An fMRI study of cognitive remediation in drug-naïve subjects diagnosed with first episode schizophrenia

• Published in: Wiener Klinische Wochenschrift Vol. 134; no. 5-6; pp. 249 - 254
• Main Authors: Furtner, Julia, Schöpf, Veronika, Erfurth, Andreas, Sachs, Gabriele
• Format: Journal Article
• Language: English
• Published: Vienna Springer Vienna 01.03.2022
• Subjects: Antipsychotic Agents - therapeutic use; Cognitive Remediation - methods; Endocrinology; Gastroenterology; Humans; Internal Medicine; Magnetic Resonance Imaging - methods; Medicine; Medicine & Public Health; Memory, Short-Term - physiology; Pneumology/Respiratory System; Schizophrenia - diagnostic imaging; Schizophrenia - therapy; Short Report; Atypical antipsychotics; Randomized study; Neuronal activity; Working memory; Activation clusters
• ISSN: 0043-5325; 1613-7671; 1613-7671
• DOI: 10.1007/s00508-021-01910-2

Summary Objective The purpose of our functional magnetic resonance imaging (fMRI) study was to examine brain activity using a “1-back” paradigm as working memory task in drug-naïve subjects with first episode schizophrenia before and after cognitive remediation training. Methods In this study 15 drug-naïve first episode subjects who met DSM-IV criteria for schizophrenia were randomized to receive either atypical antipsychotics (AP, n  = 8) or atypical antipsychotics in combination with cognitive remediation therapy (AP + CR, n  = 7), 11 subjects had a follow-up fMRI examination after therapy (AP, n  = 5; AP + CR, n  = 6). Results In 4 of the 6 AP + CR subjects the number of activation clusters increased, whereas in 4 out of the 5 AP subjects the number of clusters decreased (mean number of clusters: AP + CR = 5.53, SD 12.79, AP = −5.8, SD 6.9). Conclusion In this randomized study the number of activation clusters during a working memory task increased after cognitive remediation training. Our data show that neurobiological effects of cognitive remediation can be identified in the very early course of schizophrenia.