Barch Deanna M, Boudewyn Megan Ann, Carter Cameron C, Erickson Molly, Frank Michael J, Gold James M, Luck Steven J, MacDonald Angus W, Ragland J Daniel, Ranganath Charan, Silverstein Steven M, Yonelinas Andy
Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA.
University of California, Santa Cruz, CA, USA.
Curr Top Behav Neurosci. 2023;63:19-60. doi: 10.1007/7854_2022_391.
The development of treatments for impaired cognition in schizophrenia has been characterized as the most important challenge facing psychiatry at the beginning of the twenty-first century. The Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia (CNTRICS) project was designed to build on the potential benefits of using tasks and tools from cognitive neuroscience to better understanding and treat cognitive impairments in psychosis. These benefits include: (1) the use of fine-grained tasks that measure discrete cognitive processes; (2) the ability to design tasks that distinguish between specific cognitive domain deficits and poor performance due to generalized deficits resulting from sedation, low motivation, poor test taking skills, etc.; and (3) the ability to link cognitive deficits to specific neural systems, using animal models, neuropsychology, and functional imaging. CNTRICS convened a series of meetings to identify paradigms from cognitive neuroscience that maximize these benefits and identified the steps need for translation into use in clinical populations. The Cognitive Neuroscience Test Reliability and Clinical Applications for Schizophrenia (CNTRaCS) Consortium was developed to help carry out these steps. CNTRaCS consists of investigators at five different sites across the country with diverse expertise relevant to a wide range of the cognitive systems identified as critical as part of CNTRICs. This work reports on the progress and current directions in the evaluation and optimization carried out by CNTRaCS of the tasks identified as part of the original CNTRICs process, as well as subsequent extensions into the Positive Valence systems domain of Research Domain Criteria (RDoC). We also describe the current focus of CNTRaCS, which involves taking a computational psychiatry approach to measuring cognitive and motivational function across the spectrum of psychosis. Specifically, the current iteration of CNTRaCS is using computational modeling to isolate parameters reflecting potentially more specific cognitive and visual processes that may provide greater interpretability in understanding shared and distinct impairments across psychiatric disorders.
精神分裂症认知功能受损治疗方法的研发,被视为21世纪初精神病学面临的最重要挑战。精神分裂症认知改善的认知神经科学治疗研究(CNTRICS)项目旨在利用认知神经科学的任务和工具所具有的潜在益处,以更好地理解和治疗精神病中的认知障碍。这些益处包括:(1)使用能够测量离散认知过程的精细任务;(2)设计任务的能力,这些任务能够区分特定认知领域的缺陷与因镇静、动机不足、应试技巧差等导致的一般性缺陷所引起的表现不佳;(3)利用动物模型、神经心理学和功能成像将认知缺陷与特定神经系统相联系的能力。CNTRICS召开了一系列会议,以确定来自认知神经科学的能使这些益处最大化的范式,并确定转化应用于临床人群所需的步骤。精神分裂症认知神经科学测试信度及临床应用(CNTRaCS)联盟的成立,就是为了帮助实施这些步骤。CNTRaCS由来自全国五个不同地点的研究人员组成,他们在与被确定为CNTRICs关键部分的广泛认知系统相关的不同专业领域拥有专长。本研究报告了CNTRaCS对作为原始CNTRICs过程一部分所确定的任务进行评估和优化的进展及当前方向,以及随后向研究领域标准(RDoC)的正性效价系统领域的扩展。我们还描述了CNTRaCS目前的重点,即采用计算精神病学方法来测量精神病谱中的认知和动机功能。具体而言,CNTRaCS的当前版本正在使用计算模型来分离反映潜在更具体认知和视觉过程的参数,这些参数可能在理解精神疾病中的共同和不同损伤方面提供更大的可解释性。
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