New Computer Program Improves Behavioral Symptoms and Brain Activity in Schizophrenia

Printer-friendly versionPrinter-friendly version
Sophia Vinogradov, M.D.
Sophia Vinogradov, M.D.

A hallmark symptom of schizophrenia is difficulty in distinguishing external reality from internal experiences. Whether or not this impairment is irreversible has long been debated. Now, a pilot study at the University of California, San Francisco, led by NARSAD Independent Investigator Grantee Sophia Vinogradov, M.D., has shown that targeted computer “brain training” can improve reality monitoring in people with schizophrenia. NARSAD Young Investigator Grantee Karuna Subramaniam, Ph.D., was the lead author of the research paper, published Feb. 23, 2012 in the journal Neuron.

The symptoms of schizophrenia, beyond delusions and hallucinations, include a range of cognitive and social deficits, such as impaired memory and decision-making, as well as limited ability to read social clues. These problems are not helped by current antipsychotic drugs, and psychotherapeutic measures are of limited benefit. Dr. Vinogradov hypothesized that in order to improve a higher order cognitive function, such as the ability to distinguish experiences created internally from actual external events, training should be designed to target impairments in a range of component processes, including lower-level perceptual processing, attention, working memory, and social cognition.

In the 16-week trial, 31 schizophrenia patients were randomly assigned to one of two groups: one group to receive 80 hours of active cognitive training, the other to serve as controls and spend the 80 hours of the trial period playing various commercial computer games. All the participants were assessed before and after the trial by means of behavioral performance tests and functional magnetic resonance imaging (fMRI) of brain activation patterns. Sixteen healthy comparison subjects were also studied for their brain activation patterns, but did not undergo training.

Before the training, the schizophrenia patients all made errors in reality monitoring tasks. Even when they performed accurately, they showed abnormally low activation of the medial prefrontal cortex (mPFC), a region of the brain associated with self-referential thinking. One of the questions the researchers wanted to answer was whether improved reality monitoring correlated with increased mPFC activity. The cognitive training included auditory verbal processing exercises for ten weeks, visual processing exercises for six weeks and emotion identification exercises throughout the 16 weeks. All of the exercises became progressively more difficult as the patients showed improved performance.

In contrast to the control patients who showed no behavioral or neural improvements, the patients who received the training program demonstrated that they could perform a complex reality monitoring task, one that had not been part of their training exercises, and this improved ability correlated with increased mPFC activity. Equally significant, tests showed that increased mPFC activity was associated with later improved social functioning. Another striking aspect of the research, the authors point out, is that the mean length of illness of the patients was 19 years, showing that even the chronically ill could benefit from this type of training. “These findings,” they state, “demonstrate that a serious behavioral deficit in schizophrenia, and its underlying neural dysfunction, can be improved by well-designed computer cognitive training, resulting in a better quality of life.”

Article comments

Is there any evidence about how long the improvements may last, or if they are permanent?

Is this therapy available for clinical use with patients yet? If so, where?

Thanks so much for making us avare of this very exciting work!

It this therapy available in British Columbia, Canada?

How may one learn more about this study?

How do I sign my son up for this?? He has both Schizophrenia and Asperger's (he is extremely bright with 2 Bachelor degrees). Sharonjml@gmail.com 360-609-3596

Sounds very hopeful.
Please let us know if this software will be available for therapists or clients to purchase at some point or if training in its use might be available in the San Francisco area.

If you have another similar study would you please consider my son Adam Grover. He is 37 years old and you did an MRI on him several years ago. He lives in the Bay Area.

Thanks

This is exciting. How long before it will approved by insurance companies and available to patients?

When, where, how can I get my 35 year old son the opportunity for this training?

Where and when can my son get this help?

If someone lives in the San Francisco Bay Area and has a diagnosis of Schizophrenia or Schizoaffective disorder, they may be eligible to participate in the current research.

They can call Dr. Vinogradov's research coordinator, Brooke Powell, at 415-221-4810 ext 3077, for more information.

I do not live in the San Francisco Bay Area, I live in Austin, Texas. Will there be research, etc, in Texas any time?

I have triplets with schizophrenia, identical boys and a girl. All three are experiencing little to no psychosis. One identical twin is in college, the most impaired identical twin is maintaining his employment of 3 years as a courtesy clerk at a local grocery store chain and is performing progressively better in respect to the negative symptoms. The fraternal twin was the least impacted and is now able to work and go to school but is very disciplined in her regiment. A fourth son, paniced afater his diagnosis and committed suicide. I would be most appreciative of aquiring this software and the identical twins may be interested in a participating in research.

Hello
When, where, how can we get my 14 year old son the opportunity for testing? We live near SF about 4hrs away., (he has signs of delusions and poss hallucinations, social deficits, impaired memory and decision-making, and no ability to read social clues) We think Schizoaffective and Asperger's, no diagnosis or treatment has been given. He is extremely bright.
Thank you -
setterlund@sbcglobal.net

We live in the Midwest - any chance of any testing here or the opportunity for my son's Dr to have him work with these computer programs? He was diagnosed 5 years ago with SZ., and is in his early twenties and struggles every day.

my 23 year old son had 4 months left in college before he was to get his 4 year degree he just all of a sudden went into a mental break down was held in rehab against his will for aweek and treated with schizo meds and returned home with mom he does not seem to be a danger to his self are ours but he will not go to follow up counsling and in seems to be out of touch with the real world he says god will take care of his needs what can i do ? he was not aloud to go back to the college because he wont go to counsling that he needs please help this mom to help her son thank you

IS THERE A SIMILAR COMPUTER PROGRAM FOR DEPRESSION OR MIGHT THIS ECT WORK ON DEPRESSION?

How can we access this computer programming? It must be available somewhere.

This sounds very hopeful. Is this therapy available for clinical use for patients yet? If so, where?
Thank you

Please call Dr. Vinogradov's research coordinator, Brooke Powell, at 415-221-4810 ext 3077, for more information about purchasing the computer software.

I viewed the “Changing Your Mind” episode on the nature of things with David Suzuki, which led me to research more and come to this article. I quickly recognised that I have lived most of my life with many of the cognitive impairments as described in your second paragraph above. I don't suffer from the distortion of reality which is most commonly found in schizophrenic individuals. I was just wondering if; 1)you could indicate some of the medical blood test, such as (BDNF) and other so that I can get some preliminary diagnostic, and 2) if I can buy the computer games that you have perfected for this treatment. Thank you, Pierre

Add new comment

comments

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.

Please note that researchers cannot give specific recommendations or advice about treatment; diagnosis and treatment are complex and highly individualized processes that require comprehensive face-to- face assessment. Please visit our "Ask an Expert" section to see a list of Q & A with NARSAD Grantees.
By submitting this form, you accept the Mollom privacy policy.