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Early auditory processing abnormalities alter individual learning trajectories and sensitivity to computerized cognitive training in schizophrenia

Published online by Cambridge University Press:  08 April 2024

Juan L. Molina ,
Yash B. Joshi ,
John A. Nungaray ,
Joyce Sprock ,
Mouna Attarha ,
Bruno Biagianti ,
Michael L. Thomas ,
Neal R. Swerdlow  and
Gregory A. Light
Juan L. Molina*
Affiliation:
Department of Psychiatry, University of California, San Diego, CA, USA VA Desert Pacific Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, USA
Yash B. Joshi
Affiliation:
Department of Psychiatry, University of California, San Diego, CA, USA VA Desert Pacific Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, USA
John A. Nungaray
Affiliation:
Department of Psychiatry, University of California, San Diego, CA, USA
Joyce Sprock
Affiliation:
Department of Psychiatry, University of California, San Diego, CA, USA VA Desert Pacific Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, USA
Mouna Attarha
Affiliation:
Department of R&D, Posit Science Corporation, San Francisco, CA, USA
Bruno Biagianti
Affiliation:
Department of Psychology, University of Milano-Bicocca, Milan, Italy
Michael L. Thomas
Affiliation:
Department of Psychology, Colorado State University, Fort Collins, CO, USA
Neal R. Swerdlow
Affiliation:
Department of Psychiatry, University of California, San Diego, CA, USA
Gregory A. Light
Affiliation:
Department of Psychiatry, University of California, San Diego, CA, USA VA Desert Pacific Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, USA
*
Corresponding author: Juan L. Molina; Email: jlm028@health.ucsd.edu
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Abstract

Background

Auditory system plasticity is a promising target for neuromodulation, cognitive rehabilitation and therapeutic development in schizophrenia (SZ). Auditory-based targeted cognitive training (TCT) is a ‘bottom up’ intervention designed to enhance the speed and accuracy of auditory information processing, which has been shown to improve neurocognition in certain SZ patients. However, the dynamics of TCT learning as a function of training exercises and their impact on neurocognitive functioning and therapeutic outcomes are unknown.

Methods

Forty subjects (SZ, n = 21; healthy subjects (HS), n = 19) underwent comprehensive clinical, cognitive, and auditory assessments, including measurements of auditory processing speed (APS) at baseline and after 1-h of TCT. SZ patients additionally completed 30-hours of TCT and repeated assessments ~10–12 weeks later.

Results

SZ patients were deficient in APS at baseline (d = 0.96, p < 0.005) relative to HS. After 1-h of TCT, analyses revealed significant main effects of diagnosis (d = 1.75, p = 0.002) and time (d = 1.04, p < 0.001), and a diagnosis × time interaction (d = 0.85, p = 0.02) on APS. APS learning effects were robust after 1-h in SZ patients (d = 1.47, p < 0.001) and persisted throughout the 30-h of training. Baseline APS was associated with verbal learning gains after 30-h of TCT (r = 0.51, p = 0.02) in SZ.

Conclusions

TCT learning metrics may have prognostic utility and aid in the prospective identification of individuals likely to benefit from TCT. Future experimental medicine studies may advance predictive algorithms that enhance TCT-related clinical, cognitive and functional outcomes.

Keywords

cognitive rehabilitationcognitive trainingearly auditory processingschizophrenia
Type
Original Article
Information
Psychological Medicine , First View , pp. 1 - 8
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Copyright
Copyright © The Author(s), 2024. Published by Cambridge University Press

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