Cited by 360Schizophrenia research and treatmentDementia and Cognitive Impairment ResearchMental Health and Psychiatry

Neuroprotective Effects of Cognitive Enhancement Therapy Against Gray Matter Loss in Early Schizophrenia: Results From a 2-Year Randomized Controlled Trial

Open access
Eack, Shaun M., Hogarty, Gerard E., Cho, Raymond Y., Prasad, Konasale M. R., Greenwald, Deborah P., Hogarty, Susan S., Keshavan, Matcheri S.·2010·Archives of General Psychiatry

Abstract

CONTEXT: Cognitive rehabilitation has shown efficacy in improving cognition in patients with schizophrenia but the underlying neurobiologic changes that occur during these treatments and support cognitive improvement are not well known. OBJECTIVE: To examine differential changes in brain morphology in early course schizophrenia during cognitive rehabilitation vs supportive therapy. DESIGN: Randomized controlled trial. SETTING: An outpatient research clinic at a university-based medical center that provides comprehensive care services for patients with severe mental illness. PATIENTS: A total of 53 symptomatically stable but cognitively disabled outpatients in the early course of schizophrenia or schizoaffective disorder. INTERVENTIONS: A 2-year trial with annual structural magnetic resonance imaging and cognitive assessments. Cognitive enhancement therapy is an integrated approach to the remediation of cognitive impairment in schizophrenia that uses computer-assisted neurocognitive training and group-based social-cognitive exercises. Enriched supportive therapy is an illness management approach that provides psychoeducation and teaches applied coping strategies. MAIN OUTCOME MEASURES: Broad areas of frontal and temporal gray matter change were analyzed with longitudinal, voxel-based morphometry methods using mixed-effects models followed by volumetric analyses of regions that demonstrated significant differential changes between treatment groups. RESULTS: Patients who received cognitive enhancement therapy demonstrated significantly greater preservation of gray matter volume over 2 years in the left hippocampus, parahippocampal gyrus, and fusiform gyrus, and significantly greater gray matter increases in the left amygdala (all corrected P < .04) compared with those who received enriched supportive therapy. Less gray matter loss in the left parahippocampal and fusiform gyrus and greater gray matter increases in the left amygdala were significantly related to improved cognition and mediated the beneficial cognitive effects of cognitive enhancement therapy. CONCLUSION: Cognitive enhancement therapy may offer neurobiologic protective and enhancing effects in early schizophrenia that are associated with improved long-term cognitive outcomes.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1001/archgenpsychiatry.2010.63

Cites

60 of 60 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • In some studies of behavioral interventions, younger people with schizophrenia and those early in the course of illness appeared to benefit more from cognitive remediation than older people.

    “In some studies of behavioral interventions not reviewed comprehensively in this report, younger people with schizophrenia and those early in the course of illness appeared to benefit more from cognitive remediation than older people.63–65”

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 4

  1. [34]First MB Spitzer RL Gibbon M Williams JBW Structured Clinical Interview For DSM-IV-TR Axis I Disorders, Research Version, Patient Edition New York Biometrics Research, New York State Psychiatric Institute 2002
  2. [35]Ben-Yishay Y Piasetsky EB Rattok J A systematic method for ameliorating disorders in basic attention Meir MJ Benton AL Diller L Neuropsychological rehabilitation 165 181 New York Guilford Press 1985
  3. [53]Selman RL Schultz LH Making a Friend in Youth Chicago, IL University of Chicago Press 1990
  4. [54]Wyer RS Srull TK Handbook of social cognition. Vol. 1: Basic Processes Hillside, NJ Lawrence Earlbaum Association 1994

Cited by

Sorted by citations

Authors
Eack, S. M., Hogarty, G. E., Cho, R. Y., Prasad, K. M. R., Greenwald, D. P., Hogarty, S. S., & Keshavan, M. S.
Affiliations
  • University of Pittsburgh (US)
  • Beth Israel Deaconess Medical Center (US)
Venue
Archives of General Psychiatry
Published
2010-07-01
Volume
67
Issue
7
Pages
674
ISSN
0003-990X (ISSN-L)
OpenAlex
W2094767250
Cited by
360
References
60
Citations by year
2026: 6 · 2025: 5 · 2024: 14 · 2023: 8 · 2022: 19 · 2021: 14 · 2020: 15 · 2019: 36 · 2018: 19 · 2017: 25 · 2016: 22 · 2015: 27 · 2014: 32 · 2013: 42 · 2012: 50
FWCI
25.80
Type
journal article
Language
en
Open access
Locations
  • Archives of General Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (KL2TR000146)
  • National Institute of Mental Health (MH 79537, MH-60902, R01MH060902, K23MH072995, F31MH079537)
  • National Center for Research Resources (KL2RR024154)
  • National Center for Advancing Translational Sciences
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
Keywords
cognitive enhancement therapy, early schizophrenia, gray matter loss, cognitive rehabilitation, neuroprotection, hippocampus, parahippocampal gyrus, fusiform gyrus, amygdala, brain structure, social cognitive training, illness management, cognitive impairment, schizoaffective disorder, voxel-based morphometry
MeSH terms
Adult, Amygdala, Atrophy, Cognition Disorders, Female, Frontal Lobe, Hippocampus, Humans, Longitudinal Studies, Magnetic Resonance Imaging, Male, Neuropsychological Tests, Psychotherapy, Psychotic Disorders, Schizophrenia, Schizophrenic Psychology, Social Support, Temporal Lobe, Cognitive Behavioral Therapy, Treatment Outcome, Parahippocampal Gyrus

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review