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Randomized Controlled Trial
. 2014 Mar;153(1-3):177-83.
doi: 10.1016/j.schres.2014.01.016. Epub 2014 Jan 30.

d-Cycloserine augmentation of cognitive remediation in schizophrenia

Christopher K Cain  1 , Margaret McCue  2 , Iruma Bello  3 , Timothy Creedon  4 , Dei-In Tang  5 , Eugene Laska  6 , Donald C Goff  7
Affiliations
Randomized Controlled Trial

d-Cycloserine augmentation of cognitive remediation in schizophrenia

Christopher K Cain et al. Schizophr Res. 2014 Mar.

Abstract

d-Cycloserine (DCS) has been shown to enhance memory and, in a previous trial, once-weekly DCS improved negative symptoms in schizophrenia subjects. We hypothesized that DCS combined with a cognitive remediation (CR) program would improve memory of a practiced auditory discrimination task and that gains would generalize to performance on unpracticed cognitive tasks. Stable, medicated adult schizophrenia outpatients participated in the Brain Fitness CR program 3-5 times per week for 8weeks. Subjects were randomly assigned to once-weekly adjunctive treatment with DCS (50mg) or placebo administered before the first session each week. Primary outcomes were performance on an auditory discrimination task, the MATRICS cognitive battery composite score and the Scale for the Assessment of Negative Symptoms (SANS) total score. 36 subjects received study drug and 32 completed the trial (average number of CR sessions=26.1). Performance on the practiced auditory discrimination task significantly improved in the DCS group compared to the placebo group. DCS was also associated with significantly greater negative symptom improvement for subjects symptomatic at baseline (SANS score ≥20). However, improvement on the MATRICS battery was observed only in the placebo group. Considered with previous results, these findings suggest that DCS augments CR and alleviates negative symptoms in schizophrenia patients. However, further work is needed to evaluate whether CR gains achieved with DCS can generalize to other unpracticed cognitive tasks.

Keywords: Cognitive remediation; MATRICS; Memory; SANS; Schizophrenia; d-Cycloserine.

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Figures

Figure 1
Figure 1
Flow of participants involved in study.
Figure 2
Figure 2. D-cycloserine facilitates auditory discrimination memory
A) Baseline performance. B) Performance across the 8-week trial, expressed as a change from baseline. All assessments were made prior to DCS (black) or Placebo (white) administration. *p<0.05 vs. Placebo, n.s. = not significant (p>0.05). Error bars = standard error of the mean.
Figure 3
Figure 3. Eight week change in SANS total score for participants with clinically significant negative symptoms at baseline
Error bars = standard error of the mean.
See this image and copyright information in PMC

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