Effectiveness of Targeted Cognitive Training for Neurological Deficits in People With Schizophrenia

Schizophrenia is a chronic brain disorder that causes severe disability. It is characterized
by psychotic symptoms, including hallucinations and delusions. Neurocognitive deficits, such
as impaired neurocognitive processing efficiency, also affect people with schizophrenia.
This deficiency in the speed and accuracy with which the brain perceives and responds to
targets causes scrambled messages to be transmitted in the brain, thereby affecting
executive control and memory. Medications are available that effectively treat the psychotic
symptoms. The neurocognitive deficits, however, do not subside with medication treatment,
and are responsible for the failure to improve the e their psychosocial functioning of
people with schizophrenia, even after their psychotic symptoms have gone into remission. The
targeted cognitive training (TCT) exercises in this study are specifically designed to
improve speed and accuracy in the perception of and response to verbal and visuo-spatial
targets. This study will determine the effectiveness of reward-intensive, computer-based TCT
in improving neurocognitive deficits in people with schizophrenia.

Participants in this double-blind study will be paired according to IQ and baseline symptom
severity. One member of each pair will be randomly assigned to training exercises that use
TCT. The other will be assigned to a control intervention, which will involve commercially
available computer games. All participants will complete exercises with their assigned
intervention for 1 hour per day, 5 days per week, until 90 hours of training has been
accumulated. Neuroimaging will be performed on a subgroup of participants to examine changes
in brain activation patterns in response to the cognitive training. Upon study completion
and at the 6-month follow up visit, participants will be assessed for improvement in the
following areas: cognitive performance; symptom profile; quality of life; and social cue
recognition.