A new study shows that targeted cognitive training (TCT) benefits patients with severe schizophrenia, improving verbal learning and auditory perception while lessening the severity of auditory hallucinations.
Schizophrenia is among the most difficult mental illnesses to treat, according to researchers at the University of California San Diego.
One reason is that it is characterized by a wide range of dysfunction, from hallucinations and mood disorders to cognitive impairment, especially verbal and working memory, researchers said.
They add that issues with verbal and working memory can be explained, in part, by abnormalities in early auditory information processing.
Recently, targeted cognitive training (TCT) has emerged as a promising therapeutic intervention for schizophrenic patients. TCT uses computerized training, such as sophisticated brain games, to target specific neural pathways, including memory, learning and auditory-based senses, to alter the way the patients process information.
TCT has proven effective for mild to moderate forms of schizophrenia under carefully controlled conditions. But it has been unclear whether the approach might benefit patients with chronic, refractory schizophrenia treated in non-academic settings, such as those cared for in locked residential rehabilitation centers, the researchers noted.
That led a research team at the UC San Diego School of Medicine to investigate whether TCT improved auditory and verbal outcomes among the most difficult of schizophrenia patients.
“Chronic, treatment-refractory patients mandated to locked residential care facilities make up just a small subgroup of persons with schizophrenia, but they consume a disproportionately large share of mental health care resources. Finding an effective therapy for them is critical,” said Gregory A. Light, PhD, professor of psychiatry at UC San Diego School of Medicine and director of the Mental Illness, Research, Education and Clinical Center at the Veterans Affairs San Diego Healthcare System, who led the research.
Light’s research team studied 46 patients with schizophrenia psychosis recruited from a community-based residential treatment program, each following acute hospitalization. All were deemed “gravely disabled,” unable to care for themselves, and under the guardianship of a private party or government agency, the researchers report.
Patients were randomized to either standard treatment-as-usual (TAU) or TAU plus TCT, in which they used laptop computers to perform various learning and memory game exercises, often involving auditory cues.
The researchers found that in patients who completed the roughly three months of TAU-TCT treatment, verbal learning and auditory perception scores improved, while the severity of auditory hallucinations lessened.
The researchers note the benefits were not negatively impacted by age, clinical symptoms, medication, or the duration of their illness.
“Our results suggest that chronically ill, highly disabled patients can benefit from TCT,” said Light. “That contradicts current assumptions.”
The study was published in Schizophrenia Research.