Effects on the brain of a psychological treatment: cognitive remediation therapy: functional magnetic resonance imaging in schizophrenia.
BACKGROUND
The results of one randomised control trial testing a psychological rehabilitation programme aimed at information processing strategies showed improvements in cognition post-treatment.


OBJECTIVE
To determine whether there are concomitant brain activation changes as a result of engaging in cognitive remediation therapy (CRT).


METHODS
Three groups (patients receiving control therapy or CRT and a healthy control group) were investigated in a repeated measures design using the two-back test. Functional magnetic resonance imaging (fMRI) data and a broad assessment of executive functioning were completed at baseline and post-treatment. Brain activation changes were identified after accounting for possible task-correlated motion artefact.


RESULTS
fMRI analyses indicate that the control group showed decreased activation but the two patient groups showed an increase in activation over time. The patient group that received successful CRT had significantly increased brain activation in regions associated with working memory, particularly the frontocortical areas.


CONCLUSIONS
This is the first time that brain activation changes in a seriously disabled group of patients with schizophrenia can be associated clearly with psychological rather than pharmacological therapy.
Wykes
Til
T
Department of Psychiatry, Institute of Psychiatry, London, UK. t.wykes@iop.kcl.ac.uk
Brammer
Michael
M
Mellers
John
J
Bray
Peter
P
Reeder
Clare
C
Williams
Clare
C
Corner
Julia
J
D000328:Adult; D001921:Brain / Q000503:physiopathology*; D016022:Case-Control Studies; D003071:Cognition / Q000502:physiology; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008568:Memory / Q000502:physiology; D009483:Neuropsychological Tests; D012559:Schizophrenia / Q000503:physiopathology / Q000628:therapy*; D012565:Schizophrenic Psychology; D013997:Time Factors