title: Intensive Auditory Cognitive Training Improves Verbal Memory in Adolescents and Young Adults at Clinical High Risk for Psychosis.
abstract: Individuals at clinical high risk (CHR) for psychosis demonstrate cognitive impairments that predict later psychotic transition and real-world functioning. Cognitive training has shown benefits in schizophrenia, but has not yet been adequately tested in the CHR population.
  
  
  
  In this double-blind randomized controlled trial, CHR individuals (N = 83) were given laptop computers and trained at home on 40 hours of auditory processing-based exercises designed to target verbal learning and memory operations, or on computer games (CG). Participants were assessed with neurocognitive tests based on the Measurement and Treatment Research to Improve Cognition in Schizophrenia initiative (MATRICS) battery and rated on symptoms and functioning. Groups were compared before and after training using a mixed-effects model with restricted maximum likelihood estimation, given the high study attrition rate (42%).
  
  
  
  Participants in the targeted cognitive training group showed a significant improvement in Verbal Memory compared to CG participants (effect size = 0.61). Positive and Total symptoms improved in both groups over time.
  
  
  
  CHR individuals showed patterns of training-induced cognitive improvement in verbal memory consistent with prior observations in schizophrenia. This is a particularly vulnerable domain in individuals at-risk for psychosis that predicts later functioning and psychotic transition. Ongoing follow-up of this cohort will assess the durability of training effects in CHR individuals, as well as the potential impact on symptoms and functioning over time. Clinical Trials Number: NCT00655239. URL: https://clinicaltrials.gov/ct2/show/NCT00655239?term=vinogradov&rank=5.
authors.affiliation: Department of Psychiatry, University of California, San Francisco, San Francisco, CA;
authors.forename: Rachel
authors.initials: R
authors.lastname: Loewy
authors.affiliation: Department of Psychiatry, University of California, San Francisco, San Francisco, CA; Department of Psychiatry, San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Fisher
authors.affiliation: Department of Psychiatry, University of California, San Francisco, San Francisco, CA;
authors.forename: Danielle A
authors.initials: DA
authors.lastname: Schlosser
authors.affiliation: Department of Psychiatry, San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA.
authors.forename: Bruno
authors.initials: B
authors.lastname: Biagianti
authors.affiliation: Department of Psychiatry, University of California, San Francisco, San Francisco, CA;
authors.forename: Barbara
authors.initials: B
authors.lastname: Stuart
authors.affiliation: Department of Psychiatry, University of California, San Francisco, San Francisco, CA; Department of Psychiatry, San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA.
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Mathalon
authors.affiliation: Department of Psychiatry, University of California, San Francisco, San Francisco, CA; Department of Psychiatry, San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA Sophia.vinogradov@ucsf.edu.
authors.forename: Sophia
authors.initials: S
authors.lastname: Vinogradov
mesh_terms: D000293:Adolescent; D000328:Adult; D001307:Auditory Perception / Q000502:physiology*; D002648:Child; D060825:Cognitive Dysfunction / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D000072466:Cognitive Remediation / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology*; D017063:Outcome Assessment, Health Care; D011618:Psychotic Disorders / Q000150:complications*; D012559:Schizophrenia / Q000150:complications*; D014706:Verbal Learning / Q000502:physiology*; D055815:Young Adult
keywords: cognitive remediation; prodrome; schizophrenia