Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Summer;7(2):211-230.
doi: 10.1086/686538. Epub 2016 May 2.

Cognitive Enhancement Therapy Improves Resting-State Functional Connectivity in Early Course Schizophrenia

Shaun M Eack  1 , Christina E Newhill  2 , Matcheri S Keshavan  3
Affiliations

Cognitive Enhancement Therapy Improves Resting-State Functional Connectivity in Early Course Schizophrenia

Shaun M Eack et al. J Soc Social Work Res. 2016 Summer.

Abstract

Objective: Cognitive remediation is emerging as an effective psychosocial intervention for addressing untreated cognitive and functional impairments in persons with schizophrenia, and might achieve its benefits through neuroplastic changes in brain connectivity. This study seeks to examine the effects of cognitive enhancement therapy (CET) on fronto-temporal brain connectivity in a randomized controlled trial with individuals in the early course of schizophrenia.

Method: Stabilized, early course outpatients with schizophrenia or schizoaffective disorder (N = 41) were randomly assigned to CET (n = 25) or an active enriched supportive therapy (EST) control (n = 16) and treated for 2 years. Functional MRI data were collected annually, and pseudo resting-state functional connectivity analysis was used to examine differential changes in fronto-temporal connectivity between those treated with CET compared with EST.

Results: Individuals receiving CET evidenced significantly less functional connectivity loss between the resting-state network and the left dorsolateral prefrontal cortex as well as significantly increased connectivity with the right insular cortex compared to EST (all corrected p < .01). These neural networks are involved in emotion processing and problem-solving. Increased connectivity with the right insula significantly mediated CET effects on improved emotion perception (z' = -1.96, p = .021), and increased connectivity with the left dorsolateral prefrontal cortex mediated CET-related improvements in emotion regulation (z' = -1.71, p = .052).

Conclusions: These findings provide preliminary evidence that CET, a psychosocial cognitive remediation intervention, may enhance connectivity between frontal and temporal brain regions implicated in problem-solving and emotion processing in service of cognitive enhancement in schizophrenia.

Keywords: cognitive remediation; functional magnetic resonance imaging; schizophrenia; social cognition.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Participant flow in a 2-year randomized-controlled trial of cognitive enhancement therapy versus enriched supportive therapy for early course schizophrenia. *One participant in EST had fMRI data available only at Year 2.
Figure 2
Figure 2
Fronto-temporal resting state functional connectivity changes during a 2-year trial of cognitive enhancement therapy versus enriched supportive therapy in early course schizophrenia.
Figure 3
Figure 3
Two-year associations between changes in resting state connectivity and emotion processing outcomes in early course schizophrenia.
See this image and copyright information in PMC

References

    1. Ben-Yishay Y, Piasetsky EB, Rattok J. A systematic method for ameliorating disorders in basic attention. In: Meir MJ, Benton AL, Diller L, editors. Neuropsychological rehabilitation. Guilford Press; New York, NY: 1985. pp. 165–181.
    1. Bracy OL. PSSCogRehab [Computer software] Psychological Software Services; Indianapolis, IN: 1994.
    1. Braw Y, Bloch Y, Mendelovich S, Ratzoni G, Gal G, Harari H, Levkovitz Y. Cognition in young schizophrenia outpatients: Comparison of first-episode with multiepisode patients. Schizophrenia Bulletin. 2008;34:544–554. http://dx.doi.org/10.1093/schbul/sbm115. - DOI - PMC - PubMed
    1. Buckner RL, Andrews-Hanna JR, Schacter DL. The brain’s default network: Anatomy, function, and relevance to disease. Annals of the New York Academy of Sciences. 2008;1124:1–38. http://dx.doi.org/10.1196/annals.1440.011. - DOI - PubMed
    1. Carter CS, Barch DM. Cognitive neuroscience-based approaches to measuring and improving treatment effects on cognition in schizophrenia: The CNTRICS initiative. Schizophrenia Bulletin. 2007;33:1131–1137. http://dx.doi.org/10.1093/schbul/sbm081. - DOI - PMC - PubMed

LinkOut - more resources