title: Sensorimotor gating and clinical outcome following cognitive behaviour therapy for psychosis.
abstract: BACKGROUND
  Prepulse inhibition (PPI) of the startle response refers to the ability of a weak prestimulus to transiently inhibit the response to a closely following strong sensory stimulus. PPI provides an operational index of sensorimotor gating and is reduced, on average, in people with schizophrenia, relative to healthy people. Given the variable response to Cognitive Behaviour Therapy for psychosis (CBTp) and positive associations between pre-therapy brain and cognitive functions and CBT outcome across disorders, we examined whether pre-therapy level of PPI is associated with clinical outcome following CBTp.
  
  
  METHODS
  Fifty-six outpatients stable on medication with at least one distressing symptom of schizophrenia and willing to receive CBTp in addition to their usual treatment were assessed on acoustic PPI. Subsequently, 28 patients received CBTp (CBTp+treatment-as-usual, 23 completers) for 6-8months and 28 continued with their treatment-as-usual (TAU-alone, 17 completers). Symptoms were assessed (blindly) at entry and follow-up.
  
  
  RESULTS
  The CBTp+TAU and TAU-alone groups did not differ demographically, clinically or in PPI at baseline. The CBTp+TAU group showed improved symptoms relative to the TAU-alone group, which showed no change, at follow-up. Pre-therapy PPI level correlated positively with post-CBTp symptom improvement.
  
  
  CONCLUSIONS
  Relatively intact sensorimotor gating is associated with a good clinical response following a 6-8months course of NICE compliant CBTp in schizophrenia. Pharmacological or psychological interventions capable of improving PPI may enhance the effectiveness of CBTp in people with schizophrenia, particularly in those who fail to show clinical improvement with currently available antipsychotic drugs and adjunctive CBTp.
authors.affiliation: Department of Psychology, Institute of Psychiatry, King's College London, London, UK. veena.kumari@kcl.ac.uk
authors.forename: Veena
authors.initials: V
authors.lastname: Kumari
authors.forename: Preethi
authors.initials: P
authors.lastname: Premkumar
authors.forename: Dominic
authors.initials: D
authors.lastname: Fannon
authors.forename: Ingrid
authors.initials: I
authors.lastname: Aasen
authors.forename: Satya
authors.initials: S
authors.lastname: Raghuvanshi
authors.forename: Anantha P
authors.initials: AP
authors.lastname: Anilkumar
authors.forename: Elena
authors.initials: E
authors.lastname: Antonova
authors.forename: Emmanuelle R
authors.initials: ER
authors.lastname: Peters
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kuipers
mesh_terms: D000161:Acoustic Stimulation; D000328:Adult; D000704:Analysis of Variance; D014150:Antipsychotic Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000188:drug therapy / Q000534:rehabilitation*; D055139:Sensory Gating / Q000187:drug effects / Q000502:physiology*; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents