Sensory-targeted cognitive training for schizophrenia

ABSTRACT

Introduction: Auditory and visual dysfunctions are key pathophysiological features of schizophrenia (Sz). Therefore, remedial interventions that directly target such impairments could potentially drive gains in higher-order cognition (e.g., memory, executive functions, emotion processing), symptoms and functional outcome, in addition to improving sensory abilities in this population. Here, we reviewed available sensory-targeted cognitive training (S-TCT) programs that were investigated so far in Sz patients.

Area covered: A systematic review of the literature was conducted following PRISMA guidelines. Twenty-seven relevant records were included. The superiority of S-TCT over control conditions on higher-order cognition measures was repeatedly demonstrated, but mostly lost significance at later endpoints of evaluation. Clinical symptoms and functional outcome were improved in a minority of studies. S-TCT interventions were associated with the relative normalization of several neurobiological biomarkers of neuroplasticity and sensory mechanisms.

Expert commentary: S-TCT, although time-intensive, is a cost-efficient, safe and promising technique for Sz treatment. Its efficacy on higher-order cognition opens a critical window for clinical and functional improvement. The biological impact of S-TCT may allow for the identification of therapeutic biomarkers to further precision-medicine. Additional research is required to investigate the long-term effects of S-TCT, optimal training parameters and potential confounding factors associated with the illness.

KEYWORDS:

• Biomarkers
• remediation
• schizophrenia
• sensory dysfunction
• targeted cognitive training

Article highlights

• Several studies have now evaluated the efficacy of S-TCT programs and yielded promising preliminary results to improve higher-order cognition in Sz. This approach is informed by neuroscientific research demonstrating auditory and visual perceptual process deficits in the illness.

• These findings propose that S-TCT may open a critical window for long-term clinical and real-life functional improvement in Sz.

• S-TCT is associated with relative improvement of neurobiological biomarkers of neuroplasticity and sensory mechanisms, which may allow the identification of therapeutic biomarkers to further precision-medicine in this field.

• Future studies must look for optimal S-TCT parameters, dose-response effects, acceptability enhancement of the training, impact of confounding factors associated with the illness and potential add-on techniques.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.