title: Brain effects of cognitive remediation therapy in schizophrenia: a structural and functional neuroimaging study.
abstract: BACKGROUND
  Cognitive remediation therapy positively affects cognition and daily functioning in patients with schizophrenia. However, studies on the underlying neurobiological mechanisms of this treatment are scarce. The aim of the current study was to investigate functional and structural connectivity brain changes in schizophrenia patients after cognitive remediation therapy using a whole-brain approach that combined functional magnetic resonance imaging and diffusion tensor imaging.
  
  
  METHODS
  A randomized controlled trial with 30 schizophrenia outpatients and 15 healthy volunteers. A strategy-learning-based treatment was used as a cognitive remediation therapy. A social skills training that provides useful information about illness management was used as an active control. We investigated changes in the pattern of functional connectivity assessed during an n-back task by tensorial independent component analysis as implemented in the multivariate exploratory linear decomposition into independent components and in the fractional anisotropy index of white matter integrity using tract-based spatial statistics.
  
  
  RESULTS
  Brain networks activation pattern significantly changed in patients exposed to the cognitive treatment in the sense of normalizing toward the patterns observed in healthy control subjects. Additionally, in white matter, they showed an increase in fractional anisotropy index in the anterior part of the genu of the corpus callosum. Cognitive improvement, functional, and also structural changes showed statistically significant correlations.
  
  
  CONCLUSIONS
  Improvement in brain functioning detected after cognitive remediation therapy in schizophrenia patients might be based on an increase of the interhemispheric information transfer between the bilateral prefrontal cortexes via the corpus callosum.
authors: Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain. rpenades@clinic.ub.es
authors: Rafael
authors: R
authors: Penadés
authors: Nuria
authors: N
authors: Pujol
authors: Rosa
authors: R
authors: Catalán
authors: Guillem
authors: G
authors: Massana
authors: Giuseppina
authors: G
authors: Rametti
authors: Clemente
authors: C
authors: García-Rizo
authors: Nuria
authors: N
authors: Bargalló
authors: Cristóbal
authors: C
authors: Gastó
authors: Miquel
authors: M
authors: Bernardo
authors: Carme
authors: C
authors: Junqué
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001921:Brain / Q000098:blood supply / Q000503:physiopathology*; D003072:Cognition Disorders / Q000209:etiology / Q000473:pathology / Q000534:rehabilitation; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010100:Oxygen / Q000097:blood; D012559:Schizophrenia / Q000150:complications*; D012565:Schizophrenic Psychology
chemical_list: D010100:Oxygen