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对于早期精神分裂症患者,针对性认知训练的反应可能具有神经保护作用。

Response to targeted cognitive training may be neuroprotective in patients with early schizophrenia.

作者信息

Ramsay Ian S, Fryer Susanna, Roach Brian J, Boos Alison, Fisher Melissa, Loewy Rachel, Ford Judith M, Vinogradov Sophia, Mathalon Daniel H

机构信息

University of Minnesota, Department of Psychiatry and Behavioral Sciences, USA.

University of California, San Francisco, Department of Psychiatry and Behavioral Science, USA; San Francisco Veterans Affairs Medical Center, USA.

出版信息

Psychiatry Res Neuroimaging. 2021 Jun 30;312:111285. doi: 10.1016/j.pscychresns.2021.111285. Epub 2021 Apr 7.

Abstract

Individuals with schizophrenia exhibit widespread cortical thinning associated with illness severity and deficits in cognition. However, intact cortical thickness (CTh) may serve as a protective factor. The current study sought to examine changes in CTh in response to auditory targeted cognitive training (TCT) in individuals with recent onset schizophrenia. Participants underwent MRI scanning and a cognitive assessment before and after being randomly assigned to 40 h of either TCT (N = 21) or a computer games control condition (CG; N = 22) over 16 weeks. Groups did not differ at baseline on demographic variables or measures of CTh. At the level of group averages, neither group showed significant pre-post changes in CTh in any brain region. However, changes in CTh related to individual differences in treatment outcome, as improved global cognition in the TCT group corresponded to reduced cortical thinning in frontal, temporal, parietal, and occipital lobes. These relationships were not observed in the CG group. The current findings suggest that TCT may be neuroprotective in early schizophrenia, such that individuals who improved in response to training also showed a reduction in cortical thinning that may be otherwise hastened due to age and illness.

摘要

精神分裂症患者表现出广泛的皮质变薄,这与疾病严重程度和认知缺陷有关。然而,完整的皮质厚度(CTh)可能是一种保护因素。当前研究旨在考察近期发病的精神分裂症患者在接受听觉定向认知训练(TCT)后CTh的变化。参与者在被随机分配到16周内接受40小时的TCT(N = 21)或电脑游戏对照条件(CG;N = 22)前后,分别接受了MRI扫描和认知评估。两组在人口统计学变量或CTh测量的基线水平上没有差异。在组平均水平上,两组在任何脑区的CTh前后均未显示出显著变化。然而,CTh的变化与治疗结果的个体差异有关,因为TCT组整体认知的改善与额叶、颞叶、顶叶和枕叶皮质变薄的减少相对应。这些关系在CG组中未观察到。当前研究结果表明,TCT在早期精神分裂症中可能具有神经保护作用,即对训练有反应而改善的个体也表现出皮质变薄的减少,否则皮质变薄可能会因年龄和疾病而加速。

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