fMRI of Cognitive Remediation Therapy in Schizophrenia

精神分裂症认知矫正治疗的功能磁共振成像

• 批准号: 6821565
• 负责人: BRUCE E. WEXLER
• 金额: $ 19.64万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-07-16 至 2006-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6821565
• 关键词: behavioral /social science research tag; brain imaging /visualization /scanning; clinical research; cognition disorders; cognitive behavior therapy; frontal lobe /cortex; functional magnetic resonance imaging; human subject; human therapy evaluation; image processing; mood disorders; patient oriented research; schizophrenia

DESCRIPTION (provided by applicant): Cognitive dysfunctions are major and debilitating features of schizophrenia and schizoaffective disorder (scz-sza). Even after clinical symptom remission, persistent cognitive deficits limit school and work performance and response to behavioral treatments. Some of the most prominent and problematic of these dysfunctions, those in working memory and certain types of problem solving, are thought to reflect frontal lobe dysfunction. Since frontal lobe dysfunction is central in current models of the pathophysiology of scz-sza, cognitive deficits are of relevance both to patient quality of life and to the pathophysiology of the illness. Because of this, new efforts to understand and treat the cognitive deficits of scz-sza are significant for both understanding and for treating the disorders. Most currently available treatments are of limited benefit for the cognitive deficits of scz-sza. One possible, promising exception are new behavioral treatments developed specifically to address the cognitive deficits with varying mixes of instructions and drill and practice. We have been leaders in the development and evaluation of these treatments, and have provided preliminary evidence of substantial and enduring improvements in cognitive function. At this early state in the research, there are several important questions about the relationship between the observed improvements in cognitive function and possible changes in underlying brain dysfunctions. Answers to these questions are important for understanding the nature of the treatments, optimizing further development of the treatments and assessing the potential of the treatments to fundamentally alter the course of illness. An R-0l funded evaluation of behavioral effects of cognitive treatment is ongoing in our laboratory. R-21 support is requested to support exploratory and developmental fMRI studies that will provide preliminary data on changes in regional brain activation associated with behavioral treatment of cognitive dysfunctions, and develop methods for fuller study of these changes.

描述（由申请人提供）：认知功能障碍是精神分裂症和精神分裂症（SCZ-SZA）的主要和使人衰弱的特征。即使在临床症状缓解后，持续的认知缺陷也会限制学校的工作表现以及对行为治疗的反应。这些功能障碍中最突出和有问题的一些，那些在工作记忆和某些类型的问题解决的功能中，被认为反映了额叶功能障碍。由于额叶功能障碍在SCZ-SZA病理生理学的当前模型中至关重要，因此认知缺陷既与患者的生活质量和疾病的病理生理学都相关。因此，了解和治疗SCZ-SZA的认知缺陷的新努力对于理解和治疗疾病都是重要的。当前的大多数可用治疗方法对SCZ-SZA的认知缺陷有限。一种可能有希望的例外是专门为解决认知缺陷而开发的新行为治疗方法，其中包括不同的指令，练习和实践。我们一直是这些治疗方法发展和评估的领导者，并提供了认知功能的实质性和持久改善的初步证据。在研究的早期状态下，关于观察到的认知功能的改善与潜在脑功能障碍的可能变化之间的关系存在几个重要问题。这些问题的答案对于理解治疗的性质，优化治疗的进一步发展以及评估治疗方法从根本上改变疾病进程的潜力很重要。在我们的实验室中，R-0L资助的认知治疗行为影响的评估正在进行中。请求R-21支持以支持探索性和发育功能磁共振成像研究，该研究将提供有关与认知功能障碍行为治疗相关的区域大脑激活变化的初步数据，并开发了对这些变化进行更全面研究的方法。