Abstract Cognitive deficits in schizophrenia are a major contributor to poor functional outcomes and everyday functioning, making them a promising therapeutic target. Recent years have witnessed a ...dramatic increase in the use of digital interventions, such as game-based therapy, targeting various domains of cognition to treat mental disorders. Game-based digital interventions have been suggested to have therapeutic value in health care for people with schizophrenia. To support this idea, a novel, online training program (Komori Life) that targets cognitive deficits in schizophrenia was tested for feasibility of use and initial efficiency. Inpatients with schizophrenia were randomized to complete 20 sessions of either Komori Life ( N = 40 completers) or treatment as usual ( N = 40 completers). Cognitive and clinical assessments were performed at enrollment and after completion of the training intervention for all patients. In addition, 32 healthy volunteers were recruited as controls, and an eye-tracking paradigm was employed to assess attentional biases to emotional information before and after game intervention for all subjects. The results showed that there were no group differences in cognitive or clinical assessments at baseline between the two patient groups. After game training, there were still no group × time interactions on cognitive or clinical assessment scores. Regarding eye movement measurements, both patient groups showed increased attention to threatening stimuli compared to healthy controls in terms of attentional maintenance at baseline. After game training, the game training group revealed greater improvement in attentional bias towards threatening scenes (decreased percentage of total duration and percentage of total fixations towards threatening stimuli) relative to the treatment as usual group. Moreover, our results partially indicated that training effectiveness was associated with cognitive improvement and that heightened attentional maintenance to threats was associated with worse cognitive performance. This study provides initial evidence that a remote, online cognitive training program is feasible and effective in improving cognitive function in schizophrenia. This form of training may serve as a complementary therapy to existing psychiatric care. Clinical trial registration: the trial is registered at http://www.chictr.org.cn , identifier ChiCTR2100048403.
Abstract Patients with schizophrenia exhibit abnormalities in spatial frequency sensitivity, and it is believed that these abnormalities indicate more widespread dysfunction and dysregulation of ...bottom-up processing. The early visual system, including the first-order Lateral Geniculate Nucleus of the thalamus (LGN) and the primary visual cortex (V1), are key contributors to spatial frequency sensitivity. Medicated and unmedicated patients with schizophrenia exhibit contrasting changes in spatial frequency sensitivity, thus making it a useful probe for examining potential effects of the disorder and antipsychotic medications in neural processing. We constructed a parameterized, rate-based neural model of on-center/off-surround neurons in the early visual system to investigate the impacts of changes to the excitatory and inhibitory receptive field subfields. By incorporating changes in both the excitatory and inhibitory subfields that are associated with pathophysiological findings in schizophrenia, the model successfully replicated perceptual data from behavioral/functional studies involving medicated and unmedicated patients. Among several plausible mechanisms, our results highlight the dampening of excitation and/or increase in the spread and strength of the inhibitory subfield in medicated patients and the contrasting decreased spread and strength of inhibition in unmedicated patients. Given that the model was successful at replicating results from perceptual data under a variety of conditions, these elements of the receptive field may be useful markers for the imbalances seen in patients with schizophrenia.
Previous studies on putative neural mechanisms of negative symptoms in schizophrenia mainly used single modal imaging data, and seldom utilized schizophrenia patients with prominent negative symptoms ...(PNS).This study adopted the multimodal fusion method and recruited a homogeneous sample with PNS. We aimed to identify negative symptoms-related structural and functional neural correlates of schizophrenia. Structural magnetic resonance imaging (sMRI) and resting-state functional MRI (rs-fMRI) were performed in 31 schizophrenia patients with PNS and 33 demographically matched healthy controls.Compared to healthy controls, schizophrenia patients with PNS exhibited significantly altered functional activations in the default mode network (DMN) and had structural gray matter volume (GMV) alterations in the cerebello-thalamo-cortical network. Correlational analyses showed that negative symptoms severity was significantly correlated with the cerebello-thalamo-cortical structural network, but not with the DMN network in schizophrenia patients with PNS.Our findings highlight the important role of the cerebello-thalamo-cortical structural network underpinning the neuropathology of negative symptoms in schizophrenia. Future research should recruit a large sample and schizophrenia patients without PNS, and apply adjustments for multiple comparison, to verify our preliminary findings.
Schizophrenia Vita, Antonio; Barlati, Stefano; De Peri, Luca ...
The Lancet (British edition),
09/2016, Letnik:
388, Številka:
10051
Journal Article
Recenzirano
We read with interest the Seminar on schizophrenia by Michael J Owen and colleagues (July 2, p 86) in which clinical, epidemiological, pathophysiological, and treatment aspects of the disorder are ...reviewed comprehensively and thoughtfully. We think that additional points could have been usefully included in the discussion.
Dans cette étude de corpus, on aborde la question du comportement dialogique de soutien en entretien clinique avec le patient souffrant de schizophrénie. Nous partons de l’analyse des interactions ...langagières, en présupposant que le cadre spécifique de l’interaction verbale de type clinique est un lieu d’expression privilégié de “comportement dialogique de soutien”. Sur la base d’une exploration empirique, nous proposons l’élaboration d’un modèle interlocutoire dynamique de ce que l’on pourrait interpréter comme une forme d’écoute attentive, de soutien, en nous basant notamment sur des indicateurs lexicaux particuliers que sont les backchannels. Nous décrivons les différents types d’organisation discursive au sein desquelles les interlocuteurs adoptent un comportement de soutien manifeste. Nous extrayons les propriétés des configurations discursives au sein desquelles le comportement de soutien de l’un des interlocuteurs (la psychologue, par exemple) a pour effet d’amener le locuteur (le patient, par exemple) à modifier sa stratégie argumentative. Les analyses empiriques portent sur la totalité du temps d'enregistrement de 10 entretiens réalisés avec des personnes souffrant de schizophrénie (recueillis en hôpital psychiatrique) et 10 entretiens réalisés avec des sujets témoins.
Organizations & functions of backchannel verbal behavior in clinical interaction with the person with schizophrenia.
In this corpus study, we address the issue of supportive dialogic behavior in clinical interviews with patients suffering from schizophrenia. We start from the analysis of language interactions, presupposing that the specific framework of the verbal interaction of clinical type is the privileged place of expression of "supportive dialogic behavior". On the basis of an empirical exploration, we propose the elaboration of a dynamic interlocutory model of what could be interpreted as a form of attentive, supportive listening, based in particular on particular lexical indicators that are the backchannels. We describe the different types of discourse organization in which interlocutors adopt a supportive behavior. We extract the properties of discourse configurations in which the supportive behavior of one of the interlocutors (e.g. the psychologist) has the effect of leading the speaker (e.g. the patient) to modify his argumentative strategy. The empirical analyses cover the entire recording time of 10 interviews with people suffering from schizophrenia (collected in psychiatric hospitals) and 10 interviews with control subjects.
Abstract
This paper discusses the current evidence from animal and human studies for a central role of inflammation in schizophrenia. In animal models, pre- or perinatal elicitation of the immune ...response may increase immune reactivity throughout life, and similar findings have been described in humans. Levels of pro-inflammatory markers, such as cytokines, have been found to be increased in the blood and cerebrospinal fluid of patients with schizophrenia. Numerous epidemiological and clinical studies have provided evidence that various infectious agents are risk factors for schizophrenia and other psychoses. For example, a large-scale epidemiological study performed in Denmark clearly showed that severe infections and autoimmune disorders are such risk factors. The vulnerability-stress-inflammation model may help to explain the role of inflammation in schizophrenia because stress can increase pro-inflammatory cytokines and may even contribute to a chronic pro-inflammatory state. Schizophrenia is characterized by risk genes that promote inflammation and by environmental stress factors and alterations of the immune system. Typical alterations of dopaminergic, serotonergic, noradrenergic, and glutamatergic neurotransmission described in schizophrenia have also been found in low-level neuroinflammation and consequently may be key factors in the generation of schizophrenia symptoms. Further support for the relevance of a low-level neuroinflammatory process in schizophrenia is provided by the loss of central nervous system volume and microglial activation demonstrated in neuroimaging studies. Last but not least, the benefit of anti-inflammatory medications found in some studies and the intrinsic anti-inflammatory and immunomodulatory effects of antipsychotics provide further support for the role of inflammation in this debilitating disease.
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