NEURO-COGS: Neurometabolic Mechanisms of Cognitive Training in Schizophrenia

Inclusion Criteria:

All participants (healthy control and SZ):

• Age: 18-79
• Have given written informed consent
• Be able to read and write in English
• General health status: Participants should be in good general physical health (no major neurological disorder or head injury with prolonged unconsciousness, and no current moderate or severe substance use disorder)
• Geographic location: Minnesota counties that are approximately within 1 hour driving distance to Twin Cities, including, but not limited to, Hennepin, Ramsey, Washington, Anoka, Wright, Carver, Scott, Dakota, Sherburn
• Agree to refrain from using recreational drugs for 1 week prior to each scanning session, including, but not limited to, marijuana

For people with schizophrenia (SZ):

• Current DSM-5 diagnosis of schizophrenia or schizoaffective disorder. Participants should be in stable psychiatric health, evidenced by no suicide attempt or psychiatric hospitalization within the past 1 month. (Initial diagnosis will be assessed using SCID 5 or MINI-7, and confirmation of ongoing SZ status and symptom changes will be monitored at each major timepoint using BPRS.)
• All SZ must have achieved clinical stability, defined as outpatient status for at least one month prior to study participation, plus stable doses of psychiatric medications for at least 1 month prior to study participation (as reported by participants and confirmed via medication list (procured by participants via their own medical or pharmacy records) and/or current pill bottle labels).

• All participants should have symptom ratings below a rating of 7 "extremely severe" on a severity scale of 1-7 on the BPRS and/or below grade 3 on longitudinal assessment defined by (as determined by the PI):

  • Grade 1: Worsening of 1 point on any item within each BPRS factor
  • Grade 2: Worsening of 2 points on any item within each BPRS factor
  • Grade 3: Worsening of 3+ points on any item within each BPRS factor, or a change to a rating of extremely severe
  • Grade 4: Suicide attempt with intent to die

Exclusion Criteria:

Exclusion criteria for both groups are:

• Presence of major neurological disorder
• Conditions preventing MR scanning or other MRI contraindications:

Implanted devices or ferromagnetic objects, current pregnancy (positive pregnancy test on day of MRI scanning or currently breast-feeding), etc. Significant movement disorders including tardive dyskinesia that could disrupt MRI and MRS recordings. Medically significant condition considered unsuitable for the current study (e.g., epilepsy, etc.)

• Estimated IQ < 70
• Other relevant comorbidity (e.g., epilepsy, developmental disability) or visual impairment
• Presence of current substance use disorder (moderate or severe; excluding caffeine and nicotine), as measured by the MINI-7 or SCID 5 based on DSM-5 criteria.

For healthy controls, additionally:

• Personal or immediate first-degree family history of a psychotic or mood disorder. Specifically, current or past history of meeting DSM-5 criteria for schizophrenia spectrum or other psychotic disorders, or Bipolar I or II Disorder, major depressive disorder, posttraumatic stress disorder, panic disorder, obsessive compulsive disorder, dysthymic disorder. Those with a first or second-degree relative with a current or past history of meeting DSM-5 criteria for schizophrenia or other psychotic disorders or bipolar I or II disorder, because they might have an underlying genetic susceptibility for psychosis symptoms.
• Presence of symptoms of the following DSM-5 disorders (as assessed by the MINI-7 or SCID 5):
• Major Depressive Episode
• Suicidality
• Manic and Hypomanic Episodes
• Panic disorder
• Obsessive-Compulsive Disorder
• Posttraumatic Stress Disorder
• Alcohol Use Disorder
• Substance Use Disorder (Non-Alcoholic)
• Psychotic Disorders and Mood Disorders with Psychotic Features
• Medication or substance induced psychosis
• Major Depressive Disorder (MDD)
• MDD with Psychotic Features
• Bipolar I
• Bipolar II
• Other Specified Bipolar and Related Disorder