Table 1 Training to improve neurocognitive deficits
DRILL AND STRATEGY | |||||
|---|---|---|---|---|---|
Authors | Targeted deficits | Type of training | Measured variables | Results | Control and samples |
[24] | Memory and problem solving | Cognitive Remediation (CR) and Treatment-As-Usual (TAU) | Psychiatric symptoms | Both CR groups improved on the Positive, negative and general psychopathology subscales but also on the Positive and Depression factors | Control group N = 54 |
[25] | Autobiographical memory | Group therapy and exercises to recollect specific events | Autobiographical memory, executive functioning | Improvements on the variables that were preserved after 3 months | Placebo group N = 27 |
[26] | Cognitive deficits, and transfert to functional competence | CR + skills training CR + TAU Skills training + TAU | Cognitive performance (reasoning, problem solving, processing speed, verbal memory, working memory) Social competence, functional competence, real-world functional behaviour | CR produced robust improvements in neurocognition, but not after functional skills training. Social competence improved with both trainings. Functional competence higher and more durable with combined treatment. Functional competence and real-world behavior was more likely when supplemental skills training and cognitive remediation were combined. | Control group N = 107 |
[27] | Neurocognition and transfert to social competence | CR and Functional Adaptation skills training (FAST) Control: FAST or CR | Functional competence, information processing, verbal fluency, working memory, executive functioning, verbal memory | The early-course group had larger improvements in measures of processing speed and executive functions, adaptive competence and real-world work skills. Verbal memory, verbal fluency and social competence did not improve | None N = 39 |
[28] | Neurocognition at large | CR and one-on-one training and guided practice | Attention, working and episodic memory, executive functioning, processing speed, everyday community functioning | No improvements were found | Placebo group N = 69 |
[29] | Psychiatric symptoms and cognition (episodic memory and attention) | Neurcognitive Enhancement Therapy (NET) + Work therapy and Verbal memory task based on a dichotic listening (DL) with distracter paradigm NET + Work therapy alone | Symptoms, attention and memory | Significant effect on memory but not on attention or symptoms. nor at 6 months follow up | Control group N = 125 |
[30] | Attention, memory and executive functioning | CR and group therapy | Verbal learning and memory, executive functioning, visual learning and memory, depression, positive and negative symptoms | Significant improvements in neuropsychological functioning, depression and negative symptoms of schizophrenia after CRT | Control group N = 42 |
[31] | Executive functioning | Cognitive Adaptation Training (CAT) applied to integrated treatment (IT) consisting of assertive community treatment (ACT) | Social functioning, symptoms and quality of life; executive functioning | Improved social functioning and compliance with IT and ACT. No solid evidence demonstrating that IT improves when adding CAT | Control group N = 62 |
[32] | Verbal and visual memory, sustained attention and executive functioning | CR with Neuropsychological Educational Approach to Remediation (NEAR) | Processing speed, executive functioning, sustained attention, verbal memory, visual memory, reasoning/cognitive flexibility, social/occupational functioning, life skills, quality of life, self-esteem | Experimental group showed improvement in all variables, gains maintained after 4 months | Control group N = 40 |
[33] | Verbal memory, working memory, motor speed, verbal fluency, attention, processing speed and executive functioning | CR with NEAR | Verbal memory,working memory, motor speed, verbal fluency, attention and speed of information processing, executive functioning | Improvement in all outcomes compared to control with CR | Control group N = 51 |
[34] | Cognitive deficits to improve work outcomes | Errorless learning Conventional instruction | Work performance, job tenure, personal well-being (self-esteem, job satisfaction, work stress) | The patients in the errorless learning group performed better on work performance | Control group N=40 |
[35] | Neurocognition at large | Cognitive (CR) and supported education | Self-esteem, short term memory, verbal learning and memory, executive functioning, sustained attention, psychomotor speed, educational attainment | CR can be successfully integrated into an educational setting. Improvements in concentration , learning, some aspects of executive functioning, psychosis symptomatology | None N=16 |
[36] | Cognitive deficits to improve work outcomes | Thinking Skills for Work Program (TSWP) + Supported Employment (SE) and Supported Employment only | Attention, psychomotor speed, information processing speed, verbal learning and memory, executive functioning, premorbid academic achievement, symptoms, employment outcomes | For TSWP+SE, improvement in executive functioning and in the composite cognition score. Improved significantly more on Depression and Autistic preoccupation (symptoms). Participants were significantly more likely to work, worked more hours and earned more wages | Control group N = 44 |
[37] | Cognitive deficits to improve work outcomes | Thinking Skills for Work Program (TSWP) + Supported Employment (SE) and Supported Employment only | Work outcomes | In TSWP+SE, over 2-3 years, participants were more likely to work, held more jobs, worked more weeks, worked more hours, and earned more wages. Cognitive functioning and symptoms not assessed. | Control group N = 44 |
[38] | Problem-solving | Computer-assisted problem-solving remediation (PS), memory remediation or TAU | Problem-solving, memory, verbal knowledge, independent living | PS improved problem solving skills | Control group N = 54 |
[39] | Cognitive differentiation, social perception, communication, social skills, and interpersonal problem solving | Integrated Psychological Therapy (IPT) | intellectual ability, memory, verbal fluency, executive functioning and psychosocial functioning | Improvement in memory and executive functioning for those with cognitive impairments | Control group N = 27 |
[40] | Social functioning and neurocognitive deficits | CR and Cognitive Behavior Therapy (CBT) for control | Working memory, psychomotor speed, verbal memory, nonverbal memory, and executive functioning, and social functioning | Overall improvement in neurcognition especially in verbal and nonverbal memory and executive functioning. Improvement in social functioning | Control group N = 40 |
[41] | Verbal and working memory, selective attention and semantic fluency | CR | Verbal and working memory, speed/coordination, selection attention, semantic and letter fluency, executive functioning, sustained attention, interpersonal relations, instrumental role, self-directedness | 3, 6 and months follow up: improvements in attention, psychomotor coordination, cognitive flexibility | Placebo condition N = 100 |
[42] | Memory and executive functioning | One program including 1) paper-and-pencil training 2) computer exercises | Visual attention, cognitive flexibility, sustained attention, inhibition, working memory, long-term verbal memory, executive functioning, planning | CR showed improvements in neuro- and socio-cognitive functions but not on arousal or cognitive flexibility | Placebo group N = 59 |
[43] | Attention | Attention Process Training (APT) and attention-shaping procedure after | Verbal learning, sustained attention | Dramatic improvement in attentiveness in APT but attention-shaping procedure appears to account for the change | Control group N = 31 |
[44] | Neurocognition linked to social competence and behavior | Integrated Psychological Therapy (IPT), supportive therapy and TAU | Social competence, pre-attentional processing, attention, memory, executive functioning and symptoms | IPT improved social competence only | Control group N = 90 |
[45] | Memory, attention, vigilance, executive functioning | CR alone or CR+pharmacotherapy | Attention, learning, memory, executive functioning, functional capacity, negative symptoms, subjective quality of life | CR improved verbal and visual memory at 3 months, not maintained at 6 months. Verbal learning, executive functioning and attention improved at 6 months. Quality of life improvements at 3 months, increased at 6 months | Control group N = 38 |
[46] | Cognitive deficits and negative symptoms | Cognitive strategy training (CAST) and training of self-management skills for negative symptoms (TSSN) | Attention, verbal memory and planning, social withdrawal/social anhedonia, lack of drive, affect flattening | CAST=Greater improvement on attention and verbal memory but not planning ability. Higher job placement TSSN=no improvement in negative symptoms | Control group N = 138 |
[47] | Memory, cognitive flexibility and planning | Neurocognitive remediation and intensive occupational therapy (control) | Cognitive flexibility, planning and working memory. Social behaviour, self-esteem | Improvements in cognitive flexibility and working memory no changes in symptoms or social functioning, 6 month follow up | Control group N = 33 |
[48] | Memory, cognitive flexibility and planning | CR and Intensive occupational therapy | Memory, working memory, cognitive flexibility, response inhibition, planning, symptoms and functioning, self-esteem | Effects of CR at follow-up are still significant on working memory, there were no more effects on self-esteem, 3 and 6 month follow up | Control group N = 33 |
[49] | Memory, cognitive flexibility and planning | CR and TAU | Working Memory, cognitive flexibility, and planning, Secondary: self-esteem, positive and negative symptoms, social functioning | Improvement in working memory and cognitive flexibility, Memory improvement predicted improvement in social functioning. | Control Group N = 85 |
[50] | Memory, cognitive flexibility and planning | CR with remembering, complex planning, problem-solving and TAU | Memory, cognitive flexibility, planning, social behaviour, quality of life, self-esteem | CR improved cognitive flexibility, social functioning, 14 et 18 weeks follow up | Control group N = 40 |
DRILL AND PRACTICE | |||||
[51] | Neurocognitive deficits | Neurocognitive enhancement therapy (NET) & working therapy (WT) | Cognitive flexibility, social inference, emotion recognition, abstract thought, verbal learning, memory | NET + WT greater improvements in executive functioning, working memory and affect recognition | Control group N = 65 |
[52] | Working memory deficits | CR and working therapy (WT) | Attention, memory and executive functioning | CRT+WT yield greater improvements and effects remain over time (6 months) | Control group N = 102 |
[53] | Cognitive deficits to improve work outcomes | Neurocognitive enhancement therapy (NET) + work therapy | Work productivity (hours and dollars earned) | Patients worked more hours, had more dollars earned and tended to have more competitive-wage employment | Control group N = 145 |
[54] | Attention, memory and executive functioning | Neurocognitive enhancement therapy (NET) + Work therapy Work therapy alone | Working memory, verbal and nonverbal memory, thought disorder, executive functioning | Significant improvements in working memory and executive functioning.Both groups had a significant effect on memory (verbal and visual) | Control group N = 145 |
[55] | Functional outcomes (follow up study using the same NET program so classified here instead of in Table 2) | Neurocognitive Enhancement Therapy (NET) + vocational program (VOC) | Work hours, employment rates | NET+VOC patients worked more hours during the 12 month follow-up period and they had higher rates of employment | Control group N = 72 |
[56] | Neurocognition, negative symptoms, self-esteem | Computer-assisted cognitive rehabilitation (CACR) | Attentional deficit, verbal and auditory memory, general level of cognitive functioning, negative symptoms, self-esteem | CACR improved verbal/conceptual learning and memory and executive functioning | Placebo group N = 34 |
[57] | Repetition and memory | Virtual reality training | Orientation, attention, calculations, constructions, memory, language, and reasoning | Improvement of overall cognition | Control group N = 27 |
[58] | Attention/concentration, working memory, logic, and executive functions | CR | Attention/vigilance, verbal/non-verbal working memory, verbal and visual learning and memory, speed of processing, reasoning, problem-solving, quality of life and social autonomy | Improvements in attention/vigilance, verbal memory, problem solving | Control group N = 77 |
[59] | Cognitive deficits | Pharmacotherapy and cognitive retraining (CR) together 1) drug+CR, 2) drug + control CR, 3) placebo + CR, 4) placebo+control CR | Verbal working memory, attention/vigilance Measures of tolerability and safety | CR- significant improvement in verbal working memory. Trend toward improvement in Attention/Vigilance | Control groups N = 104 |
[60] | Executive functioning (and metacognition) | Problem Solving and Cognitive Flexibility trainin (REPYFLEC) | Verbal and visual memory. cognitive flexibility, inhibition of impulsive responses, planning and organization, working memory and time-estimation capacity, attention, processing speed and cognitive flexibility social behavior and relationships, autonomy, employment-occupation and leisure, self-care, social behavior and autonomy | Significant improvements in executive function, negative symptoms and Positive change in life skills and psychosocial functioning. Skills maintained at follow-up especially in self-care, social behavior and employment-occupation. | Control group N = 62 |
[61] | Attentional deficit | Computer-Assisted cognitive rehabilitation or computer games | Various measures of attention such as trail making, letter-cancellation, Stroop, seach-a-word, etc. | Both groups improved in letter-cancellation task due to practice effect | Control group N = 10 |
[62] | Verbal and global cognition | Auditory training | Global cognition, speed of processing, verbal memory/learning, problem-solving, nonverbal memory, visual learning/memory, social cognition | Strong improvement in verbal and global cognition | Placebo group N = 55 |
[63] | Cognition in general | Targeted cognitive training (TCT) | Global cognition, speed of processing, verbal working and learning memory and cognitive control | TCT improvements in verbal learning/memory and cognitive control even 6 months after therapy | Control group N = 32 |
[64] | Cognitive deficits in memory | Computerized cognitive remediation training - digits sequenced recall and words sequenced recall (control: work therapy only) | Cognitive deficits, more specifically memory | Significantly greater improvements on the computerized memory task (digits sequenced recall) remained at the 6 month follow up | Control group N = 94 |
[65] | Memory, attention, cognitive flexibility | Vocational Program (VOC) and NET+VOC | Cognitive flexibility and executive functioning, working memory, visual and verbal memory, social cognition | VOC+NET greater improvement on all outcomes. No improvement in affect recognition after 1 year | Placebo group N = 72 |
[66] | Neural correlates of emotion identification | Training of Affect Recognition (TAR) and TAU | Emotion identification, emotion discrimination, digit symbol, digit span, symptoms, neural activation | TAR improved performance in emotion recognition and discrimination more than TAU and controls. Psychopathological status improvements for both TAR and TAU | Control group and healthy controls N = 30 |
[67] | Effects of age on cognitive functioning | CR and TAU | Working memory, cognitive flexibility and planning. Groups split on age | CR improved working memory only in younger group | Control group N = 134 |
[8] | attention, memory, language and problem-solving | CR and computer-skills training | Working memory, verbal episodic memory, speed of processing, visual episodic memory, reasoning and problem-solving | CR improved working memory but both groups showed improvement on other measures | Placebo group N = 42 |
[68] | Cognitive functioning in general | CR | Attention, psychomotor speed, verbal working memory, verbal learning and memory and executive functioning, information processing speed, academic achievement | Cognitive remediation improvements in overall cognitive functioning, psychomotor speed, and verbal learning | Control group N = 85 |
[69] | Cognitive functioning | Attention Process Training (APT) | Attention, memory and executive functioning Other: positive and negative symptoms | Neither group improved in symptoms and attention and memory measures. APT group had higher performance on executive function | Placebo group N = 24 |
[70] | Attention and information processing | Continuous Performance Test (CPT) | Attention and negative symptoms | CPT improved both measures | Control group N = 54 |
[71] | Memory | Memory remediation (MR), problem-solving remediation and TAU | Memory, verbal learning, problem-solving | MR improved memory but not verbal recall | Control group N = 54 |
[72] | Cognitive impairment | Brain Fitness Program (BFP) | Cognitive performance (CogStat) Functional capacity, auditory processing speed for verbal and non-verbal tasks | BFP training improved auditory processing speed but no effect on cognitive impairments | None N = 55 |
[73] | Divergent thinking | Rock-paper-scissors task, calculation tiles task | Idea, design and letter fluency, digit span, social functioning | Improvements in idea fluency, functioning, and interpersonal relations | Control group N = 17 |
[74] | Visual motion processing | Target discrimination | Perceptual motion and direction processing | Greater perceptual improvement in schizophrenia | Healthy controls N = 27 |
[75] | Cognitive and daily functioning deficits (but concentrating on the neurobiological mechanism that underline them) | CR and Social Skills Training | Functional and structural connectivity brain changes | Brain networks activation pattern significantly changed in patients exposed to the cognitive treatment in the sense of normalizing toward the patterns observed in healthy control subjects | Control groupN = 30 |
[76] | Dysfunctional organization of the auditory/verbal system | Targeted auditory/verbal discrimination Training (TAD) or CRT (CogPack) | Verbal learning and fluency, recall, working memory, clinical symptoms as exploratory measure | Improvement in verbal learning and memory for TAD but no effect on clinical symptoms | Control group N = 39 |
[77] | Brain oscillary activity, linked to dysfunctional information processing | Specific cognitive exercises (CE) fostering auditory/verbal discrimination or standard broad-range cognitive training (CP) | Verbal memory, global functioning, brain oscillary activity | CE improves brain oscillary activity and reduces information processing dysfunction | Control group and healthy controls N = 51 |
[78] | Verbal memory and learning, processing speed, working memory and attention | CR | Verbal memory, visual working memory, visuo-spatial memory, processing speed, psychomotor speed, working memory, verbal fluency, attention, visual-perceptual function | Patients in all groups improved in measures of information processing, verbal memory, and visuospatial memory | One placebo group and one control group N = 44 |
[79] | Cognitive deficits | CR (Cogpack) | Memory functions, attention, concentration, logical abilities, verbal reasoning | Cogpack improves cognitive functioning in persons at risk. Specifically at risk group improve in long-term memory functions, attention, and concentration. Patients with schizophrenia – no improvement. | Control group N =16 schizophrenia N = 10 at risk |
[80] | Planning and problem-solving, processing speed, memory and attention | Plan-a-day And Training for basic cognition | Planning ability, problem-solving, global assessment, functional capacity, working memory, verbal memory, processing speed and inhibition | Both groups improved in measures of cognitive functioning and functional capacity. Plan-a-day improved planning | None N = 89 |
[81] | Verbal learning and processing speed | CR | Word fluency, memory and recall, | All outcomes improved in CR | Control group N = 42 |
[82] | Impairment in reality monitoring | CR | Reality monitoring Prefrontal cortex activity | Improvement in reality monitoring that correlated with increased medial prefrontal cortex activity (related to improvement in social functioning 6 months later) | Control group N = 31 (schizophrenia) N = 15 healthy controls |
[83] | Visual and auditory learning | CR consisting of visual, auditory and cognitive control | Visual memory, visual-spatial memory, auditory verbal memory, verbal and letter learning | Visual training strongly predicts visual learning but not auditory learning | Placebo control N = 14 |
[84] | Perceptual, memory and motor functions | Sustained and repeated training with no instructions, increasingly demanding tasks | Visual word, visual dot localization, motor processing | After training, most participants performed as well or better than best controls on tasks | Control group and healthy controls N = 22 |