title: A pilot study on the effects of cognitive remediation on hemodynamic responses in the prefrontal cortices of patients with schizophrenia: a multi-channel near-infrared spectroscopy study.
abstract: The regional neuronal changes taking place between before and after cognitive rehabilitation are still not characterized in schizophrenia patients. In addition, it is not known whether these regional changes are predictive or correlated with treatment response. We conducted a preliminary quasi-experimental study to investigate the effects of a Neuropsychological Educational Approach to Cognitive Remediation (NEAR), one of the cognitive remediation therapies, on neurocognitive functioning assessed by the Japanese version of the Brief Assessment of Cognition in Schizophrenia (BACS-J), and on prefrontal and temporal hemodynamic responses during working memory (WM) task (2-back, letter version) using 52-channel near-infrared spectroscopy (NIRS). We assessed 19 patients with schizophrenia or schizoaffective disorder twice with an interval of 6months. Moreover, taking into consideration the possible practice effect, we assessed 12 control patients twice with an interval of 6months. The NEAR group, in comparison with the control group, showed significant improvement in two subcomponents of BACS-J, that is, motor speed and executive function along with the composite scores. The NEAR group also showed a significant increase in brain activation in the bilateral cortical regions associated with WM, and in comparison with the control group the between-group differences were restricted to the right frontopolar area. In addition, the amount of enhancement in some cognitive subcomponents was positively correlated with the magnitude of an increase in hemodynamic response during WM task predominantly in the right hemispheres. These findings suggest that neurocognitive deficits in schizophrenia and their neural dysfunction may be improved by NEAR, and NIRS may be a useful tool to assess the changes of the neural activity underlying the improvement of neurocognitive functioning elicited by neurocognitive rehabilitation.
authors.affiliation: Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, Yonago, Tottori, Japan. Electronic address: pshh0517@yahoo.co.jp.
authors.forename: Shenghong
authors.initials: S
authors.lastname: Pu
authors.affiliation: National Center of Neurology and Psychiatry, Tokyo, Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Nakagome
authors.affiliation: Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, Yonago, Tottori, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamada
authors.affiliation: Division of Neuropsychiatry, Yowa Hospital, Yonago, Tottori, Japan; Connecticut Mental Health Center, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States.
authors.forename: Satoru
authors.initials: S
authors.lastname: Ikezawa
authors.affiliation: Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, Yonago, Tottori, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Itakura
authors.affiliation: Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, Yonago, Tottori, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Satake
authors.affiliation: Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, Yonago, Tottori, Japan.
authors.forename: Hisahito
authors.initials: H
authors.lastname: Ishida
authors.affiliation: Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, Yonago, Tottori, Japan.
authors.forename: Izumi
authors.initials: I
authors.lastname: Nagata
authors.affiliation: Department of Clinical Psychology, Graduate School of Medical Sciences, Tottori University Faculty of Medicine, Yonago, Tottori, Japan.
authors.forename: Tamiko
authors.initials: T
authors.lastname: Mogami
authors.affiliation: Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, Yonago, Tottori, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Kaneko
mesh_terms: D000328:Adult; D003072:Cognition Disorders / Q000209:etiology / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology; D009483:Neuropsychological Tests; D010108:Oxyhemoglobins / Q000378:metabolism*; D010865:Pilot Projects; D017397:Prefrontal Cortex / Q000378:metabolism*; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000150:complications / Q000473:pathology*; D019265:Spectroscopy, Near-Infrared
chemical_list: D010108:Oxyhemoglobins
keywords: Cognitive rehabilitation; Near-infrared spectroscopy (NIRS); Neurocognitive deficits; Neuropsychological Educational Approach to Cognitive Remediation (NEAR); Schizophrenia; Working memory (WM) task