Cognitive remediation in schizophrenia: the earlier the better?
Autor: | Maria Gloria Rossetti, Chiara Ricciardi, Paolo Brambilla, Marcella Bellani, Cinzia Perlini, Niccolò Zovetti |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Time Factors
Epidemiology review Epidemiology for Behavioural Neurosciences Affect (psychology) 03 medical and health sciences 0302 clinical medicine Cognition Social cognition Early Medical Intervention Neuroplasticity medicine Humans Effects of sleep deprivation on cognitive performance neuroimaging Functional Neuroimaging Public Health Environmental and Occupational Health Brain medicine.disease Cognitive training 030227 psychiatry cognitive remediation early schizophrenia Psychiatry and Mental health Schizophrenia Cognitive remediation therapy Psychology Neuroscience 030217 neurology & neurosurgery |
Zdroj: | Epidemiology and Psychiatric Sciences |
Popis: | Impairments in neuro and social cognition are considered core features of schizophrenia (SCZ) since they affect patients' functioning and contribute to poor socio-occupational outcomes. Therefore, the improvement of cognitive performances has become a primary goal in the care of patients with SCZ, especially in the first phases of the disease, as early interventions may favour better long-term outcomes. Cognitive remediation (CR) is a behavioural training aimed at improving cognitive functions with the goal of durability and generalisation in everyday life. Neuroimaging studies suggest that CR leads to neuroplasticity in chronic SCZ, whereas only a few studies tested the neural effects of CR in the early phase of the disease. Thus, in this review, we aimed at summarising CR-induced structural and functional brain changes in early SCZ. Existing evidence showed a protective effect of CR on grey matter volume in selected medial-temporal (i.e. hippocampus, parahippocampus and amygdala) and thalamic regions whereas functional changes affected mostly dorsolateral prefrontal and insular cortices both associated with improvements in cognitive performance and emotion regulation. Overall, CR in early SCZ appears to be associated with neural adaptations mostly allocated in prefrontal and limbic regions, however future longitudinal studies are needed to clarify whether the positive effects of cognitive training persist over time. It may also be interesting to investigate whether the application of CR in the early v. the late stage of the disease may lead to incremental benefits. |
Databáze: | OpenAIRE |
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