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：
8624560
负责人：
KEITH H NUECHTERLEIN
金额：
$ 34.65万
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 2015-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8624560
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 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 public health relevance 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）：该 R34 申请旨在将我们改善精神分裂症认知的创新治疗方法从可行性阶段推进到试点干预试验阶段。我们提出了一项为期 6 个月的随机对照试验，以对比单独进行相同的认知训练，将基于神经可塑性的认知训练与释放神经营养素的有氧运动相结合的新型干预措施的效果。这两种治疗方法都满足了 NIMH 战略计划和 NIMH 主任 Tom Insel 的要求，即创建可以“广泛传播”并“以最低成本轻松向现有员工传授”的创新干预措施。主要治疗目标是整体认知缺陷水平和独立生活技能受损。次要结果变量是关键的神经营养生长因子，即脑源性神经营养因子（BDNF）。我们假设，将基于神经可塑性的计算机认知训练和神经营养素增强体育锻炼相结合，即使相对于单独的认知训练，也会产生巨大的认知和功能改善。根据理论考虑和我们的初步试验数据，新的认知训练加上有氧运动干预有可能对严重精神疾病患者的生活产生真正的影响。在我们的认知训练计划中添加有氧运动将具有帮助改善药物副作用的额外好处，降低患代谢综合征的风险，并有助于防止通常在精神分裂症发作及其药物治疗后出现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恢复社会功能时提出了巨大的挑战。认知矫正和体育锻炼分别被证明有望改善精神分裂症的认知缺陷，但单独使用效果中等。我们的初步试点数据表明，整合这两种干预措施比单独进行认知训练能产生更大的认知收益。我们认为，与定期有氧运动相关的神经营养因子的增加提供了一个平台，使基于神经可塑性的认知训练能够比单独认知训练研究中通常观察到的更大程度地影响认知。我们以精神分裂症首次发作后不久的时期为目标，在确定慢性残疾之前，最大限度地将认知改善推广到功能结果。