Effects on the brain of a psychological treatment: cognitive remediation therapy: Functional magnetic resonance imaging in schizophrenia

• Published in: British journal of psychiatry 2002-08, Vol.181 (2), p.144-152
• Main Authors: WYKES, TIL, BRAMMER, MICHAEL, MELLERS, JOHN, BRAY, PETER, REEDER, CLARE, WILLIAMS, CLARE, CORNER, JULIA
• Format: Article
• Language: English
• Subjects: Adult; Brain; Brain - physiopathology; Brain mapping; Brain research; Case-Control Studies; Cognition; Cognition - physiology; Cognitive ability; Cognitive Behavioral Therapy - methods; Community; Executive function; Functional magnetic resonance imaging; Humans; Information processing; Intervention; Magnetic Resonance Imaging; Male; Memory; Memory - physiology; Mental disorders; Neuroimaging; Neuropsychological Tests; NMR; Nuclear magnetic resonance; Occupational therapy; Patients; Psychiatry; Psychological intervention; Psychotropic drugs; Rehabilitation; Schizophrenia; Schizophrenia - physiopathology; Schizophrenia - therapy; Schizophrenic Psychology; Short term memory; Time Factors
• ISSN: 0007-1250; 1472-1465
• DOI: 10.1192/bjp.181.2.144

The results of one randomised control trial testing a psychological rehabilitation programme aimed at information processing strategies showed improvements in cognition post-treatment. To determine whether there are concomitant brain activation changes as a result of engaging in cognitive remediation therapy (CRT). Three groups (patients receiving control therapy or CRT and a healthy control group) were investigated in a repeated measures design using the two-back test. Functional magnetic resonance imaging (fMRI) data and a broad assessment of executive functioning were completed at baseline and post-treatment. Brain activation changes were identified after accounting for possible task-correlated motion artefact. fMRI analyses indicate that the control group showed decreased activation but the two patient groups showed an increase in activation over time. The patient group that received successful CRT had significantly increased brain activation in regions associated with working memory, particularly the frontocortical areas. This is the first time that brain activation changes in a seriously disabled group of patients with schizophrenia can be associated clearly with psychological rather than pharmacological therapy.