Poppe Anika, Bais Leonie, van Duin Daniëlle, Ćurčić-Blake Branislava, Pijnenborg Gerdina Hendrika Maria, van der Meer Lisette
Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands.
Department of Rehabilitation, Lentis Psychiatric Institute, Lagerhout E35, 9741 KE Zuidlaren, the Netherlands.
Schizophr Res Cogn. 2025 Jun 10;42:100358. doi: 10.1016/j.scog.2025.100358. eCollection 2025 Dec.
Cognitive impairments are commonly experienced by individuals with severe mental illness (SMI) and are associated with problems in everyday life. This pragmatic, randomized, controlled, pilot trial explored the acceptability, feasibility, and preliminary effects of cognitive remediation (CR) combined with transcranial direct current stimulation (tDCS) for cognitive and everyday functioning in individuals with SMI in long-term psychiatric clinical care. We hypothesized that combining CR and tDCS is feasible and acceptable to individuals with SMI.
Twenty-four individuals with SMI were randomized to either CR + active tDCS ( = 13) or CR + sham tDCS ( = 11) over 32 sessions (16 weeks). Acceptability was evaluated in semi-structured interviews. Cognitive and everyday functioning were evaluated at baseline, post-16 week waiting period, post-intervention, and 6-months post-intervention.
Overall, participants were positive about the training. Over 60 % of participants successfully finished at least 20 sessions, meeting the predefined criteria for feasibility. CR appeared to yield subjective improvements to participants, significant improvements in cognitive tests post-intervention and at follow-up and improved self-reported negative symptoms at follow-up. Observer-rated everyday functioning and cognition, and subjective cognitive complaints did not change following CR.
This study concludes that CR is an acceptable and feasible intervention for individuals with SMI in long-term psychiatric clinical care. The addition of tDCS requires further investigation to ascertain its potential benefits.
严重精神疾病（SMI）患者常出现认知障碍，且与日常生活中的问题相关。这项实用、随机、对照的试点试验探讨了认知康复（CR）联合经颅直流电刺激（tDCS）对长期精神科临床护理中SMI患者认知及日常功能的可接受性、可行性和初步效果。我们假设CR与tDCS联合对SMI患者是可行且可接受的。
24名SMI患者被随机分为CR + 有源tDCS组（n = 13）或CR + 假tDCS组（n = 11），共进行32次治疗（16周）。通过半结构化访谈评估可接受性。在基线、16周等待期后、干预后及干预后6个月评估认知和日常功能。
总体而言，参与者对训练持积极态度。超过60%的参与者成功完成了至少20次治疗，达到了预先定义的可行性标准。CR似乎使参与者主观上有所改善，干预后及随访时认知测试有显著改善，随访时自我报告的阴性症状有所改善。观察者评定的日常功能和认知以及主观认知主诉在CR后未发生变化。
本研究得出结论，CR对长期精神科临床护理中的SMI患者是一种可接受且可行的干预措施。tDCS的添加需要进一步研究以确定其潜在益处。
