Enhancing Cognitive Training Through Exercise After a First Schizophrenia Episode
| Status: | Completed |
|---|---|
| Conditions: | Schizophrenia, Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - 45 |
| Updated: | 12/9/2017 |
| Start Date: | November 2013 |
| End Date: | July 2017 |
This is a randomized controlled 6-month trial of the efficacy of a novel intervention
combining neuroplasticity-based cognitive training with aerobic exercise, compared to the
same systematic cognitive training alone. The primary treatment targets are overall cognitive
deficit level and independent living skills. The investigators hypothesize that combining
neuroplasticity-based computerized cognitive training and neurotrophin-enhancing physical
exercise will produce large cognitive and functional improvements, even relative to cognitive
training alone. Adding aerobic exercise to a cognitive training program will have the
additional benefit of helping to ameliorate medication side effects, reduce the risk for
developing metabolic syndrome, and help to prevent the deterioration in physical health that
usually follows the onset of schizophrenia and its pharmacologic treatment. The investigators
target the period shortly after a first episode of schizophrenia to maximize the
generalization of cognitive improvement to functional outcome, before chronic disability is
established.
combining neuroplasticity-based cognitive training with aerobic exercise, compared to the
same systematic cognitive training alone. The primary treatment targets are overall cognitive
deficit level and independent living skills. The investigators hypothesize that combining
neuroplasticity-based computerized cognitive training and neurotrophin-enhancing physical
exercise will produce large cognitive and functional improvements, even relative to cognitive
training alone. Adding aerobic exercise to a cognitive training program will have the
additional benefit of helping to ameliorate medication side effects, reduce the risk for
developing metabolic syndrome, and help to prevent the deterioration in physical health that
usually follows the onset of schizophrenia and its pharmacologic treatment. The investigators
target the period shortly after a first episode of schizophrenia to maximize the
generalization of cognitive improvement to functional outcome, before chronic disability is
established.
The Cognitive Training and Exercise intervention involves 24 weeks of systematic computerized
cognitive training, 4 hours per week, plus aerobic exercise, four 30 minute sessions per
week. The first 12 weeks involves neurocognitive training, using auditory training exercises
from Posit Science Brain HQ. The second 12 weeks involves social cognitive training, using
the Posit Science SocialVille modules. Aerobic exercise occurs as two 30-minute sessions at
the clinic and two at home weekly. Intensity of aerobic exercise is tailored to maintain an
individualized target heart rate zone and is monitored by a heart rate recorder. A weekly
one-hour Bridging Skills Group with other members of the treatment condition is designed to
aid generalization of training to everyday life situations.
cognitive training, 4 hours per week, plus aerobic exercise, four 30 minute sessions per
week. The first 12 weeks involves neurocognitive training, using auditory training exercises
from Posit Science Brain HQ. The second 12 weeks involves social cognitive training, using
the Posit Science SocialVille modules. Aerobic exercise occurs as two 30-minute sessions at
the clinic and two at home weekly. Intensity of aerobic exercise is tailored to maintain an
individualized target heart rate zone and is monitored by a heart rate recorder. A weekly
one-hour Bridging Skills Group with other members of the treatment condition is designed to
aid generalization of training to everyday life situations.
Inclusion Criteria:
1. a first episode of a psychotic illness that began within the past two years;
2. a diagnosis by Diagnostic and Statistical Manual of Mental Disorders of schizophrenia,
schizoaffective disorder, mainly depressed type, or schizophreniform disorder;
3. between 18 and 45 years of age;
4. sufficient acculturation and fluency in the English language to avoid invalidating
research measures of thought, language, and speech disorder or of verbal cognitive
abilities; and
5. residence within commuting distance of the Aftercare Research Program at the
University of California, Los Angeles.
Exclusion Criteria:
1. evidence of a known neurological disorder (e.g., epilepsy) or significant head injury;
2. evidence of alcohol or substance use disorder within the six months prior to the first
episode and evidence that substance abuse triggered the psychotic episode or makes the
schizophrenia diagnosis ambiguous;
3. mental retardation, i.e. premorbid intelligence quotient less than 70.
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