August 5, 2011
Discovery News
Staff Reporter

Computer-based brain training looks to be effective for treating some symptoms.
Though the condition is commonly associated with hearing voices or experiencing hallucinations, the most debilitating effects of schizophrenia are cognitive and social deficits that limit one’s abilities to hold jobs or perform daily activities.

“The medications we now have for schizophrenia are good for symptom reduction,” Sophia Vinogradov, professor of psychiatry at UC-San Francisco, told Discovery News, “but they’re not great at all — they do nothing — for the cognitive deficits, which are really part of the core assets of the illness and the functional impairment of the illness.”

Vinogradov is trying to determine whether computer-based cognitive remediation, a type of brain training through video game-like programs, is effective for treating schizophrenia.

The idea stems from previous decades of research, when scientists discovered the uncanny neural flexibility of the brain. Since weaker neural pathways have the potential to be strengthened through performing a set of tasks, there might be ways to train the brain to function better in individuals with schizophrenia whose memory, attention and problem solving are worse than healthy people’s.

In a handful of blinded and randomized trials with computer-based training, Vinogradov has reported cognitive improvements for both recently diagnosed patients and those living with the disorder for several years. So far, treatment — such as 50 hours of training over a 10-week period — has shown great promise for patients when compared to control groups. In the future, the intensity of treatments may vary by patient, but so far, results show that more training is better, she said.

In one setup, Vinogradov created a control condition in which patients played entertaining video games not designed to treat the disorder. These patients did not show the same improvements as the experimental group, ruling out the notion that video games themselves could help.

She and her colleagues have set the stage for organizing larger randomized trials that put these programs in the position to be approved as medical devices by the FDA.

Michael Merzenich, a professor emeritus at UC-San Francisco and co-founder of brain training software company Posit Science, said he foresees computer treatments being offered to patients either at home or in medical offices. He currently provides brain training software to researchers like Vinogradov and believes the work could have far-reaching implications to limit and possibly cure schizophrenia.

“The complicated set of changes that are occurring in the brain to account for recovery can only occur through the brain basically correcting itself,” he said. “This is the natural way, this is the natural benefit, you can say. It’s incredibly more sophisticated than doing what we now do [with therapy and medications].”

Alice Medalia, a professor of clinical psychiatry at Columbia University Medical Center who was not involved in the research, told Discovery News that cognitive remediation relies heavily on brain plasticity, or the brain’s ability to reorganize itself through forming new neural connections or by adding cells.

“What happens is neurons and the brain adjust their activity and organization in response to new situations or changes in the environment,” Medalia said, “and in this case, in response to working on these computer-based exercises.”

Computer-based techniques will most likely fit into wider treatment programs that include therapy and medications, too. But the appeal of using computer programs to treat schizophrenia lies in its focus on cognition and its ability to be used by patients who may have anxiety toward receiving treatment that requires social interactions with others, she said. Much like other forms of cognitive remediation, computer training can be tailored to individuals’ needs in efforts to improve daily functioning rather than cognitive test scores alone.

“The goal is not to improve people’s performance on tests,” Medalia said. “The goal is to improve their ability to use cognition in day-to-day life.”