Predictors of response to cognitive remediation in patients with major psychotic disorders: A narrative review.
Journal
Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073
Informations de publication
Date de publication:
15 02 2021
15 02 2021
Historique:
received:
22
07
2020
revised:
19
11
2020
accepted:
04
12
2020
pubmed:
20
12
2020
medline:
22
4
2021
entrez:
19
12
2020
Statut:
ppublish
Résumé
Cognitive impairments are prominent features of individuals diagnosed with major psychotic disorders (MPD), negatively affecting occupational and social functioning. Over the past few years, several cognitive remediation (CR) interventions have been developed, with different foundation principles, targets, and mechanisms of action. The vast majority consists of drill and practice approaches that are grounded in the principle of neuropsychology. More recently, neuroplasticity-based cognitive training (NBCT) has shown promise. While several CR approaches have shown moderate efficacy, improving both cognition and real-world functioning, there is considerable variability in individual treatment response. Studies that have investigated factors that predict CR outcome and can be used to guide treatment have historically grouped all CR approaches together. Here, we aim to explore common and distinct predictors of response to neuroplasticity-based and neuropsychology-based CR. an electronic database search on MEDLINE/PubMed was conducted in February 2020 to identify articles investigating predictors of response to CR. We limited our queries to peer-reviewed, English-language journal articles describing trials of CR for adults with MPD. a total of 58 articles were examined, and 14 different categories of CR predictors were identified. CR predictors that most stood out were age, shorter illness duration, lower symptoms severity, lower antipsychotic medications, and the delivery of CR in combination with other treatments. Although results are still mixed, demographical variables appear to be far less important for NBCT than they are for other CR programs. Clinical and genetic variables - such as symptoms severity, lower antipsychotic dose, serum BDNF and serum D-serine - seem to influence more significantly NBCT than neuropsychology-based CR. Data on NBCT is relatively scarce, and further research is required to better understand which predictive factors uniquely pertain to it. The identification of predictors of response to CR will allow to implement a personalized medicine approach, in which each patient can receive a personalized cognitive remediation program according to their specific needs.
Sections du résumé
BACKGROUND
Cognitive impairments are prominent features of individuals diagnosed with major psychotic disorders (MPD), negatively affecting occupational and social functioning. Over the past few years, several cognitive remediation (CR) interventions have been developed, with different foundation principles, targets, and mechanisms of action. The vast majority consists of drill and practice approaches that are grounded in the principle of neuropsychology. More recently, neuroplasticity-based cognitive training (NBCT) has shown promise. While several CR approaches have shown moderate efficacy, improving both cognition and real-world functioning, there is considerable variability in individual treatment response. Studies that have investigated factors that predict CR outcome and can be used to guide treatment have historically grouped all CR approaches together. Here, we aim to explore common and distinct predictors of response to neuroplasticity-based and neuropsychology-based CR.
METHODS
an electronic database search on MEDLINE/PubMed was conducted in February 2020 to identify articles investigating predictors of response to CR. We limited our queries to peer-reviewed, English-language journal articles describing trials of CR for adults with MPD.
RESULTS
a total of 58 articles were examined, and 14 different categories of CR predictors were identified. CR predictors that most stood out were age, shorter illness duration, lower symptoms severity, lower antipsychotic medications, and the delivery of CR in combination with other treatments. Although results are still mixed, demographical variables appear to be far less important for NBCT than they are for other CR programs. Clinical and genetic variables - such as symptoms severity, lower antipsychotic dose, serum BDNF and serum D-serine - seem to influence more significantly NBCT than neuropsychology-based CR.
CONCLUSIONS
Data on NBCT is relatively scarce, and further research is required to better understand which predictive factors uniquely pertain to it. The identification of predictors of response to CR will allow to implement a personalized medicine approach, in which each patient can receive a personalized cognitive remediation program according to their specific needs.
Identifiants
pubmed: 33341008
pii: S0165-0327(20)33100-1
doi: 10.1016/j.jad.2020.12.011
pii:
doi:
Substances chimiques
Antipsychotic Agents
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
264-270Subventions
Organisme : NIMH NIH HHS
ID : R43 MH121209
Pays : United States
Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.