Neural activity during emotion recognition after combined cognitive plus social cognitive training in schizophrenia

Abstract

Cognitive remediation training has been shown to improve both cognitive and social cognitive deficits in people with schizophrenia, but the mechanisms that support this behavioral improvement are largely unknown. One hypothesis is that intensive behavioral training in cognition and/or social cognition restores the underlying neural mechanisms that support targeted skills. However, there is little research on the neural effects of cognitive remediation training. This study investigated whether a 50 h (10-week) remediation intervention which included both cognitive and social cognitive training would influence neural function in regions that support social cognition. Twenty-two stable, outpatient schizophrenia participants were randomized to a treatment condition consisting of auditory-based cognitive training (AT) [Brain Fitness Program/auditory module ~60 min/day] plus social cognition training (SCT) which was focused on emotion recognition [~5-15 min per day] or a placebo condition of non-specific computer games (CG) for an equal amount of time. Pre and post intervention assessments included an fMRI task of positive and negative facial emotion recognition, and standard behavioral assessments of cognition, emotion processing, and functional outcome. There were no significant intervention-related improvements in general cognition or functional outcome. fMRI results showed the predicted group-by-time interaction. Specifically, in comparison to CG, AT+SCT participants had a greater pre-to-post intervention increase in postcentral gyrus activity during emotion recognition of both positive and negative emotions. Furthermore, among all participants, the increase in postcentral gyrus activity predicted behavioral improvement on a standardized test of emotion processing (MSCEIT: Perceiving Emotions). Results indicate that combined cognition and social cognition training impacts neural mechanisms that support social cognition skills.

Copyright © 2012 Elsevier B.V. All rights reserved.

Figures

Figure 1

Group*Time interaction effects in the expected direction (i.e. AT+SCT have greater activity post vs. pre training) for recognition of negative emotions as compared to recognition of object color (Contrast: Negative Emotions > Objects). There was a significant interaction in right postcentral gyrus (peak voxel x,y,z coordinates: 42, −20, 44). The bar plot shows neural activity (percent signal change) for the contrast Negative Emotions > Objects for each group at each time point. The scatter plot shows the correlation between the change in neural activity (Post activity minus Pre activity) with the change in MSCEIT Perceiving Emotions score (Post score minus Pre score) across all participants.

Figure 2

Group*Time interaction effects in the expected direction (i.e. AT+SCT have greater activity post vs. pre training) for recognition of positive emotions as compared to recognition of object color (Contrast: Positive Emotions > Objects): A) right postcentral gyrus [peak voxel x,y,z coordinates: 42, −20, 44]; B) left angular gyrus [peak voxel x,y,z coordinates: −44, −58, 42]. For each region, the bar plot shows neural activity (percent signal change) for the contrast Positive Emotions > Objects for each group at each time point. The scatter plot shows the correlation between the change in neural activity (Post activity minus Pre activity) with the change in MSCEIT Perceiving Emotions score (Post score minus Pre score) across all participants. Note: In Fig 2B two people in AT+SCT group have zero change on MSCEIT and approximately the same level of brain activity, so the two diamond symbols are overlapping and only 10 diamonds are visible.

Figure 3

Group*Time interaction effects in the expected direction (i.e. AT+SCT have greater activity post vs. pre training) for recognition of positive emotions as compared to recognition of negative emotions (Contrast: Positive Emotions > Negative Emotions). A) right ventral striatum with peak in globus pallidus [peak voxel x,y,z coordinates: 20, 4, 0]. The bar plot shows neural activity (percent signal change) for the contrast Positive Emotions > Negative Emotions for each group at each time point. There was no significant correlation between change in ventral striatum activity and change in MSCEIT Perceiving Emotions score. B) Left precentral gyrus [peak voxel x,y,z coordinates: −44, 0, 24]. The bar plot shows neural activity (percent signal change) for the contrast Positive Emotions > Negative Emotions for each group at each time point. The scatter plot shows the correlation between the change in neural activity (Post activity minus Pre activity) with the change in behavioral performance (Post score minus Pre score) on the MSCEIT Perceiving Emotions score.