Verbal learning deficits associated with increased anticholinergic burden are attenuated with targeted cognitive training in treatment refractory schizophrenia patients

Autor: Lauren Cardoso, Yash B. Joshi, Michael L. Thomas, Joyce Sprock, Gregory A. Light, Juan L. Molina, Emily B. H. Treichler, Neal R. Swerdlow, Andrew W. Bismark, John Nungaray, William C. Hochberger
Rok vydání: 2019
Předmět:
Adult
Male
medicine.medical_specialty
medicine.drug_class
Anticholinergic medication
Verbal learning
Residential rehabilitation
Rehabilitation Centers
Medical and Health Sciences
Article
Cholinergic Antagonists
03 medical and health sciences
0302 clinical medicine
Clinical Research
Internal medicine
medicine
Anticholinergic
Humans
2.1 Biological and endogenous factors
In patient
Aetiology
Biological Psychiatry
Psychiatry
Cognitive Behavioral Therapy
business.industry
Treatment refractory
Rehabilitation
Psychology and Cognitive Sciences
Cognition
Verbal Learning
medicine.disease
Serious Mental Illness
Cognitive training
030227 psychiatry
Brain Disorders
Psychiatry and Mental health
Cognitive impairment
Mental Health
Schizophrenia
Schizophrenic Psychology
Female
business
Cognition Disorders
Targeted cognitive training
030217 neurology & neurosurgery
Zdroj: Schizophr Res
Popis: Targeted cognitive training (TCT) has been reported to improve verbal learning deficits in patients with schizophrenia (SZ). Despite positive findings, it is not clear whether demographic factors and clinical characteristics contribute to the success of TCT on an individual basis. Medication-associated anticholinergic burden has been shown to impact TCT-associated verbal learning gains in SZ outpatients, but the role of anticholinergic medication burden on TCT gains in treatment refractory SZ patients has not been described. In this study, SZ patients mandated to a locked residential rehabilitation center were randomized to treatment as usual (TAU; n = 22) or a course of TAU augmented with TCT (n = 24). Anticholinergic medication burden was calculated from medication data at baseline and follow-up using the Anticholinergic Cognitive Burden (ACB) Scale. MATRICS Consensus Cognitive Battery Verbal Learning domain scores were used as the primary outcome variable. The TAU and TCT groups were matched in ACB at baseline and follow-up. While baseline ACB was not associated with verbal learning in either group, increases in ACB over the course of the study were significantly associated with deterioration of verbal learning in the TAU group (r = −0.51, p = 0.02). This was not seen in subjects randomized to TCT (r = −0.13, p = 0.62). Our results suggest that TCT may blunt anticholinergic medication burden associated reduction in verbal learning in severely disabled SZ inpatients.
Databáze: OpenAIRE