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Neuroplastic Changes Following Social Cognition Training in Schizophrenia: A Systematic Review

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Abstract

Social cognitive impairment is a key feature of schizophrenia and social cognition training (SCT) is a promising tool to address these deficits. Neurobiological dysfunction in schizophrenia has been widely researched, but neuronal changes induced by SCT have been scarcely explored. This review aims to assess the neuroplastic effects of SCT in patients with schizophrenia spectrum disorders. PubMed and Web of Science databases were searched for clinical trials testing the effects of SCT in functional and structural brain measurements of adult patients with schizophrenia or schizoaffective disorders. A total of 11 studies were included: five used fMRI, two used EEG and ERP, one used ERP only, two used MEG and one study used MRI. Data extracting and processing regarding sociodemographic and clinical variables, intervention characteristics, neuroimaging procedures, neuroplastic findings, effect sizes and study quality criteria was completed by two raters. Results indicate a wide range of structural and functional changes in numerous regions and circuits of the social brain, including early perceptual areas, the limbic system and prefrontal regions. Despite the small number of trials currently available, evidence suggests that SCT is associated with neuroplastic changes in the social brain and concomitant improvements in social cognitive performance. There is a lack of extensive knowledge about the neural mechanisms that underlie social cognitive enhancement after treatment, but the reported findings may shed light on the neural substrates of social cognitive impairment in schizophrenia and how improved treatment procedures can be developed and applied.

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Authors and Affiliations

  1. Polytechnic Institute of Porto, Health School, Rua Valente Perfeito, 332, 4400-330, Vila Nova de Gaia, Portugal

    Carlos Campos, Susana Santos & Nuno Barbosa Rocha

  2. Panic and Respiration Laboratory, Institute of Psychiatry, Federal University of Rio de Janeiro, Av. Venceslau Brás, 71, Campus da Praia Vermelha, Rio de Janeiro, Brazil

    Carlos Campos & Sérgio Machado

  3. Department of Psychology, University of North Carolina-Chapel Hill, 235 E. Cameron Avenue, Chapel Hill, NC, 27599-3720, USA

    Emily Gagen

  4. Physical Activity Neuroscience, Physical Activity Postgraduate Program, Salgado de Oliveira University (UNIVERSO), Rua Marechal Deodoro, 263 – Centro, Niterói, Brazil

    Sérgio Machado

  5. School of Accounting and Administration of Porto, Polytechnic Institute of Porto, Rua Jaime Lopes Amorim, s/n, 4465-004 S, Mamede de Infesta, Portugal

    Susana Rocha

  6. Department of Psychology and Program in Neuroscience and Behavior, Wesleyan University, 45 Wyllys Ave, Middletown, CT, 06459, USA

    Matthew M. Kurtz

  7. Department of Psychiatry, Yale School of Medicine, 300 George St., Suite 901, New Haven, CT, 06511, USA

    Matthew M. Kurtz

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  1. Carlos Campos
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  2. Susana Santos
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  3. Emily Gagen
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Appendix 1. Measures Used in the studies

Appendix 1. Measures Used in the studies

Social Cognitive Measures

Emotion Perception

  • Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT: Perceiving Emotions subtest) (Mayer, Salovey, Caruso, & Sitarenios, 2003)

  • Emotion discrimination task (Habel et al., 2010)

  • Pictures of Facial Affect (PFA) (Ekman and Friesen 1976)

  • Benton Face Recognition Test (BFRT) (Benton, 1994)

  • Emotion attribution task (Blair & Cipolotti, 2000; Mazza et al., 2007)

  • Facial affect recognition task (Popova et al. 2014)

Theory of Mind

  • Advanced Theory of Mind Scale (Happé, 1994)

Social function

  • Empathy Questionnaires (EQ) (Baron-Cohen & Wheelwright, 2004)

  • Social Performance Scale (PSP) (Morosini, Magliano, Brambilla, Ugolini, & Pioli, 2000)

Neurocognition Measures

  • Wechsler Memory Scale (WMS) (Wechsler, 1987)

  • Wechsler Adult Intelligence Scale (WAIS) (Wechsler, 1981)

  • California Verbal Learning Test (CVLT) (Delis, Kramer, Kaplan, & Ober, 1987)

  • Wisconsin Card Sorting Test (WCST) (Heaton, Chelune, Talley, Kay, & Curtiss, 1993)

  • Tower of London (Culbertson & Zillmer, 2001)

  • Trail Making Test part B (TMT-B) (Reitan, 1992; Reitan & Wolfson, 1985)

  • Wechsler Abbreviated Scale of Intelligence (WASI) (Wechsler, 1999)

  • Matrics Consensus Cognitive Battery-Composite (MCCB) (Nuechterlein et al., 2008)

  • RAVEN-Matrizen-test, standard progressive matrices (Heller, Kratzmeier, & Lengfelder, 1998)

  • Forward and Backward Digit Span (Evans, Chua, McKenna, & Wilson, 1997)

  • Trail Making Test part A (TMT-A) (Reitan, 1992; Reitan & Wolfson, 1985)

  • Rey Auditory Verbal Learning Test (RAVLT) (Evans et al., 1997)

  • Behavioural Assessment of the Dysexecutive Syndrome (BADS) (Evans et al., 1997)

  • Brief Assessment of Cognition in Schizophrenia (BACS) (Keefe et al., 2004)

  • Neuropsychological Assessment Battery (NAB) (Stern & White, 2003)

Symptoms

  • Positive and Negative Syndrome Scale (PANSS) (Kay, Flszbein, & Opfer, 1987)

  • Psychopathy Check List: Short Version (PCL:SV) (Hart & Cox, 1995)

  • Historical Clinical and Risk Management Scales (HCR-20) (Müller-Isberner, Jöckel, & Gonzalez Cabeza, 1998)

  • Brief Psychiatric Rating Scale (BPRS) (Ventura et al., 1993)

Functioning

  • Global Assessment of Functioning (GAF) (American Psychiatric, 2000)

  • Quality of life scale (QLS) (Bilker et al., 2003)

Other Measures

  • Neurological Evaluation Scale (NES) (Buchanan & Heinrichs, 1989)

  • Edinburgh Handedness Questionnaire (EHQ) (Oldfield, 1971)

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Campos, C., Santos, S., Gagen, E. et al. Neuroplastic Changes Following Social Cognition Training in Schizophrenia: A Systematic Review. Neuropsychol Rev 26, 310–328 (2016). https://doi.org/10.1007/s11065-016-9326-0

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