Neuroimaging studies of cognitive remediation in schizophrenia:A systematic and critical review

作     者：Rafael Penadés Alexandre González-Rodríguez Rosa Catalán Bàrbara Segura Miquel Bernardo Carme Junqué 

作者机构：Department of Psychiatry and PsychologyClinical Institute of NeurosciencesHospital Clínic Neuropsychology LabUniversity of Barcelona Institut d’InvestigacionsBiomèdiques August Pi i Sunyer 

出 版 物：《World Journal of Psychiatry》 (世界精神病学杂志)

年 卷 期：2017年第7卷第1期

页      面：34-43页

核心收录：

学科分类：1002[医学-临床医学] 100205[医学-精神病与精神卫生学] 10[医学] 

基　　金：Supported by a grant from the Instituto de Salud Carlos Ⅲ of Fondo de Investigaciones Sanitarias FIS No.PI 11/09158(to Penadés R) 

主　　题：Cognitive remediation Cognitive training Neuroimaging Cognition Prefrontal cortex Thalamus Plasticity Schizophrenia 

摘      要：AIM To examine the effects of cognitive remediation therapies on brain functioning through neuroimaging procedures in patients with *** A systematic, computerised literature search was conducted in the PubM ed/Medline and PsychI nfo databases. The search was performed through February 2016 without any restrictions on language or publication date. The search was performed using the following search terms: [(cogniti* and remediation or training or enhancement) and(fMRI or MRI or PET or SPECT) and(schizophrenia or schiz*)]. The search was accompanied by a manual online search and a review of the references from each of the papers selected, and those papers fulfilling our inclusion criteria were also *** A total of 101 studies were found, but only 18 of them fulfilled the inclusion criteria. These studies indicated that cognitive remediation improves brain activation in neuroimaging studies. The most commonly reported changes were those that involved the prefrontal and thalamic regions. Those findings are in agreement with the hypofrontality hypothesis, which proposes that frontal hypoactivation is the underlying mechanism of cognitive impairments in schizophrenia. Nonetheless,great heterogeneity among the studies was found. They presented different hypotheses, different results and different findings. The results of more recent studies interpreted cognitive recovery within broader frameworks, namely, as amelioration of the efficiency of different networks. Furthermore, advances in neuroimaging methodologies, such as the use of wholebrain analysis, tractography, graph analysis, and other sophisticated methodologies of data processing, might be conditioning the interpretation of results and generating new theoretical frameworks. Additionally, structural changes were described in both the grey and white matter, suggesting a neuroprotective effect of cognitive remediation. Cognitive, functional and structural improvements tend