Remediation of Working Memory in Schizophrenia

Not Applicable

Completed

Conditions: Schizoaffective Disorder
Schizophrenia

Interventions: Behavioral: Cognitive Remediation
Behavioral: Computer Skills

Registration Number: NCT00995553

Lead Sponsor: VA Office of Research and Development

Brief Summary: The primary aim of the study is to test the efficacy of a novel cognitive remediation intervention that targets working memory-related functions. To accomplish this goal, 80 volunteer patients with schizophrenia will be enrolled and randomized to either a cognitive remediation condition that targets working memory or a computer skills training intervention that teaches computer applications. In both conditions participants will receive computer training three times a week for 4 months. The investigators hypothesize that patients who receive the cognitive remediation intervention will demonstrate significantly greater change on neuropsychological measures of working memory and executive abilities than patients who receive the computer skills course. In addition, the investigators hypothesize that the intervention-induced cognitive change will be associated with concurrent improvements in functional capacity and psychosocial functioning in the community. A second study goal is to examine the stability of the intervention-induced changes in cognition. Cognition and psychosocial functioning will be reassessed 4 and 8 months after treatment termination to examine the stability of treatment effects and to assess whether a less intense maintenance training (once a week sessions) provides any additional benefit to participants. Lastly, this study will examine in an exploratory manner whether there are individual differences in treatment response. The Val158Met polymorphism of the COMT gene has been found to be associated with working memory and prefrontal dysfunction in schizophrenia. The study will test whether the COMT polymorphism is predictive of response to cognitive remediation.

Detailed Description: Not available

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 86

Inclusion Criteria

Veterans with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder
No hospitalizations in the previous 4 weeks
No antipsychotic medication changes in the previous 4 weeks
Age 18-60
Does not meet DSM-IV criteria for substance dependence in the previous 6 months or substance abuse in the previous month

Exclusion Criteria

History of clinically significant head injury or neurological disease
Poor comprehension of the English language
History of diagnosis of mental retardation or pervasive developmental disorder
Unable to give informed consent

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Cognitive Remediation	Cognitive Remediation	A 48-session working memory focused cognitive remediation program is conducted. Training tasks have been selected from 3 software programs, PSS CogRehab, BrainTrain, and custom made N-back tasks.
Computer Skills	Computer Skills	This is a 48-session, time matched comparison group in which participants practice keyboarding skills and the fundamentals of Microsoft Office Word, Powerpoint, and Excel programs.

Primary Outcome Measures

Name	Time	Method
Cognitive Assessment - MATRICS Consensus Cognitive Battery	Post-intervention, within 2 weeks of completion of the 4 month intervention	The Working Memory and Attention indexes of the MATRICS Consensus Cognitive Battery was used to assess near generalization of training with untrained tasks that were conceptually similar to training tasks. Each scale provide an age and gender corrected T-score. Thus, scores can range from 0-100, with a higher score indicating better performance.

Secondary Outcome Measures

Name	Time	Method
Functional Capacity - University of California, San Diego Performance-Based Skills Assessment	Post-intervention, within 2 weeks of completion of the 4 month intervention	The UPSA is a measure of the ability to apply cognitive skills to functional tasks. The total score from this scale was used. Scores may range from 0 - 100, with higher scores being better.