10 In this brief overview, we will describe several key issues for cognitive training in schizophrenia, based on a perspective that is directly translated from current experimental neuroscience. We use the term “cognitive training” rather than “cognitive

remediation,” since this approach is analogous to physical fitness training, where specific behaviors are used to harness intact physiologic mechanisms in order to restore or enhance performance. Inhibitors,research,lifescience,medical We will: (i) highlight relevant findings from previous cognitive remediation studies in schizophrenia; (ii) delineate key factors for the design of a neuroscience -based approach to cognitive training in schizophrenia; (iii) summarize recent results from our laboratory; and (iv) indicate what we see as the Inhibitors,research,lifescience,medical next directions for the development of neuroscience-informed approaches to cognitive training in psychiatric illness. Three key findings from previous research Previous studies of traditional approaches to cognitive remediation in schizophrenia

have been confounded by various methodological issues (see refs 11,12): small subject samples, “open-label” Inhibitors,research,lifescience,medical conditions, treatment- as-usual control groups, unblinded assessments, and unspecified plans for statistical analysis. Studies that avoided these issues have tended to find only small to moderate effect sizes.11,13-15 Nonetheless, the following findings point to some interesting next steps for the field: With the exception Inhibitors,research,lifescience,medical of verbal learning and memory, the meta-analysis by www.selleckchem.com/products/Vandetanib.html McGurk et al found no significant heterogeneity in effect sizes on various MATRICSdefined cognitive domains based on either the number of hours of training or the method employed.2 This indicates that for the

majority of cognitive Inhibitors,research,lifescience,medical domains, neither the training method, nor the amount of training (several hours to over 100 hours) has been a key moderating variable. Thus, although previous cognitive remediation approaches have provided modest nonspecific cognitive benefits, further refinement of the intervention and the use of rigorous study designs are critical next steps for the field. Meta-analyses have also shown that in verbal memory, larger effect sizes are obtained when computerized training is given in a drill-and-practice approach for a large number of hours.2,12 This AV-951 suggests that computerized cognitive remediation given in a sufficiently large “dose” may be a highly important approach in schizophrenia. Significant synergy occurs when cognitive remediation is combined with a psychosocial intervention, such as vocational rehabilitation or social skills training.2-4,12,16-18 This indicates that appropriate cognitive training can best prepare the individual with schizophrenia to benefit from ecologically meaningful learning events, and underscores the fact that optimal treatment in schizophrenia will necessitate multimodal approaches.