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Patients with schizophrenia have shown cognitive improvements following
cognitive remediation, but the neuroplastic changes that support these
processes are not fully understood.
To use a triple-blind, placebo-controlled trial to examine neural
activation before and after cognitive remediation or a computer skills
training (CST) placebo (trial registration: NCT00995553)).
Twenty-seven participants underwent functional magnetic resonance imaging
before and after being randomised to either cognitive remediation
intervention or CST. Participants completed two variants of the N-back
task during scanning and were assessed on measures of cognition,
functional capacity, community functioning and symptoms.
We observed a group × time interaction in the left prefrontal cortex,
wherein the cognitive remediation group showed increased activation.
These changes correlated with improved task accuracy within the cognitive
remediation group, whereas there was no relationship between changes in
activation in untrained cognitive measures. Significant changes were not
observed in other hypothesised areas for the cognitive remediation
We replicated the finding that cognitive remediation increases left
lateral prefrontal activation during a working memory task in patients
with schizophrenia, suggesting this may be an important neural target for
these types of interventions.
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