Bergson Zachary, Ahmed Anthony O, Bell Jewel, Butler Pamela D, Gordon James, Seitz Aaron R, Silverstein Steven M, Thompson Judy L, Zemon Vance
Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.
Department of Psychiatry, Weill Cornell Medicine, White Plains, NY, USA.
Schizophr Res. 2024 Dec;274:396-405. doi: 10.1016/j.schres.2024.10.010. Epub 2024 Oct 30.
Schizophrenia (SZ) is associated with visual processing impairments, which are related to higher-level functional impairments. This study investigated the impact of a novel visual remediation intervention (VisR) targeting low- and mid-level visual processing impairments in SZ. We hypothesized that VisR would lead to greater improvements in contrast processing when compared to an active control condition and explored potential treatment-related changes in symptom severity. SZ participants (N = 47) were randomized into one of four groups: an active control group (cognitive training; AC); Contrast Sensitivity Training + AC (CST + AC); Contour Integration Training + AC (CIT + AC); and CST + CIT. Participants completed 20-40 training sessions. Clinical symptom severity was assessed using the Positive and Negative Syndrome Scale and contrast processing was assessed using steady-state visual evoked potentials to increasing levels of contrast of isolated-check pattern stimuli. A significant Group × Timepoint × Contrast interaction indicated superiority of CST + CIT over AC for improving contrast processing. Furthermore, a large, significant Group × Timepoint interaction indicated that CST + CIT was associated with a greater reduction in positive symptoms compared to AC. In addition, lower severity of positive symptoms at baseline was associated with a greater improvement in contrast processing over the course of treatment. This initial evaluation of VisR demonstrated that it is well tolerated and may produce greater improvements in contrast processing and positive symptoms compared to an intervention targeting only high-level cognitive functions.
精神分裂症（SZ）与视觉处理障碍有关，而视觉处理障碍又与更高级别的功能障碍相关。本研究调查了一种新型视觉修复干预措施（VisR）对SZ患者低水平和中等水平视觉处理障碍的影响。我们假设，与主动对照条件相比，VisR在对比处理方面会带来更大的改善，并探索了与治疗相关的症状严重程度的潜在变化。SZ患者（N = 47）被随机分为四组之一：主动对照组（认知训练；AC）；对比敏感度训练+AC（CST + AC）；轮廓整合训练+AC（CIT + AC）；以及CST + CIT。参与者完成了20至40次训练课程。使用阳性和阴性症状量表评估临床症状严重程度，并使用稳态视觉诱发电位评估对孤立方格图案刺激对比度增加水平的对比处理。显著的组×时间点×对比度交互作用表明，在改善对比处理方面，CST + CIT优于AC。此外，显著的大组×时间点交互作用表明，与AC相比，CST + CIT与阳性症状的更大减少相关。此外，基线时阳性症状的严重程度较低与治疗过程中对比处理的更大改善相关。对VisR的这一初步评估表明，它耐受性良好，与仅针对高级认知功能的干预措施相比，可能在对比处理和阳性症状方面产生更大的改善。
