Cognitive Remediation Activates Neuroplasticity and Improves Social Cognition in Schizophrenia

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2005 NARSAD Young Investigator Grantee, Christine I. Hooker, Ph.D., now an Associate Professor in Psychology at Harvard, expert on schizophrenia
Christine I. Hooker, Ph.D.

Schizophrenia-associated deficits in cognition are not substantially improved by medication, but have been shown to improve with remedial cognitive training. The mechanisms that support this improvement have been largely unknown. Social cognition skills, such as being able to recognize what emotions faces are expressing, are severely impaired in people with schizophrenia and significantly affect their ability to interact appropriately with others in daily life.

Until recently, most cognitive remediation studies have concentrated on basic cognitive skills, such as attention and memory, in which schizophrenia patients showed significant improvements but they did not show improvement in social cognition. Neuroplasticity-based rehabilitation models suggest that in order for cognitive remediation to produce long-lasting functional benefits, behavioral training needs to restore the neural mechanisms that support the cognitive skill.

Recent research led by 2005 NARSAD Young Investigator Grantee, Christine I. Hooker, Ph.D., now an Associate Professor in Psychology at Harvard, sought to identify whether a cognitive remediation intervention that targeted both cognitive and social cognitive skills would induce beneficial neural changes in regions that specifically support social cognition.

Reporting her findings in the journal Schizophrenia Research (online June 2012), Dr. Hooker explains: “Cognitive remediation holds tremendous promise as a functionally beneficial treatment for schizophrenia. To maximize these benefits, it is imperative to understand how cognitive training contributes to behavioral improvement.”

Her multi-institutional study included 22 patients with schizophrenia who were randomly selected to receive either remedial intervention or placebo treatment in the form of nonspecific computer games. The study was a collaborative effort between the University of California, Berkeley, where Dr. Hooker was doing her research and the University of California, San Francisco (UCSF). NARSAD Independent Investigator Grantee Sophia Vinogradov, M.D., Vice Chair of the Department of Psychiatry at UCSF was also part of the research team.

Pre- and post-intervention assessments included a functional MRI task of positive and negative facial emotion recognition as well as standard behavioral assessments. The project focused largely on facial emotion recognition because the neural regions that process facial emotion are clearly defined and distinct from regions that process non-emotional information. In comparison to patients who participated in computer games for an equal number of hours, the patients who participated in the cognitive plus social-cognitive training showed significant improvements in behavioral and neural measures of emotion processing. On an fMRI facial emotion task, the cognitive plus social-cognitive intervention was associated with an increase in neural activity and the increase in neural activity predicted behavioral improvement in emotion recognition.

Since emotion recognition skills have been shown to predict broader measures of social functioning in schizophrenia, the findings suggest that targeted training which includes emotion recognition could have downstream functional benefits for individuals with schizophrenia. The findings also suggest that even among patients with chronic schizophrenia, dysfunctional neural circuits are malleable and can potentially benefit from neuroplasticity-based cognitive training.

Article comments

Hello
Would neuroplasticity based cognitive training work with prosopagnosia? I understand that some prosopagnosics are able to read facial expressions, but could it help them to see faces more holistically?

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My son Jeffery, 26, CMU graduate has lost "his brain" As well as responding appropriately to people's faces and speech.We line in the tri-state ny,nj, conn area is there a place he can go that won't cost a fortune. (He has medicare) Yours Truly Steven Sander

For answers to specific questions, please submit questions through our "Ask the Expert" section: http://bbrfoundation.org/question. Also, look through our previously answered questions in case an answer is already provided to your question: http://bbrfoundation.org/answers/ask-an-expert. To contact specific researchers, you must contact the university or institution they work for. Thanks. - Brain & Behavior Research Foundation.

How do I cite and reference this page, please?

Hi, thanks for asking. In your citation and reference of this page, we ask that you credit the Brain & Behavior Research Foundation and include a link to our website (specific to this article). If you have any other questions, please send us an email: jokun@bbrfoundation.org. Thanks, Josh Okun - Associate Manager of Web Services, Brain & Behavior Research Foundation.

Hi Josh, I am wondering regarding referencing, who is the author of the article? Thank you. Very interesting topic.

Thank you very much for igniting my interest.

though I should point out that the psychology of the human mind will always ignite my spark... ;)

I have seen a research article by a UC Berkeley Neuroscience faculty which talked about changes in our genetic structure with meditation and/or relaxation techniques. This info came about as a by-product of Schizophrenia research. The faculty member's first name started as Patricia, however, I do not remember any other info. I have been unsuccessful in getting this info even via Google

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