From The Quarterly, Spring 2013

The changes to brain function that schizophrenia effects, the cognitive deficits that inflict the most devastating long-term disabilities, are difficult to reverse and can worsen with recurring psychotic episodes. Recent research strongly indicates that the earlier the intervention to prevent or minimize the brain changes caused by schizophrenia, the better the long-term functional results.



Although a person’s predisposition for schizophrenia is likely determined even before birth, the disorder does not usually manifest itself until late adolescence or early adulthood. Dr. Loewy and her colleagues, among them NARSAD Grantee Sophia Vinogradov, M.D., have been working to develop computer-based early interventions aimed at preventing or reversing the cognitive damage of schizophrenia. They have been conducting trials with two specific groups of young people. Those in the first group are in what is called the prodromal, or pre-onset, stage; that is, they have exhibited behaviors that point to risk for schizophrenia but have not yet displayed full-blown psychosis. Those in the second group have recently experienced their first psychotic break.



Among the critical thinking skills that can be affected by schizophrenia is information processing, the ability to pick out and retain with speed and accuracy what is important in a particular situation and respond appropriately as, for example, in negotiating traffic, holding a conversation or reading the emotion on someone’s face. Progressive brain changes and inefficient information processing have been observed to occur during the early phases of psychosis.



Dr. Loewy and team have created software specifically aimed at strengthening information processing, beginning with a focus on auditory processing: information about sounds. Participants in the lab’s trial are asked to spend an hour a day, five days a week, for eight weeks with laptop computers, listening to differing sounds and making distinctions among the sounds. The first signals they hear are simple, and they must note, simply, if the sound is going up or going down. As the trial progresses, the tasks become increasingly more difficult, requiring greater effort. The program is designed to maintain an 80 percent accuracy rate, which keeps the participants having to push their efforts.

    

Early results with a small trial sample lead Dr. Loewy to feel hopeful that this kind of cognitive training can be effective in averting long-term brain impairment for people with schizophrenia. The question still needing to be pursued is whether this method of changing cognitive function can improve their real-world functioning.

Rachel Loewy, Ph.D.

Associate Professor, Department of Psychiatry,

University of California, San Francisco;

2007 and 2009 NARSAD Young Investigator Grantee

Women’s Mental Health Conference:

The Art & Science of Caring



On September 14, 2012 in New York City, the Brain & Behavior Research Foundation hosted the Women’s Mental Health Conference: The Art & Science of Caring. The event included a panel discussion on Early Intervention, Rehabilitation and Reintegration; small group discussions with leading researchers across mental illnesses; and a final panel discussion on overcoming stigma and the future of public policy and research. This is a highlight of some of the presentations. Full transcripts of the talks are available at bbrfoundation.org/2012-WMHC.