Gandara Veronica, Pineda Jaime A, Shu I-Wei, Singh Fiza
Department of Psychiatry, University of California at San Diego (UCSD), La Jolla, CA.
Department of Cognitive Science, University of California at San Diego (UCSD), La Jolla, CA.
Schizophr Bull Open. 2020 Jan;1(1):sgaa005. doi: 10.1093/schizbullopen/sgaa005. Epub 2020 Mar 2.
Schizophrenia (SCZ) is a neurodevelopmental disorder characterized by positive symptoms (hallucinations and delusions), negative symptoms (anhedonia, social withdrawal) and marked cognitive deficits (memory, executive function, and attention). Current mainstays of treatment, including medications and psychotherapy, do not adequately address cognitive symptoms, which are essential for everyday functioning. However, recent advances in computational neurobiology have rekindled interest in neurofeedback (NF), a form of self-regulation or neuromodulation, in potentially alleviating cognitive symptoms in patients with SCZ. Therefore, we conducted a systematic review of the literature for NF studies in SCZ to identify lessons learned and to identify steps to move the field forward. Our findings reveal that NF studies to date consist mostly of case studies and small sample, single-group studies. Despite few randomized clinical trials, the results suggest that NF is feasible and that it leads to measurable changes in brain function. These findings indicate early proof-of-concept data that needs to be followed up by larger, randomized clinical trials, testing the efficacy of NF compared to well thought out placebos. We hope that such an undertaking by the field will lead to innovative solutions that address refractory symptoms and improve everyday functioning in patients with SCZ.
精神分裂症（SCZ）是一种神经发育障碍，其特征为阳性症状（幻觉和妄想）、阴性症状（快感缺乏、社交退缩）以及明显的认知缺陷（记忆、执行功能和注意力）。目前的主要治疗方法，包括药物治疗和心理治疗，并未充分解决认知症状，而认知症状对日常功能至关重要。然而，计算神经生物学的最新进展重新激发了人们对神经反馈（NF）的兴趣，神经反馈是一种自我调节或神经调节形式，有可能缓解SCZ患者的认知症状。因此，我们对SCZ的NF研究文献进行了系统综述，以总结经验教训并确定推动该领域向前发展的步骤。我们的研究结果表明，迄今为止的NF研究主要包括案例研究和小样本单组研究。尽管随机临床试验较少，但结果表明NF是可行的，并且会导致脑功能出现可测量的变化。这些发现表明了早期的概念验证数据，需要通过更大规模的随机临床试验进行跟进，将NF与精心设计的安慰剂进行疗效对比测试。我们希望该领域的此类工作能够带来创新解决方案，解决难治性症状并改善SCZ患者的日常功能。
