Enhancing Cognitive Training through Exercise after a First Schizophrenia Episode

第一次精神分裂症发作后通过锻炼加强认知训练

基本信息

批准号：
8776334
负责人：
KEITH H NUECHTERLEIN
金额：
$ 34.81万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-12-01 至 2016-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8776334
关键词：
Address Adverse effects Aerobic Exercise Applications Grants Biological Brain Brain-Derived Neurotrophic Factor Chronic Cognition Cognitive Cognitive deficits Cognitive remediation Communities Data Deterioration Disease Educational Intervention Educational process of instructing Exercise Goals Growth Factor Health Impaired cognition Impairment Independent Living Individual Intervention Intervention Studies Intervention Trial Lead Measures Meta-Analysis Metabolic syndrome National Institute of Mental Health Neuronal Plasticity Outcome Measure Outpatients Persons Pharmaceutical Preparations Public Health Randomized Randomized Controlled Clinical Trials Randomized Controlled Trials Relative (related person)Risk Schizophrenia Staging Strategic Planning Training Programs base cognitive function cognitive training computerized cost design disability efficacy testing efficacy trial first episode schizophrenia functional improvement functional outcomes improved innovation neurotrophic factor neurotropin novel physical conditioning prevent primary outcome programs remediation secondary outcome severe mental illness skills treatment duration

项目摘要

DESCRIPTION (provided by applicant): This R34 application is designed to move our innovative treatment approach to improving cognition in schizophrenia from the feasibility stage to the pilot intervention trial stage. We propose a randomized controlled 6-month trial of the efficacy of a novel intervention combining neuroplasticity-based cognitive training with neurotrophin-releasing aerobic exercise, compared to the same cognitive training alone. Both of these treatments address the NIMH Strategic Plan and NIMH Director Tom Insel's request to create innovative interventions that can be "disseminated broadly" and "readily taught to the existing workforce with minimal cost." The primary treatment targets are overall cognitive deficit level and impairment in independent living skills. A secondary outcome variable will be a key neurotrophic growth factor, brain-derived neurotrophic factor (BDNF). We hypothesize that combining neuroplasticity-based computerized cognitive training and neurotrophin-enhancing physical exercise will produce large cognitive and functional improvements, even relative to cognitive training alone. Based on theoretical considerations and our initial pilot data, the new cognitive training plus aerobic exercise intervention has the potential to make a real difference in the lives of individuals with severe mental illness. Adding aerobic exercise to our cognitive training program will have the additional benefit of helping to ameliorate medication side effects, reduce the risk for developing metabolic syndrome, and help to prevent the deterioration in physical health that usually follows the onset of schizophrenia and its pharmacologic treatment. Cognitive deficits in persons with schizophrenia present an enormous challenge when helping them to return to functioning in the community. Cognitive remediation and physical exercise have each been shown separately to have promise for improving cognitive deficits in schizophrenia, but used separately yield moderate effects. Our initial pilot data suggest that integrating these two interventions produces larger cognitive gains than the cognitive training alone. We posit that the increases in neurotrophic factors associated with regular aerobic exercise provide a platform which allows neuroplasticity-based cognitive training to impact cognition to a greater degree than is typically observed in studies of cognitive training alone. We target the period shortly after a first episode of schizophrenia to maximize the generalization of cognitive improvement to functional outcome, before chronic disability is established.

描述（由申请人提供）：此R34申请旨在将我们创新的治疗方法转化为将精神分裂症的认知从可行性阶段提高到飞行员干预试验阶段。我们提出了一项随机对照的6个月试验，该试验与仅相同的认知训练相比，将基于神经塑性的认知训练与神经营养蛋白释放有氧运动相比，将基于神经塑性的认知训练与神经营养蛋白释放有氧运动的功效相比。这两种治疗方法都涉及NIMH战略计划，以及NIMH董事汤姆·因斯尔（Tom Insel）的要求，要求创建创新干预措施，这些干预措施可以“大致传播”，并“以最低的成本向现有的劳动力教授。”主要的治疗目标是总体认知缺陷水平和独立生活技能的损害。次要结果变量将是关键的神经营养生长因子，脑衍生的神经营养因子（BDNF）。我们假设将基于神经塑性的计算机认知训练与神经营养蛋白增强体育锻炼相结合将产生较大的认知和功能改善，甚至相对于仅相对于认知训练。根据理论考虑和我们最初的试验数据，新的认知训练以及有氧运动干预有可能对患有严重精神疾病的人的生活产生真正的改变。在我们的认知训练计划中添加有氧运动将有其他好处，以帮助改善药物副作用，降低发展代谢综合征的风险，并有助于防止精神分裂症及其药理治疗的身体健康状况恶化。精神分裂症患者的认知缺陷在帮助他们返回社区工作时提出了巨大的挑战。认知补救和体育锻炼分别显示出有望改善精神分裂症的认知缺陷，但分别使用了中等影响。我们最初的试点数据表明，与仅认知训练相比，整合这两种干预措施会产生更大的认知增长。我们认为，与常规有氧运动相关的神经营养因素的增加提供了一个平台，可以使基于神经可塑性的认知训练能够在更大的程度上影响认知，这比仅在认知训练的研究中通常观察到的程度更大。我们在精神分裂症的第一集后不久，针对这一时期，以最大程度地提高对功能结果的认知改善的概括，并在建立慢性残疾之前。