In a study at the San Francisco VA Medical Center and the University of California, San Francisco, people with schizophrenia who completed intensive computer-based cognitive training raised their ability to distinguish between reality and their own internal thoughts. The results appeared in Neuron on Feb. 23.
Brain scans showed improvements in a part of the cortex that researchers say supports the ability to discern reality.
Senior study author Sophia Vinogradov, MD, of VA and UCSF, notes that the ability to "separate the inner world from outer reality ï¿½ is a complex cognitive function that is impaired in schizophrenia."
In the study, 31 patients with schizophrenia underwent brain scans while doing a "reality monitoring" task. The task involved telling the difference between words they made up in their head and ones they had been shown by a researcher as part of an exercise.
One group of schizophrenia patients then completed 80 hours of specialized computerized training, spread over four months. Another group played generic computer games.
All the patients then repeated the original reality-monitoring task in the MRI scanner. Compared to their pre-training assessments, those who had done the computerized cognitive training scored better. Those who had played computer games showed no improvement. The training group also showed increased activity in the medial prefrontal cortex.
Six months later, the training group showed improvements on tests of social function. The computer-games group showed no such gains.
Vinogradov says the results show that some of the brain impairments that mark schizophrenia are amenable to change, given the right training. She says the study "sets the groundwork for what could be a new treatment approach in psychiatric illness—a new tool we could use in addition to medication, psychotherapeutic approaches or cognitive behavioral approaches."
This work was funded by the National Institute of Mental Health. Vinogradov is a consultant to Brain Plasticity Institute, Inc., which has a financial stake in computerized cognitive training programs. The company is also participating in VA- and Department of Defense-sponsored research on traumatic brain injury, Alzheimer's disease, and other areas.