Cognitive remediation positively impacts cognition and psychopathological symptoms in patients with schizophrenia: A preliminary study

Cognitive impairment is common in patients with schizophrenia and has been found to predict functioning and quality of life. Here we investigated the efficacy of a computer assisted cognitive rehabilitation intervention in patients with Schizophrenia.
Twenty patients with schizophrenia were recruited. Ten participants were randomly allocated to the intervention group (IG) and the other ten served as a sham control group (CG). The IG received biweekly, 60-minute sessions of cognitive rehabilitation with the REHACOM software, and routine psychiatric care for 8-weeks. The CG completed nonspecific sham computer-based activities at home with the same frequency and duration and routine psychiatric care. Primary cognitive outcome measures included the TMT parts A and B, Verbal Fluency Test (VFT), SDMT and secondary outcome measures, the PANSS and WHODAS Scales.
Groups were well matched on demographic and clinical characteristics, premorbid intelligence and severity of cognitive deficits at baseline. Post treatment assessment of the IG group showed significant improvements compared to the CG in attention/processing speed, executive function, semantic fluency, negative, general and total PANSS scales, and the WHODAS.
We provide preliminary evidence supporting the efficacy of restorative cognitive rehabilitation, suggesting that adaptive neuroplasticity may occur after cognitive remediation in this population.

认知损害在精神分裂症患者中十分常见，且已被证实可预测患者的社会功能与生活质量。本研究旨在探讨计算机辅助认知康复干预对精神分裂症患者的疗效。

本研究共招募20名精神分裂症患者，其中10名被随机分配至干预组（IG），剩余10名作为假对照组成员（CG）。干预组在8周内，每两周接受1次时长60分钟的基于REHACOM软件的认知康复训练，并辅以常规精神科护理；对照组则在家中完成相同频率、相同时长的非特异性假计算机操作活动，同时接受常规精神科护理。主要认知结局指标包括连线测验A、B部分（Trail Making Test A/B, TMT）、言语流畅性测验（Verbal Fluency Test, VFT）以及符号数字模态测验（Symbol Digit Modalities Test, SDMT）；次要结局指标则包括阳性与阴性症状量表（Positive and Negative Syndrome Scale, PANSS）及世界卫生组织残疾评定量表（World Health Organization Disability Assessment Schedule, WHODAS）。

两组在基线期的人口学特征、临床特征、病前智力水平及认知损害严重程度方面均匹配良好。

干预后评估结果显示，与对照组相比，干预组在注意力/加工速度、执行功能、语义流畅性、阴性症状量表分、一般精神病理量表分及PANSS总分，以及WHODAS评分方面均出现显著改善。

本研究为恢复性认知康复的疗效提供了初步证据，提示该人群在接受认知矫正治疗后可能出现适应性神经可塑性变化。