Schizophrenia Research-Cognition最新文献_第9页

Through the lens of schizophrenia: Recognizing negative facial expressions and family patterns 透过精神分裂症的视角：识别负面面部表情和家庭模式

IF 2.3 Q2 PSYCHIATRY

Schizophrenia Research-Cognition

Pub Date : 2024-11-05 DOI: 10.1016/j.scog.2024.100336

Leila Shateri , Hamid Yari Renani , Abbas Bakhshipour Rudsari , Touraj Hashemi Nosratabad , Zahra Saeidi

Schizophrenia is a complex disorder with symptoms such as hallucinations, delusions, and impaired social interactions, and deficits in facial emotion recognition are a key area of impairment. Studies indicate that recognizing facial emotions is essential for social interaction, and individuals with schizophrenia show significant difficulties, especially in recognizing negative emotions. Previous research has primarily focused on patients, with less attention on their first-degree relatives. This study investigates the ability to recognize negative facial expressions in paranoid and non-paranoid schizophrenia patients, their siblings, and matched healthy controls. This cross-sectional study included 60 paranoid schizophrenia patients, 60 non-paranoid schizophrenia patients, 59 siblings of paranoid patients, 60 siblings of non-paranoid patients, and 30 healthy controls, recruited from outpatients at Razi Hospital in Tabriz, Iran. The mean age was 35.7 years, and 54 % of participants were female. The Ekman 60 Faces Test assessed the recognition of basic facial emotions, focusing on negative emotions. The results revealed that paranoid schizophrenia patients showed significantly lower performance in recognizing negative facial emotions (mean score: 15.7) compared to non-paranoid patients (16.4) and siblings (28.1 for paranoid siblings, 27.4 for non-paranoid siblings). In contrast, healthy controls scored highest (29.0). This study highlights the deficits in emotion recognition in schizophrenia and their potential genetic underpinnings within family lines, contributing to understanding social cognition deficits related to the disorder.

精神分裂症是一种复杂的疾病，具有幻觉、妄想和社会交往障碍等症状，而面部情绪识别障碍是其主要障碍之一。研究表明，识别面部情绪对于社会交往至关重要，而精神分裂症患者在识别面部情绪方面表现出明显的困难，尤其是在识别负面情绪方面。以往的研究主要集中在患者身上，对他们的一级亲属关注较少。本研究调查了偏执型和非偏执型精神分裂症患者、他们的兄弟姐妹以及匹配的健康对照组识别负面面部表情的能力。这项横断面研究从伊朗大不里士市拉齐医院的门诊病人中招募了 60 名偏执型精神分裂症患者、60 名非偏执型精神分裂症患者、59 名偏执型患者的兄弟姐妹、60 名非偏执型患者的兄弟姐妹和 30 名健康对照组。参与者的平均年龄为 35.7 岁，54% 为女性。艾克曼 60 面孔测试评估了对基本面部情绪的识别能力，重点是负面情绪。结果显示，偏执型精神分裂症患者在识别面部负面情绪方面的表现（平均分：15.7）明显低于非偏执型患者（16.4）和兄弟姐妹（偏执型兄弟姐妹为 28.1，非偏执型兄弟姐妹为 27.4）。相比之下，健康对照组的得分最高（29.0）。这项研究强调了精神分裂症患者在情绪识别方面的缺陷及其在家族中的潜在遗传基础，有助于理解与精神分裂症有关的社会认知缺陷。

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引用次数: 0

Transcranial direct current stimulation and its effect on cognitive symptoms of schizophrenia: An updated review 经颅直流电刺激及其对精神分裂症认知症状的影响：最新综述

IF 2.3 Q2 PSYCHIATRY

Schizophrenia Research-Cognition

Pub Date : 2024-10-23 DOI: 10.1016/j.scog.2024.100335

Sadia Rehman Safwi , Abid Rizvi , Mohammad Amir Usmani , Karrar Husain , Kanwarjeet Brar , Deep Yadava

Objective

Cognitive impairments in schizophrenia significantly affect functional outcomes and quality of life. This meta-analysis evaluates the effectiveness of transcranial direct current stimulation (tDCS) as an intervention for cognitive deficits in individuals with schizophrenia.

Methods

From May 20 to June 15, 2024, a systematic search of PubMed, Medline, Embase, and the Cochrane central register of controlled trials was conducted. After applying eligibility criteria, 13 randomized sham-controlled trials were included, involving 261 participants in the tDCS group and 247 in the sham group. Standardized mean difference (SMD) was computed to measure the effect size of cognitive outcomes. Statistical analyses were performed using a random-effects model to account for heterogeneity.

Results

The pooled analysis yielded an SMD of 0.09 (95 % CI: −0.17 to 0.35), indicating a non-significant difference between tDCS and sham on cognitive outcomes. Moderate heterogeneity (I² = 44 %) was observed, attributed to variations in tDCS protocols, participant demographics, and cognitive assessment tools. Although certain studies showed improvements in specific domains like working memory, the overall impact of tDCS on cognitive symptoms was not statistically significant.

Conclusions

This meta-analysis underscores the lack of significant evidence for tDCS in improving cognitive deficits in schizophrenia. The findings highlight the urgent need for standardizing tDCS protocols and employing domain-specific cognitive assessments. This standardization, along with the collection of more domain-specific data, is crucial for future research and the improvement of current methodologies.

目的精神分裂症患者的认知障碍会严重影响其功能结果和生活质量。本荟萃分析评估了经颅直流电刺激（tDCS）作为精神分裂症患者认知障碍干预措施的有效性。方法从 2024 年 5 月 20 日至 6 月 15 日，对 PubMed、Medline、Embase 和 Cochrane 对照试验中央登记册进行了系统检索。采用资格标准后，共纳入 13 项随机假对照试验，其中 tDCS 组有 261 人参与，假对照组有 247 人参与。计算标准化平均差（SMD）来衡量认知结果的效应大小。结果汇总分析得出的SMD为0.09（95 % CI：-0.17至0.35），表明tDCS与假体在认知结果上的差异不显著。观察到中度异质性（I2 = 44 %），归因于 tDCS 方案、参与者人口统计学和认知评估工具的差异。尽管某些研究显示工作记忆等特定领域有所改善，但tDCS对认知症状的总体影响在统计学上并不显著。研究结果突出表明，迫切需要对 tDCS 方案进行标准化，并采用特定领域的认知评估。标准化以及收集更多特定领域的数据对于未来研究和改进现有方法至关重要。

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引用次数: 0

Advances in the ecological validity of research on social cognition in schizophrenia: A systematic review of the literature 精神分裂症社会认知研究的生态有效性进展：文献系统回顾

IF 2.3 Q2 PSYCHIATRY

Schizophrenia Research-Cognition

Pub Date : 2024-10-17 DOI: 10.1016/j.scog.2024.100333

Alvaro Cavieres, Vanessa Acuña, Marcelo Arancibia, Camila Escobar

Introduction

Ecologically valid assessments need to require tasks representative of real, everyday interactions between people in a social environment (i.e., verisimilitude) and to predict aspects of real-life performance in those same interactions (i.e., veridicality). To determine how researchers interested in social cognition among people with schizophrenia currently understand and apply ecological validity in their work, we conducted a systematic review of studies that had the ecological validity of their results as an explicit objective.

Methods

We performed the described systematic review following PRISMA guidelines.

Results

Of the 18 studies reviewed, only two defined ecological validity, 15 incorporated modifications to improve their verisimilitude, eight proposed analyses to examine their veridicality, and seven aimed to achieve both objectives.

Conclusions

Our systematic review suggests that very few published studies on social cognition among people with schizophrenia have explicitly defined ecological validity, and most have focused only on the verisimilitude of the tasks required while neglecting the veridicality of the results.

引言生态效度评估需要能代表社会环境中人与人之间真实的日常互动的任务（即真实性），并能预测在这些互动中现实生活表现的各个方面（即真实性）。为了确定对精神分裂症患者的社会认知感兴趣的研究人员目前是如何理解并在工作中应用生态效度的，我们对以结果的生态效度为明确目标的研究进行了系统综述。结论我们的系统性综述表明，已发表的有关精神分裂症患者社会认知的研究中很少有明确定义生态效度的，大多数研究只关注任务要求的真实性，而忽视了结果的真实性。

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引用次数: 0

Negative auditory hallucinations are associated with increased activation of the defensive motivational system in schizophrenia 负性幻听与精神分裂症患者防御性动机系统的激活增加有关

IF 2.3 Q2 PSYCHIATRY

Schizophrenia Research-Cognition

Pub Date : 2024-10-16 DOI: 10.1016/j.scog.2024.100334

Anna R. Knippenberg, Sabrina Yavari, Gregory P. Strauss

Auditory hallucinations (AH) are the most common symptom of psychosis. The voices people hear make comments that are benign or even encouraging, but most often voices are threatening and derogatory. Negative AH are often highly distressing and contribute to suicide risk and violent behavior. Biological mechanisms underlying the valence of voices (i.e., positive, negative, neutral) are not well delineated. In the current study, we examined whether AH voice valence was associated with increased activation of the Defensive Motivational System, as indexed by central and autonomic system response to unpleasant stimuli. Data were evaluated from two studies that used a common symptom rating instrument, the Psychotic Symptom Rating Scale (PSY-RATS), to measure AH valence. Participants included outpatients diagnosed with SZ. Tasks included: Study 1: Trier Social Stress Task while heart rate was recorded via electrocardiography (N = 27); Study 2: Passive Viewing Task while participants were exposed to pleasant, unpleasant, and neutral images from the International Affective Picture System (IAPS) library while eye movements, pupil dilation, and electroencephalography were recorded (N = 25). Results indicated that negative voice content was significantly associated with: 1) increased heart rate during an acute social stressor, 2) increased pupil dilation to unpleasant images, 3) higher neural reactivity to unpleasant images, and 4) a greater likelihood of having bottom-up attention drawn to unpleasant stimuli. Findings suggest that negative AH are associated with greater Defensive Motivational System activation in terms of central and autonomic nervous system response.

幻听（AH）是精神病最常见的症状。人们听到的声音可能是善意的，甚至是鼓励性的，但最常见的是威胁性和贬损性的。负面的幻听通常会给人带来极大的痛苦，并导致自杀风险和暴力行为。声音的价值（即积极、消极、中性）的生物机制尚未得到很好的描述。在当前的研究中，我们考察了 AH 声音的价值是否与防御性动机系统的激活增加有关，该系统以中枢和自律神经系统对不愉快刺激的反应为指标。我们对两项研究的数据进行了评估，这两项研究使用了一种通用的症状评定工具--精神病症状评定量表（PSY-RATS）来测量AH声价。参与者包括被诊断为精神分裂症的门诊患者。任务包括研究1：特里尔社会压力任务，同时通过心电图记录心率（N = 27）；研究2：被动观看任务，同时让参与者观看国际情感图片系统（IAPS）库中的愉快、不愉快和中性图片，同时记录眼球运动、瞳孔放大和脑电图（N = 25）。结果表明，负面语音内容与以下因素有明显关联1）在急性社会压力下心率加快；2）对不愉快图像的瞳孔放大程度增加；3）对不愉快图像的神经反应性提高；4）自下而上的注意力被不愉快刺激吸引的可能性增加。研究结果表明，从中枢神经系统和自主神经系统的反应来看，消极的 AH 与更大的防御动机系统激活有关。

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引用次数: 0

SIPD or psychotic disorder with stimulant use 使用兴奋剂的 SIPD 或精神病性障碍

IF 2.3 Q2 PSYCHIATRY

Schizophrenia Research-Cognition

Pub Date : 2024-10-05 DOI: 10.1016/j.scog.2024.100332

Tania Lecomte , Donna Lang , Stéphane Potvin , Félix Diotte , Audrey Livet , Melissa Cimaglia , Amal Abdel-Baki , Marie Villeneuve , Didier Jutras-Aswad , Alicia Spidel

引用次数: 0

Migration of digital functional capacity assessments from device resident to cloud-based delivery: Development and convergent validity 将数字功能能力评估从常驻设备迁移到云端交付：开发与收敛有效性

IF 2.3 Q2 PSYCHIATRY

Schizophrenia Research-Cognition

Pub Date : 2024-09-24 DOI: 10.1016/j.scog.2024.100331

Philip D. Harvey , Richard S.E. Keefe , Peter Kallestrup , Sara J. Czaja , Hans Klein , William Horan

Decentralized clinical trials are leading to rapid changes in assessment technology, including an expansion of interest in remote delivery. As technology changes, some of the updates include migration to fully cloud-based software and data management, with attendant differences in hardware, response modalities, and modifications in the level of tester engagement. It is rare to see systematic descriptions of the process of migration and upgrading of technology-related assessments. We present comparative data on successive generations of two widely used functional capacity measures, the Virtual Reality Functional Capacity Assessment Tool (VRFCAT) and the Functional Capacity Assessment and Training System (FUNSAT). Four samples of healthy older individuals completed either the original device-resident, computer-administered versions, or cloud-based, tablet-delivered versions of these tasks. For the VRFCAT, performance and correlations with age were similar across versions, although performance was slightly (5 %) faster with iPad delivery. For the FUNSAT, performance and correlations with age and cognitive task scores were generally similar across versions for English Speakers, though there were some differences related to the testing language for the cloud-based version. These results support the feasibility of migrating digital assessments to cloud-based delivery and substantiate fundamental similarity across delivery strategies.

分散式临床试验正导致评估技术的快速变化，包括对远程交付的兴趣不断扩大。随着技术的变化，一些更新包括迁移到完全基于云的软件和数据管理，随之而来的是硬件、响应模式和测试人员参与程度的变化。很少看到对技术相关评估的迁移和升级过程进行系统的描述。我们展示了两款广泛使用的功能能力测量工具--虚拟现实功能能力评估工具（VRFCAT）和功能能力评估与训练系统（FUNSAT）--的历代比较数据。四个健康老年人样本完成了这些任务的原始设备驻留、计算机管理版本或基于云的平板电脑版本。就 VRFCAT 而言，不同版本的成绩和与年龄的相关性相似，但 iPad 版本的成绩略快一些（5%）。就 FUNSAT 而言，不同版本的英语测试成绩以及与年龄和认知任务得分的相关性基本相似，但云端版本的测试语言存在一些差异。这些结果支持了将数字评估迁移到云端交付的可行性，并证实了不同交付策略的基本相似性。

{"title":"Migration of digital functional capacity assessments from device resident to cloud-based delivery: Development and convergent validity","authors":"Philip D. Harvey , Richard S.E. Keefe , Peter Kallestrup , Sara J. Czaja , Hans Klein , William Horan","doi":"10.1016/j.scog.2024.100331","DOIUrl":"10.1016/j.scog.2024.100331","url":null,"abstract":"<div><div>Decentralized clinical trials are leading to rapid changes in assessment technology, including an expansion of interest in remote delivery. As technology changes, some of the updates include migration to fully cloud-based software and data management, with attendant differences in hardware, response modalities, and modifications in the level of tester engagement. It is rare to see systematic descriptions of the process of migration and upgrading of technology-related assessments. We present comparative data on successive generations of two widely used functional capacity measures, the Virtual Reality Functional Capacity Assessment Tool (VRFCAT) and the Functional Capacity Assessment and Training System (FUNSAT). Four samples of healthy older individuals completed either the original device-resident, computer-administered versions, or cloud-based, tablet-delivered versions of these tasks. For the VRFCAT, performance and correlations with age were similar across versions, although performance was slightly (5 %) faster with iPad delivery. For the FUNSAT, performance and correlations with age and cognitive task scores were generally similar across versions for English Speakers, though there were some differences related to the testing language for the cloud-based version. These results support the feasibility of migrating digital assessments to cloud-based delivery and substantiate fundamental similarity across delivery strategies.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"39 ","pages":"Article 100331"},"PeriodicalIF":2.3,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2215001324000325/pdfft?md5=ca8c916199d8f0f564e82d512be874d7&pid=1-s2.0-S2215001324000325-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The implementation and effectiveness of Integrated Psychological Therapy (IPT) in chronic middle-aged inpatients with schizophrenia 综合心理疗法（IPT）在慢性中年精神分裂症住院患者中的实施情况和效果

IF 2.3 Q2 PSYCHIATRY

Schizophrenia Research-Cognition

Pub Date : 2024-09-21 DOI: 10.1016/j.scog.2024.100330

Aikaterini Poulou , Fotios Anagnostopoulos , Argiro Vatakis , Robert C. Mellon , Daniel R. Mueller

Introduction

Cognitive rehabilitation is essential for schizophrenia treatment since it improves function. Moreover, the relationship between cognitive rehabilitation and functioning is significantly affected by negative symptoms and social cognition. Integrated Psychological Therapy (IPT) is a promising approach that integrates interventions in neurocognition, social cognition, and functional level. This study examines IPT's efficacy in chronic middle-aged inpatients.

Methods

A randomized controlled study involved 44 individuals with schizophrenia. Twenty-one IPT participants received 50 biweekly sessions and medication, while twenty-three control participants received treatment as usual/supportive therapy and pharmacotherapy. Pre- and post-intervention and six- and twelve-month follow-ups were arranged to assess neurocognition, social perception, psychopathology, and functioning using the Matrics Consensus Cognitive Battery, Social Perception Scale, Positive and Negative Syndrome Scale, and Global Assessment of Functioning.

Results

Speed of processing, attention/vigilance, overall composite, and neurocognitive composite scores improved significantly in the IPT group. Social Perception Scale performance improved in all areas after the intervention and persisted for 6 months. Positive, negative, and total psychopathology symptoms decreased significantly post-intervention and at the 12-month follow-up, whereas participants' functioning improved significantly.

Conclusions

Middle-aged chronic inpatients with schizophrenia may benefit from IPT in neurocognition, social perception, psychopathology, and functioning. This field of study may provide insight into schizophrenia treatment, hence further research is encouraged.

导言：认知康复对精神分裂症的治疗至关重要，因为它能改善患者的功能。此外，认知康复与功能之间的关系受到阴性症状和社会认知的显著影响。综合心理疗法（IPT）是一种将神经认知、社会认知和功能水平的干预结合在一起的有前途的方法。本研究探讨了综合心理疗法对慢性中年住院患者的疗效。21 名 IPT 参与者接受了 50 次双周疗程和药物治疗，23 名对照组参与者接受了常规治疗/支持疗法和药物治疗。干预前、干预后以及6个月和12个月的随访安排使用Matrics共识认知电池、社会感知量表、正负综合征量表和功能全面评估来评估神经认知、社会感知、精神病理学和功能。干预后，社会认知量表在所有方面的表现都有所改善，并持续了 6 个月。干预后和随访 12 个月时，阳性、阴性和总的精神病理症状明显减少，而参与者的功能则明显改善。这一研究领域可为精神分裂症的治疗提供启示，因此鼓励进一步开展研究。

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引用次数: 0

Training individuals with schizophrenia to gain volitional control of the theory of mind network with real-time fMRI: A pilot study 通过实时 fMRI 训练精神分裂症患者获得对心智理论网络的意志控制：试点研究

IF 2.3 Q2 PSYCHIATRY

Schizophrenia Research-Cognition

Pub Date : 2024-09-07 DOI: 10.1016/j.scog.2024.100329

Elizabeth A. Kruse , Abhishek Saxena , Bridget J. Shovestul , Emily M. Dudek , Stephanie Reda , Jojo Dong , Arun Venkataraman , J. Steven Lamberti , David Dodell-Feder

Individuals diagnosed with schizophrenia spectrum disorders (SSDs) often demonstrate alterations in the Theory of Mind Network (ToM-N). Here, in this proof-of-concept, single-arm pilot study, we investigate whether participants with an SSD (N = 7) were able to learn to volitionally control regions of the ToM-N (dorso/middle/ventromedial prefrontal cortex [D/M/VMPFC], left temporoparietal junction [LTPJ], precuneus [PC], right superior temporal sulcus [RSTS], and right temporoparietal junction [RTPJ]) using real-time fMRI neurofeedback (rtfMRI-NF). Region-of-interest analyses demonstrate that after neurofeedback training, participants were able to gain volitional control in the following ToM-N brain regions during the transfer task, where no active feedback was given: right temporoparietal junction, precuneus, and dorso/ventromedial prefrontal cortex (neurofeedback effect Fs > 6.17, ps < .05). These findings suggest that trained volitional control over the ToM-N is tentatively feasible with rtfMRI neurofeedback in SSD, although findings need to be replicated with more robust designs that include a control group and larger samples.

被诊断为精神分裂症谱系障碍（SSD）的患者通常会表现出思维理论网络（ToM-N）的改变。在这项概念验证、单臂试验研究中，我们调查了患有精神分裂症谱系障碍的参与者（N = 7）是否能够学会自愿控制 ToM-N 的区域（左/中/外侧前额叶皮层 [D/M/VMPFC]、左颞顶交界处 [LTPJ]、楔前区 [PC]、右颞上沟 [RSTS] 和右颞顶交界处 [RTPJ]）。兴趣区分析表明，经过神经反馈训练后，参与者能够在没有主动反馈的转移任务中获得以下 ToM-N 脑区的意志控制：右颞顶交界区、楔前区和背/内侧前额叶皮层（神经反馈效应 Fs > 6.17, ps <.05）。这些研究结果表明，通过rtfMRI神经反馈，训练对ToM-N的意志控制在SSD中是初步可行的，尽管研究结果还需要通过更稳健的设计（包括对照组和更大的样本）来重复。

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引用次数: 0

Neuroinflammation and kynurenines in schizophrenia: Impact on cognition depending on cognitive functioning and modulatory properties in relation to cognitive remediation and aerobic exercise 精神分裂症的神经炎症和犬尿氨酸：对认知的影响取决于认知功能以及与认知矫正和有氧运动有关的调节特性

IF 2.3 Q2 PSYCHIATRY

Schizophrenia Research-Cognition

Pub Date : 2024-08-29 DOI: 10.1016/j.scog.2024.100328

Jacopo Sapienza , Giulia Agostoni , Stefano Comai , Sofia Nasini , Stefano Dall'Acqua , Stefania Sut , Marco Spangaro , Francesca Martini , Margherita Bechi , Mariachiara Buonocore , Giorgia Bigai , Federica Repaci , Daniela Nocera , Chiara Ave , Carmelo Guglielmino , Federica Cocchi , Roberto Cavallaro , Giacomo Deste , Marta Bosia

Background

In the last decade, the kynurenine pathway (KP) has gained attention in the pathogenesis of cognitive impairment in schizophrenia being at the croassroad between neuroinflammation and glutamatergic and cholinergic neurotransmission. However, clinical findings are scarse and conflicting, and the specific contributions of these two systems to the neurobiology of cognitive symptoms are far from being elucidated. Furthermore, little is known about the molecular underpinnings of non-pharmacological interventions for cognitive improvement, including rehabilitation strategies.

Methods

The current study examined 72 patients with schizophrenia, divided in two clusters depending on the severity of the cognitive impairment, with the aim to evaluate the impact of inflammatory biomarkers and KP metabolites depending on cognitive functioning. Moreover, we studied their possible link to the cognitive outcome in relation to sessions of cognitive remediation therapy (CRT) and aerobic exercise (AE) in a longitudinal arm of 42 patients.

Results

Neuroinflammation appeared to exert a more pronounced influence on cognition in patients exhibiting a higher cognitive functioning, contrasting with the activation of the KP, which had a greater impact on individuals with a lower cognitive profile. Cognitive improvements after the treatments were negatively predicted by levels of TNF-α and positively predicted by the 3-hydroxykynurenine (3−HK)/kynurenine (KYN) ratio, an index of the kynurenine-3-monooxygenase (KMO) enzyme activity.

Conclusion

Overall, these findings add novel evidence on the biological underpinnings of cognitive impairment in schizophrenia pointing at a differential role of neuroinflammation and KP metabolites in inducing cognitive deficits depending on the cognitive reserve and predicting outcomes after rehabilitation.

背景近十年来，犬尿氨酸通路（Kynurenine pathway，KP）在精神分裂症认知障碍的发病机制中越来越受到关注，因为它处于神经炎症与谷氨酸能和胆碱能神经递质之间的十字路口。然而，临床研究结果稀少且相互矛盾，这两个系统对认知症状神经生物学的具体贡献也远未阐明。本研究根据认知障碍的严重程度将 72 名精神分裂症患者分为两组，目的是评估炎症生物标志物和 KP 代谢物对认知功能的影响。结果神经炎症似乎对认知功能较强的患者的认知能力产生了更明显的影响，而 KP 的激活则对认知功能较弱的患者产生了更大的影响。治疗后认知能力的改善与 TNF-α 水平呈负相关，而与 3-羟基犬尿氨酸（3-HK）/犬尿氨酸（KYN）比率（犬尿氨酸-3-单氧化酶（KMO）酶活性指数）呈正相关。结论总之，这些发现为精神分裂症认知障碍的生物学基础提供了新的证据，指出神经炎症和 KP 代谢物在诱发认知障碍方面的不同作用取决于认知储备和预测康复后的结果。

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引用次数: 0

Ecological virtual reality-based cognitive remediation among inpatients with schizophrenia: A pilot study 对精神分裂症住院患者进行基于生态虚拟现实的认知矫正：试点研究

IF 2.3 Q2 PSYCHIATRY

Schizophrenia Research-Cognition

Pub Date : 2024-08-28 DOI: 10.1016/j.scog.2024.100326

Reut Komemi , Hana Tubenbaltt , Eiran V. Harel , Mor Nahum , Lena Lipskaya-Velikovsky

Schizophrenia presents a considerable clinical challenge due to limited progress in promoting daily-life functioning among diagnosed individuals. Although cognitive remediation (CR) has emerged as a promising approach to improving cognitive and functional outcomes in schizophrenia, its effectiveness among inpatients and within hospital environments—where opportunities to practice skills in real-world contexts are limited—remains unclear. Here, we aimed to establish the feasibility and initial efficacy of a short, ecological virtual reality-based CR training (CR-EVR) in acute mental health inpatient settings. Efficacy was assessed at four levels: training engagement, near transfer, far transfer, and ecological transfer. Twenty-three inpatients with schizophrenia (Male: 33.3 ± 8.5; 4 Female) completed 8, 20-min CR-EVR sessions, with exercises training the cognitive abilities of inhibition, planning, working memory, shifting, self-initiation, persistence, and attention. Their cognitive functioning, schizophrenia symptoms, functional capacity, and participation in occupations were evaluated pre- and post-training to address four levels of effectiveness. Of the recruited participants, 25.8 % dropped out. Inpatients who completed the full protocol reported high rates of satisfaction (1-not satisfied; 5-very satisfied)) from the intervention (Median = 4, IQR:3.5–5). Post-training, significant improvements were found in the trained cognitive components (intervention engagement: −6.58 < t/Z < 2.02, p < .05), general cognitive functioning (−2.59 < t/Z < 2.29, p < .05), functional capacity (t = −2.9, p < .05), and diversity of participation in everyday activities (t = −3.36, p < .05). This preliminary study suggests that CR-EVR may be a feasible and practical tool to enhance cognitive and ecological outcomes in short-stay acute inpatient settings. Subject to further research, such intervention may be considered an add-on to current practices that promote recovery and health among inpatient populations.

精神分裂症给临床带来了相当大的挑战，因为在促进已确诊患者的日常生活功能方面进展有限。尽管认知矫正（CR）已成为改善精神分裂症患者认知和功能结果的一种很有前景的方法，但其在住院患者和医院环境中的有效性仍不清楚，因为在医院环境中，在真实世界中练习技能的机会有限。在此，我们旨在确定基于生态虚拟现实的短期 CR 培训（CR-EVR）在急性精神疾病住院患者中的可行性和初步疗效。疗效从四个层面进行评估：训练参与、近距离转移、远距离转移和生态转移。23 名精神分裂症住院患者（男：33.3 ± 8.5；女：4）完成了 8 次、每次 20 分钟的 CR-EVR 训练，训练内容包括抑制、计划、工作记忆、转移、自我启动、坚持和注意力等认知能力。在训练前和训练后，对他们的认知功能、精神分裂症症状、功能能力和职业参与情况进行了评估，以了解四个层面的效果。在招募的参与者中，有 25.8% 退出了培训。完成全部方案的住院患者对干预的满意度很高（1 分-不满意；5 分-非常满意）（中位数 = 4，IQR:3.5-5）。培训后，受训者的认知能力（干预参与度：-6.58 <；t/Z <；2.02，p <；.05）、一般认知功能（-2.59 <；t/Z <；2.29，p <；.05）、功能能力（t = -2.9，p <；.05）和参与日常活动的多样性（t = -3.36，p <；.05）均有明显改善。这项初步研究表明，CR-EVR 可能是一种可行且实用的工具，可以提高短期急诊住院病人的认知和生态效果。在进一步研究的基础上，这种干预措施可被视为目前促进住院病人康复和健康的做法的补充。

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