Cognitive interventions targeting brain plasticity in the prodromal and early phases of schizophrenia

Abstract

Several important paradigm shifts have occurred in the field of schizophrenia treatment, including an increased focus on early detection, the development of preemptive interventions, and the view of schizophrenia as a neurodevelopmental disease characterized by decreased efficiency and abnormal connectivity in cortical and subcortical neural networks. In this review, we briefly describe some of the neural impairments that contribute to the development of schizophrenia, with an emphasis on the impact of stress and trauma on cognitively vulnerable neural systems. We then present current data on two behavioral interventions that target these critical risk factors and that aim to preempt the onset of schizophrenia in vulnerable individuals or improve the clinical course in recent-onset schizophrenia: cognitive therapy and computerized cognitive training.

Conflict of interest statement

Disclosure Statement

Dr. Vinogradov is a paid consultant to Brain Plasticity Inc., a company with a commercial interest in cognitive training software. She is also a paid consultant to Amgen, Genentech, and Hoffman-LaRoche. None of the other authors have any financial interest in Brain Plasticity Inc. or Posit Science. Drs. Vinogradov, Fisher, Loewy, Hardy, and Schlosser report no competing interests.

Figures

Figure 1

Neurodevelopmental model of schizophrenia, highlighting the pre-emptive period and intervention targets discussed in this review (adapted and modified by permission of Tyrone Cannon, PhD). DA = dopamine, HPA + hypothalamic-pituitary-adrenal).

Figure 2

The impact of stress on neural circuits related to psychosis.

Figure 3

Clinical Staging Model