title: Neuroscience-informed Auditory Training in Schizophrenia: A Final Report of the Effects on Cognition and Serum Brain-Derived Neurotrophic Factor.
abstract: OBJECTIVE
  We previously reported the interim effects in a per protocol analysis of a randomized controlled trial of an innovative neuroscience-informed computerized cognitive training approach in schizophrenia. Here we report the effects of training on behavioral outcome measures in our final sample using an intent-to-treat analysis. We also report the effects on serum brain-derived neurotrophic factor (BDNF).
  
  
  METHODS
  Eighty-seven clinically stable participants with schizophrenia were randomly assigned to either targeted auditory training (AT, N=46) or a computer games control condition (CG, N=41). Participants were assessed on neurocognition, symptoms and functional outcome at baseline and after 50 hours of intervention delivered over 10 weeks. Serum BDNF was assessed at baseline, at 2 weeks, and at 10 weeks.
  
  
  RESULTS
  After the intervention, AT participants showed significant gains in global cognition, speed of processing, verbal learning, and verbal memory, relative to CG participants, with no changes in symptoms or functioning. At baseline, schizophrenia participants had significantly lower-than-normal serum BDNF. AT participants showed a significant increase in serum BDNF compared to CG participants, and "normalized" levels by post training.
  
  
  CONCLUSIONS
  Participants with chronic schizophrenia made significant cognitive gains after 50 hours of intensive computerized training delivered as a stand-alone treatment, but no improvement in symptoms or functioning. Serum BDNF levels were significantly increased, and may serve as a peripheral biomarker for the effects of training. Future research must focus on: 1) Methods of integrating cognitive training with psychosocial treatments; 2) A deeper understanding of underlying neurophysiology in order to enhance critical mechanisms of action.
authors.affiliation: Department of Psychiatry, University of California, San Francisco, CA, United States ; Department of Psychiatry, San Francisco VA Medical Center, San Francisco, CA, United States.
authors.forename: Melissa
authors.initials: M
authors.lastname: Fisher
authors.affiliation: Department of Obstetrics, Gynecology, Reproductive Sciences, University of California, San Francisco, United States.
authors.forename: Synthia H
authors.initials: SH
authors.lastname: Mellon
authors.affiliation: Department of Psychiatry, University of California, San Francisco, CA, United States.
authors.forename: Owen
authors.initials: O
authors.lastname: Wolkowitz
authors.affiliation: Department of Psychiatry, University of California, San Francisco, CA, United States ; Department of Psychiatry, San Francisco VA Medical Center, San Francisco, CA, United States.
authors.forename: Sophia
authors.initials: S
authors.lastname: Vinogradov
keywords: BDNF; Schizophrenia; cognitive remediation; neuroplasticity