The purpose of this study is to investigate the effect of a neuroplasticity-based computerized cognitive training for people with schizophrenia in the Brazilian population.
Cognitive impairments are important determinants of functional outcome in schizophrenia, which are inadequately treated by antipsychotic medication. Neuroplasticity based computerized cognitive trainings have been emerging for the last two decades and are an attempt to help patients with their cognitive impairments and global functioning. The aim of this study is to perform a computerized cognitive training to improve attention, concentration, learning, clinical symptoms and quality of life in patients. The investigators are interested in testing the differential efficacy between a specific visual versus auditory computerized cognitive training and explore the biological markers that may be involved in these neuroplasticity based training processes. The investigators will conduct a 40 hours computerized, adaptable, perception specific, cognitive training program in patients with schizophrenia. Patients will come for 1 hour, daily, and perform a visual or auditory training, or control games for about 2 months. Visual and auditory exercises are chosen to be the equivalent of one another and target cognitive domains such as divided attention, working memory and social cognition. Clinical, cognitive, emotional and biomarker data will be collected before the training, half way through, and after the training, to assess progress in several aspects of their functioning and biology. The investigators hypothesize visual and auditory trainings will be effective as compared to the control games. They also expect that auditory training to be more efficient compared to the visual training because it targets sensory functions that are mostly impaired in schizophrenia, due to auditory hallucinations patients experience. The investigators also hypothesize that both trainings will improve clinical symptoms and quality of life. On a more exploratory analysis, the investigators expect to identify new biological markers of cognitive neuroplasticity, which they expect will differentiate visual and auditory paths.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
100
Federal University of Rio de Janeiro
Rio de Janeiro, Rio de Janeiro, Brazil
RECRUITINGGlobal cognition score change
The global cognition score is a composite measure from the MATRICS (Measurement And Treatment Research to Improve Cognition in Schizophrenia) Consensus Cognitive Battery tests
Time frame: through study completion, an average of 1 year
Processing speed score change
Processing speed score will be measured using the Motor task from CANTAB (Cambridge Neuropsychological Test Automated Battery) test and the category fluency
Time frame: through study completion, an average of 1 year
Attention score change
Attention score will be measured using the Reaction time test and Rapid visual processing CANTAB tests
Time frame: through study completion, an average of 1 year
Working memory score change
Working memory will be measured using the Spatial working memory CANTAB test and the digit backward
Time frame: through study completion, an average of 1 year
Verbal memory and learning score change
Verbal memory and learning score will be measured using the Hopkins verbal learning test
Time frame: through study completion, an average of 1 year
Visuospatial memory and learning score change
Visuospatial memory and learning score will be measured using the brief visuospatial memory test
Time frame: through study completion, an average of 1 year
Reasoning and problem solving score change
Reasoning and problem solving score will be measured using the Stockings of Cambridge CANTAB test
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Time frame: through study completion, an average of 1 year
Reward task score change
Reward task score will be measured using the reward task (adapted from Graham Murray)
Time frame: through study completion, an average of 1 year
Emotional inhibition control score change
Emotional inhibition control score will be measured using the Affective go no go CANTAB test
Time frame: through study completion, an average of 1 year
Biological markers from the glutamatergic system change
Biological markers from the glutamatergic system will be measured using High profile liquid chromatography
Time frame: through study completion, an average of 1 year
Genes of neuroplasticity
Genes of neuroplasticity will be measured using candidate genotyping and Genome wide analysis
Time frame: through study completion, an average of 1 year
Eotaxin 1 change
Levels of eotaxin 1 will be measured using ELISA kit
Time frame: through study completion, an average of 1 year
Prepulse inhibition change
Prepulse inhibition will be measured via eye muscle reaction to sound
Time frame: through study completion, an average of 1 year
Eye-tracking change
Eye-tracking will be measured via an infrared camera while patients do cognitive tests
Time frame: through study completion, an average of 1 year
Electroencephalogram (EEG) change
EEG will be measured with electrodes on the surface of the skull while patients do cognitive tests
Time frame: through study completion, an average of 1 year
motivation scores change
Motivation scores will be measured with an interview and the Behavior Inhibition/Activation Scale questionnaire
Time frame: through study completion, an average of 1 year
Depression score change
Depression score will be measured using the Hamilton - Depression questionnaire
Time frame: through study completion, an average of 1 year
Anxiety score change
Depression score will be measured using the Hamilton - Anxiety questionnaire
Time frame: through study completion, an average of 1 year
Mood scores change
mood scores will be measured using the Visual analogue scale (Norris 1971)
Time frame: through study completion, an average of 1 year
Positive and negative syndrome scale score change
Clinical score will be measured using the Positive and Negative Syndrome Scale for Schizophrenia
Time frame: through study completion, an average of 1 year
Quality of Life change
Quality of life will be measured using the World Health Organization of quality of life
Time frame: through study completion, an average of 1 year