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针对精神分裂症的感觉靶向认知训练。

Sensory-targeted cognitive training for schizophrenia.

机构信息

a INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team , Lyon, F-69678 , France.

b University Lyon 1 , Villeurbanne, F-69000 , France.

出版信息

Expert Rev Neurother. 2019 Mar;19(3):211-225. doi: 10.1080/14737175.2019.1581609. Epub 2019 Feb 20.

DOI:10.1080/14737175.2019.1581609
PMID:30741038
Abstract

Auditory and visual dysfunctions are key pathophysiological features of schizophrenia (Sz). Therefore, remedial interventions that directly target such impairments could potentially drive gains in higher-order cognition (e.g., memory, executive functions, emotion processing), symptoms and functional outcome, in addition to improving sensory abilities in this population. Here, we reviewed available sensory-targeted cognitive training (S-TCT) programs that were investigated so far in Sz patients. Area covered: A systematic review of the literature was conducted following PRISMA guidelines. Twenty-seven relevant records were included. The superiority of S-TCT over control conditions on higher-order cognition measures was repeatedly demonstrated, but mostly lost significance at later endpoints of evaluation. Clinical symptoms and functional outcome were improved in a minority of studies. S-TCT interventions were associated with the relative normalization of several neurobiological biomarkers of neuroplasticity and sensory mechanisms. Expert commentary: S-TCT, although time-intensive, is a cost-efficient, safe and promising technique for Sz treatment. Its efficacy on higher-order cognition opens a critical window for clinical and functional improvement. The biological impact of S-TCT may allow for the identification of therapeutic biomarkers to further precision-medicine. Additional research is required to investigate the long-term effects of S-TCT, optimal training parameters and potential confounding factors associated with the illness.

摘要

听觉和视觉功能障碍是精神分裂症(Sz)的主要病理生理学特征。因此,直接针对这些损伤的矫正干预措施可能会在提高高级认知(例如记忆、执行功能、情绪处理)、症状和功能结果方面带来收益,同时改善该人群的感官能力。在这里,我们回顾了迄今为止在 Sz 患者中研究过的可用的感官靶向认知训练(S-TCT)计划。

涵盖领域

根据 PRISMA 指南进行了文献系统回顾。共纳入了 27 项相关记录。S-TCT 明显优于对照条件的高级认知测量,但在评估的后期终点大多失去了意义。少数研究显示临床症状和功能结果得到改善。S-TCT 干预与神经可塑性和感觉机制的几个神经生物学生物标志物的相对正常化有关。

专家评论

S-TCT 虽然时间密集,但具有成本效益、安全且是 Sz 治疗的有前途的技术。它对高级认知的疗效为临床和功能改善开辟了一个关键的窗口。S-TCT 的生物学影响可能允许确定治疗生物标志物,以进一步实现精准医学。需要进一步研究 S-TCT 的长期效果、最佳训练参数和与疾病相关的潜在混杂因素。

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