Neuroscience-Guided Cognitive Remediation in Adolescents at Risk for Psychosis

对有精神病风险的青少年进行神经科学引导的认知治疗

• 批准号: 7590275
• 负责人: Sophia Vinogradov
• 金额: $ 42.91万
• 依托单位: NORTHERN CALIFORNIA INSTITUTE/RES/EDU
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-01 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7590275
• 关键词: Adolescent; Adult; Age; Anterior; Antidepressive Agents; Antipsychotic Agents; Attention; Attenuated; Brain; Brain-Derived Neurotrophic Factor; California; Chronic Schizophrenia; Clinical; Cognition; Cognitive remediation; Computers; Control Groups; Data; Diagnostic; Episodic memory; Exercise; Functional Magnetic Resonance Imaging; Funding; Gender; Hour; Impaired cognition; Individual; Intervention; Learning; Maps; Matched Group; Measures; Memory; Neuronal Plasticity; Neurosciences; Operative Surgical Procedures; Outcome; Patients; Pattern; Pharmaceutical Preparations; Pharmacological Treatment; Plasma; Prefrontal Cortex; Problem Solving; Psychotic Disorders; Public Health; Randomized Controlled Trials; Research; Risk; Schizophrenia; Serum; Short-Term Memory; Site; Symptoms; Syndrome; Task Performances; Testing; Thinking; Training; Verbal Learning; Youth; active control; base; cingulate cortex; cognitive control; cognitive training; computerized; executive function; experience; first episode psychosis; high risk; improved; information processing; meetings; open label; prevent; processing speed; response; severe mental illness; sex; young adult

DESCRIPTION (provided by applicant): The purpose of this project is to "rescue" the psychosis-prone brain by normalizing the cognitive dysfunction of adolescents and young adults who are at high risk for developing a first psychotic episode. We will apply 80 hours (16 weeks) of intensive computerized neuroadaptive cognitive training exercises to 40 ultra high-risk (UHR) adolescents and transitional age youth, ages 16-25, who meet diagnostic criteria for the "prodromal syndrome" in schizophrenia. Subjects will be drawn collaboratively from two research sites in California (UCSF and UC Davis). The effects of this neuroplasticity-based cognitive remediation on these very high-risk youth will be compared to the effects obtained in an age- and sex- matched group of healthy comparison subjects, and to the effects obtained in a matched group of 40 UHR youth who undergo a computer games "active control" condition. This approach is supported by data from our current NIMH-funded randomized controlled trial of neuroplasticity-based cognitive remediation in adult patients with chronic schizophrenia, where highly significant improvements in processing speed, working memory, and verbal learning and memory, are apparent after 60 hours of intensive training. Preliminary "open-label" data from three UHR adolescents who participated in 40 hours of training exercises showed mean z-score improvements of 0.9 on attention/working memory, 0.7 on episodic memory, and 1.1 on executive functioning. Our overall aims are thus to: 1) Use principles from experimental neuroscience to harness mechanisms of brain plasticity and correct aberrant information processing in the cortex of UHR individuals; 2) Prevent or attenuate the onset of psychotic disorder and improve adaptive functioning in these adolescents and transitional age youth. PUBLIC HEALTH NARRATIVE: The purpose of this study is to use neuroscience-guided computerized training exercises to remediate the thinking difficulties that occur in young people who are at very high risk of developing a psychotic episode. If this intervention proves useful, it will provide a non- pharmacological treatment approach for young people that is safe and easy to apply, and that may reduce the risk for serious mental illness as well as improve long-term outcome.

描述（由申请人提供）：该项目的目的是通过标准化青少年和年轻人的认知功能障碍来“挽救”容易发生的大脑，这些功能障碍是发展第一个精神病性发作的高风险。我们将向40个高风险（UHR）青少年和16-25岁的年龄符合40个超风险（UHR）青少年和过渡年龄的年龄，将80小时（16周）进行密集的计算机化神经适应性认知训练练习，他们符合精神分裂症的“原始综合症”的诊断标准。受试者将从加利福尼亚州的两个研究站点（UCSF和UC Davis）进行协作。将这种基于神经塑性的认知补救对这些非常高风险的青年的影响与在年龄和性别匹配的健康比较主题组中获得的影响以及在接受计算机游戏“主动控制”状态的40个UHR青年中获得的影响。这种方法得到了我们当前NIMH资助的基于神经塑性的认知补救的随机对照试验的数据，在慢性精神分裂症患者中，在60小时的强化训练后，显然是在处理速度，工作记忆和言语学习和记忆方面的显着改善。参加40个小时的训练练习的三个UHR青少年的初步“开放标签”数据显示，注意/工作记忆的平均Z分数改善为0.9，偶发记忆为0.7，在执行功能方面为1.1。因此，我们的总体目的是：1）使用实验性神经科学到脑可塑性的线束机制的原则，并在UHR个体的皮层中正确的异常信息处理； 2）预防或减轻精神病的发作并改善这些青少年和过渡年龄青年的适应性功能。 公共卫生叙事：这项研究的目的是使用神经科学指导的计算机化培训练习来补救年轻人在患有精神病发作的高风险中发生的思维困难。如果这种干预措施有用，它将为年轻人提供一种非药理治疗方法，该方法安全易于应用，这可能会降低严重精神疾病的风险并改善长期结局。