaluated at baseline and at 12 weeks.
A two-way anova with neurocognitive rehabilitation and antipsychotic medication as factors revealed a significant interaction effect on motor speed. Working memory and motor speed significantly improved in the RA group compared with the CA group. We found no significant improvements between the CR group and the RR group.
A synergistic effect of neurocognitive rehabilitation and aripiprazole was observed as improvement of motor speed. In patients treated with aripiprazole, neurocognitive rehabilitation appeared to improve working memory and motor speed. Further studies of synergistic effects of neurocognitive rehabilitation and antipsychotic medication are necessary to verify these findings.
改善神经认知障碍的方法是重要的研究方向。本研究旨在探讨神经认知康复与抗精神病药物治疗精神分裂症的协同作用。
本研究纳入了一项神经认知康复随机对照试验和一项神经认知康复支持性就业准随机对照试验中的 43 例精神分裂症或分裂情感障碍患者。我们比较了利培酮和阿立哌唑在精神分裂症神经认知康复中的作用。将患者分为以下 4 组：（i）对照组-利培酮组（CR 组）（n=13）；（ii）康复组-利培酮组（RR 组）（n=9）；（iii）对照组-阿立哌唑组（CA 组）（n=10）；（iv）康复组-阿立哌唑组（RA 组）（n=11）。康复组患者接受为期 12 周、共 24 次的基于计算机的认知训练和 12 次的桥接小组训练。在基线和 12 周时评估精神症状、神经认知功能和社会功能。
采用神经认知康复和抗精神病药物作为因素的双因素方差分析显示，运动速度存在显著的交互作用。与 CA 组相比，RA 组的工作记忆和运动速度显著改善。RR 组和 CR 组之间没有显著改善。
我们观察到神经认知康复和阿立哌唑的协同作用，表现为运动速度的改善。在接受阿立哌唑治疗的患者中，神经认知康复似乎改善了工作记忆和运动速度。需要进一步研究神经认知康复和抗精神病药物的协同作用，以验证这些发现。
