New research has revealed that targeted cognitive training can successfully reduce cognitive impairment in treatment-resistant schizophrenia.
brain pathways illustration
Altering certain neural pathways may improve cognitive ability in people with treatment-resistant schizophrenia.

Schizophrenia is one of the 15 leading causes of disability globally.

In the United States, this condition affects more than 3 million people.

Symptoms of schizophrenia include psychoses, hallucinations, delusions, and unusual thinking patterns.

Emotional numbing, reduced motivation, difficulty forming and maintaining social relationships, and cognitive impairment are also among the symptoms that tend to characterize the condition.

Cognitive impairment in schizophrenia affects verbal and working memory especially. Some older research suggested that these cognitive difficulties are partly down to some deficiencies in the ability to process auditory information.

For instance, a study published in the journal NeuroImage found that “impairments in [auditory] discrimination may contribute to higher-order cognitive and psychosocial deficits in [schizophrenia].”

Recently, researchers set out to examine whether targeted cognitive training (TCT) — which uses specially designed computer games to change certain neural pathways — may improve auditory perception and verbal learning in people with a difficult form of schizophrenia.

Gregory A. Light, Ph.D — a professor of psychiatry at the University of California, San Diego School of Medicine — is the senior author of the new study, which was published in the journal Schizophrenia Research.

TCT reduces hallucinations, boosts learning

Prof. Light, who is also the director of the Mental Illness, Research, Education, and Clinical Center at Veterans Affairs San Diego Healthcare System, explains the motivation for the study.

He says, “Chronic, treatment-refractory patients mandated to locked residential care facilities make up just a small subgroup of persons with schizophrenia, but they consume a disproportionately large share of mental health care resources.”

“Finding an effective therapy for them is critical,” he continues. So, Prof. Light and team set out to examine the effects of TCT in a group of 46 people with schizophrenia psychosis.

The participants had been previously hospitalized, and at the time of the study, they were enrolled in a community-based residential care program as well as being legally under the care of a guardian.

The researchers assigned the participants to either a group that received treatment-as-usual plus TCT or a group that received treatment-as-usual only.

In the group that received both standard treatment and TCT, the participants used laptops to carry out some learning and memory tasks, which often included auditory cues. The treatments took place over a 3-month period.

At the end of the study period, verbal learning improved and hallucinations were less severe among those who received the TCT-enhanced treatment.

The age or clinical symptoms of the participants did not dampen these positive effects, and neither did the medications they were taking or how long they had been living with schizophrenia.

“Our results suggest that chronically ill, highly disabled patients can benefit from TCT,” says Prof. Light. “That contradicts current assumptions.”

He and his team previously studied the effects of computerized TCT in “more chronic, treatment-refractory patients.” At the time, the study concluded that “even highly symptomatic, functionally disabled patients with chronic illness benefit from this emerging treatment.”

However, Prof. Light cautions that much more research is needed. “We’re somewhere between the Wild West and [the] golden age of cognitive training for schizophrenia patients,” he says. “There is much still to be learned and done.”