RESEARCH PAPER
The efficacy of cognitive rehabilitation with RehaCom programme in schizophrenia patients. The role of selected genetic polymorphisms in successful cognitive rehabilitation
More details
Hide details
1
Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
2
Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland
3
Public Health Department, Pomeranian Medical University, Szczecin, Poland
Ann Agric Environ Med. 2013;20(1):77-81
KEYWORDS
ABSTRACT
Introduction. Schizophrenic patients present cognitive dysfunctions which are regarded to be one of endophenotypical markers predisposing to schizophrenia. Currently, schizophrenia can be treated as a neurodegenerative and neurodeveloping disease with genetic background.
Objective. Assessment of the possible positive effect of neuropsychological rehabilitation in schizophrenia, in patients presenting cognitive dysfunctions. An additional aim was to verify the hypothesis that some genetic polymorphisms can be a prognostic factor for success in neuropsychological rehabilitation.
Material and methods. 41 participants and 40 control subjects were randomly selected. Both groups had the diagnosis of paranoid schizophrenia. Cognitive functions were checked with the Wisconsin Card Sorting Test, Trail Making Test, and Stroop Test at the beginning and end of the experiment. In the research group, each patient trained with the rehabilitation programme RehaCom, whereas the control group did not receive such training. Genes COMT rs4680 and BDNF rs6265 were analysed in the genetic part of study.
Results. RehaCom procedures appear to be useful in the neuropsychological rehabilitation of cognitive dysfunctions in patients diagnosed with schizophrenia. The research group showed a moderate improvement in the training programmes.
Analysis of parameters obtained in the neuropsychological tests showed a slight improvement in both groups. At the present time, analysis of the polymorphisms of genes cannot be treated as a prognostic factor for the success of neuropsychological rehabilitation because statistical analyses showed few dependences with little statistical significance.
Conclusions. Cognitive rehabilitation produces moderate improvement in cognitive functioning.
REFERENCES (26)
1.
Konorski J. Conditioned reflexes and neuron organization. Tr. from the Polish ms. under the author’s supervision. Cambridge University Press 1948: 98.
2.
Caspi A, Reichenberg A, Weiser M, Rabinowitz J, Kaplan Z, Knobler H, et al. Cognitive performance in schizophrenia patients assessed before and following the first psychotic episode. Schizophrenic Res. 2003; 65: 87-94.
3.
David AS, Malmberg A, Brandt L, Allebeck P, Lewis G. IQ and risk for schizophrenia: a population-based cohort study. Psycho Med. 1997; 27: 1311-23.
4.
Fuller R, Nopoulos P, O‘Leary D. Longitudinal assessment of premorbid cognitive functioning in patients with schizophrenia through examination of standardized scholastic test performance. Am J of Psychiatry. 2002; 159: 1183-89.
5.
Jones P, Rodgers B, Murray RM. Child developmental risk factors for adult schizophrenia in the British 1946 birth cohort. Lancet. 1994; 344: 1398-402.
6.
Keefe RS, Eesley CE, Poe MP. Defining a cognitive function decrement in schizophrenia. Biol Psychiatry. 2005; 57: 688-91.
7.
Green MF, Kern RS, Braff DL. Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the‘‘right stuff’’? Schizophr Bull. 2000; 26: 119-36.
8.
Carter CS, Robertson LC, Nordahl TE, Chaderjian M, Oshora-Celaya L. Perceptual and attentional asymmetries in schizophrenia: further evidence for a left hemisphere deficit. Psychiatry Res. 1998; 62: 111-119.
9.
Goldman-Rakic P. Prefrontal cortical dysfunction in schizophrenia. The relevance of working memory. Psychopathology and brain. New York, Raven Press, 1991.
10.
Pierri JN, Volk CL, Auh S, Sampson A, Lewis DA. Somal size of cortical pyramidal neurons in schizophrenia: differential effects across neuronal populations. Biol Psychiatry. 2003; 54: 111-20.
11.
Selemon LD, Goldman-Rakic PS. The reduced neuropil hypothesis: a circuit based model of schizophrenia. Biol Psychiatry. 1999; 45: 17-25.
12.
Everett J, Lavoie K, Gagnon J, Gosselin N. Performance of patients with schizophrenia on the Wisconsin Card Sorting Test (WCST). J Psychiatry Neurosci. 2001; 26: 123-30.
13.
Perlstein WM, Elbert T, Stenger VA. Dissociation in human prefrontal cortex of affective influences on working memory-related activity. Proc Natl Acad Sci USA 2002; 99: 1736-41.
14.
Rybakowski JK, Borkowska A, Czerski PM, Hauser J. Performance on Wisconsin Card Sorting Test and polymorphism of DRD3 and COMT gene in schizophrenic patients. Mol Psychiatry. 2001; 6: 718-24.
15.
Egan MF, et al. Effect of COMT Val108/158 Met genotype on frontal lobe function and risk for schizophrenia. Proc Natl Acad Sci. USA 2001; 98: 6917-6922.
16.
Hariri AR, et al. Brain-derived neurotrophic factor val66met polymorphism affects human memory-related hippocampal activity and predicts memory performance. J Neurosci. 2003; 23: 6690-6694.
17.
Regel H, Fritsch A. Evaluationsstudie zum computergestützten. Training psychischer Basisfunktionen. Abschlußbericht zum geförderten. Forschungsprojekt. Bonn: Kuratorium ZNS 1997.
18.
Mateer CA. The rehabilitation of executive disorders. In Cognitive neurorehabilitation D.T. Stuss, G. Winocur & I. H. Robertson. London: Cambridge University Press 1999.
19.
Pfleger U. Computerunterstütztes kognitives Trainingsprogramm mit schizophrenen Patienten. Münster/New York: Waxmann – Internationale Hochschulschriften 1996; Bd. 204.
20.
Sablier J, Stip E, Franck N. Cognitive remediation and cognitive assistive technologies in schizophrenia. Encephale. 2009; 35: 160-7.
21.
Everitt BS, Vessely S. Clinical Trials in Psychiatry, 2nd Edition. Wiley, January 2008.
22.
Jarema M, Kiejna A, Landowski J, Meder J, Rabe-Jabłońska J, Rybakowski J. Standardy leczenia farmakologicznego schizofrenii. Psychiatr Pol. 2006; 6: 1171-6.
23.
An SK, Oh BH, Hyun MH, Yoo KJ. The Effect of Attention Training Using Computer-Aided Cognitive Rehabilitation Program (REHACOM) in Chronic Schizophrenics. J Korean Neuropsychiatry Assoc. 1997; 36: 72-79.
24.
Dellagi L, Ben Azouz O, Johnson I, Kebir O, Amado I, Tabbane K. Cognitive remediation therapy in schizophrenia: a case report. Tunis Med. 2009; 87: 660-3.
25.
Cochet A, Saoud M, Gabriele S, Broallier V, El Asmar C, Daléry J, et al. Impact of a new cognitive remediation strategy on interpersonal problem solving skills and social autonomy in schizophrenia. Encephale. 2006; 32: 189-95.
26.
McGurk SR, Twamley EW, Sitzer DI, McHugo GJ, Mueser KT. A MetaAnalysis of Cognitive Remediation in Schizophrenia. Am J Psychiatry. 2007; 164: 1791-802.