Skip to main content

Methods for Delivering and Evaluating the Efficacy of Cognitive Enhancement

  • Chapter
Cognitive Enhancement

Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 228))

Abstract

Cognitive deficits are related to impaired everyday functioning in multiple conditions and in healthy individuals. Treatment of cognitive functioning can be facilitated through either pharmacological or remediation strategies. The critical goals of cognitive enhancement are to improve everyday functioning in multiple domains. This chapter describes the strategies that are most desirable for the treatment of cognitive impairments and detection of potential benefits of treatment in cognitive and functional domains. These strategies include the use of performance-based assessments of cognition and functioning and the appropriate use of observational strategies to detect changes. Finally, we define several outcome-related goals and discuss the practicality of their measurement.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Bowie CR, Harvey PD, Moriarty PJ et al (2002) Cognitive assessment of geriatric schizophrenic patients with severe impairment. Arch Clin Neuropsychol 17:611–623

    Article  PubMed  Google Scholar 

  • Bowie CR, Twamley EW, Anderson H et al (2007) Self-assessment of functional status in schizophrenia. J Psychiatr Res 41:1012–1018

    Article  PubMed Central  PubMed  Google Scholar 

  • Bowie CR, McGurk SM, Mausbach BT et al (2012) Combined cognitive remediation and functional skills training for schizophrenia: effects on cognition, functional competence, and real-world behavior. Am J Psychiatry 169:710–718

    Article  PubMed  Google Scholar 

  • Bowie CR, Grossman M, Gupta M et al (2014) Cognitive remediation in schizophrenia: efficacy and effectiveness in patients with early vs. long-term course of illness. Early Interv Psychiatry 8:32–38

    Article  PubMed  Google Scholar 

  • Buchanan RW, Davis M, Goff D, Green MF, Keefe RSE, Leon A, Nuechterlein K, Laughren T, Levin R, Stover E, Fenton W, Marder S (2005) A Summary of the FDA-NIMH-MATRICS workshop on clinical trial designs for neurocognitive drugs for schizophrenia. Schizophr Bull 31:5–19

    Article  PubMed  Google Scholar 

  • Buchanan RW, Keefe RS, Umbricht D et al (2011) The FDA-NIMH-MATRICS guidelines for clinical trial design of cognitive-enhancing drugs: what do we know 5 years later? Schizophr Bull 37:1209–1217

    Article  PubMed Central  PubMed  Google Scholar 

  • Choi J, Medalia A (2010) Intrinsic motivation and learning in a schizophrenia spectrum sample. Schizophr Res 118:12–19

    Article  PubMed Central  PubMed  Google Scholar 

  • Davidson M, Harvey PD, Welsh K et al (1996) Cognitive impairment in old-age schizophrenia: a comparative study of schizophrenia and Alzheimer’s disease. Am J Psychiatry 153:1274–1279

    Article  CAS  PubMed  Google Scholar 

  • Depp CA, Mausbach BT, Harvey PD et al (2010) Social competence and observer-rated social functioning in bipolar disorder. Bipolar Disord 12:843–850

    Article  PubMed Central  PubMed  Google Scholar 

  • Dickinson D, Ramsey M, Gold JM (2007) Overlooking the obvious: a meta-analytic comparison of digit symbol coding tasks and other cognitive measures in schizophrenia. Arch Gen Psychiatry 64:532–542

    Article  PubMed  Google Scholar 

  • Durand D, Strassnig M, Sabbag S et al (2015) Factors influencing self-assessment of cognition and functioning in schizophrenia: implications for treatment studies. Eur Neuropsychopharmacol 25:185–191

    Article  CAS  PubMed  Google Scholar 

  • Fisher M, Holland C, Merzenich MM et al (2009) Using neuroplasticity-based auditory training to improve verbal memory in schizophrenia. Am J Psychiatry 166:805–811

    Article  PubMed Central  PubMed  Google Scholar 

  • Fisher M, Holland C, Subramaniam K et al (2010) Neuroplasticity-based cognitive training in schizophrenia: an interim report on the effects 6 months later. Schizophr Bull 36:869–879

    Article  PubMed Central  PubMed  Google Scholar 

  • Fisher M, Loewy R, Carter C et al (2015) Neuroplasticity-based auditory training via laptop computer improves cognition in young individuals with recent onset schizophrenia. Schizophr Bull 41:250–258.

    Article  PubMed  Google Scholar 

  • Freedman R, Olincy A, Buchanan RW et al (2008) Initial phase 2 trial of a nicotinic agonist in schizophrenia. Am J Psychiatry 165:1040–1047

    Article  PubMed Central  PubMed  Google Scholar 

  • George MS et al (2007) A single 20 mg dose of dihydrexidine (DAR-0100), a full dopamine D1 agonist, is safe and tolerated in patients with schizophrenia. Schizophr Res 93:42–50

    Article  PubMed  Google Scholar 

  • Goldberg TE, Keefe RSE, Goldman R et al (2010) Circumstances under which practice does not make perfect: a review of the practice effect literature in schizophrenia and its relevance to clinical treatment studies. Neuropsychopharmacology 35:1053–1062

    Article  PubMed Central  PubMed  Google Scholar 

  • Green MF (1996) What are the functional consequences of neurocognitive deficits in schizophrenia? Am J Psychiatry 153:321–330

    Article  CAS  PubMed  Google Scholar 

  • Green MF, Kern RS, Braff DL et al (2000) Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the ‘right stuff’? Schizophr Bull 26:119–136

    Article  CAS  PubMed  Google Scholar 

  • Harvey PD (2009) Pharmacological cognitive enhancement in schizophrenia. Neuropsychol Rev 19:324–335

    Article  PubMed  Google Scholar 

  • Harvey PD (2012) Clinical applications of neuropsychological assessment. Dialogues Clin Neurosci 14:91–99

    PubMed Central  PubMed  Google Scholar 

  • Harvey PD, Velligan DI, Bellack AS (2007) Performance-based measures of functional skills: usefulness in clinical treatment studies. Schizophr Bull 33:1138–1148

    Article  PubMed Central  PubMed  Google Scholar 

  • Harvey PD, Helldin L, Bowie CR et al (2009a) Performance-based measurement of functional disability in schizophrenia: a cross-national study in the United States and Sweden. Am J Psychiatry 166:821–827

    Article  PubMed Central  PubMed  Google Scholar 

  • Harvey PD, Keefe RS, Patterson TL et al (2009b) Abbreviated neuropsychological assessments in schizophrenia: association with different outcomes measures. J Clin Exp Neuropsychol 31:462–471

    Article  PubMed Central  PubMed  Google Scholar 

  • Harvey PD, Sabbag S, Prestia D et al (2012) Functional milestones and clinician ratings of everyday functioning in people with schizophrenia: overlap between milestones and specificity of ratings. J Psychiatr Res 46:1546–1552

    Article  PubMed Central  PubMed  Google Scholar 

  • Harvey PD, Raykov T, Twamley EW et al (2013a) The factor structure of neurocognition and functional capacity in schizophrenia: a multidimensional examination of temporal stability. J Int Neuropsychol Soc 2013(19):656–663

    Article  Google Scholar 

  • Harvey PD, Siu C, Hsu J et al (2013b) Effect of lurasidone on neurocognitive performance in patients with schizophrenia: a short-term placebo- and active-controlled study followed by a 6-month double-blind extension. Eur Neuropsychopharmacol 11:1373–1382

    Article  Google Scholar 

  • Heaton RK (1992) Comprehensive norms for an expanded Halstead-Reitan battery: demographic corrections, research findings, and clinical applications. Psychological Assessment Resources, Lakeland, FL

    Google Scholar 

  • Heaton RK, Pendleton MG (1981) Use of neuropsychological tests to predict patients everyday functioning. J Consult Clin Psychol 49:807–821

    Article  CAS  PubMed  Google Scholar 

  • Heaton RK, Temkin N, Dikmen S et al (2001) Detecting change: a comparison of three neuropsychological methods, using normal and clinical samples. Arch Clin Neuropsychol 16:75–91

    Article  CAS  PubMed  Google Scholar 

  • Insel TR, Gogtay N (2014) National institute of mental health clinical trials: new opportunities, new expectations. JAMA Psychiatry 71:745–746

    Article  PubMed  Google Scholar 

  • Iverson GL, Brooks BL, Ashton VL et al (2009) Does familiarity with computers affect computerized neuropsychological test performance? J Clin Exp Neuropsychol 31(5):594–604

    Article  PubMed  Google Scholar 

  • Jeste SD, Patterson TL, Palmer BW et al (2003) Cognitive predictors of medication adherence among middle-aged and older outpatients with schizophrenia. Schizophr Res 63:49–58

    Article  PubMed  Google Scholar 

  • Keefe RS, Goldberg TE, Harvey PD et al (2004) The brief assessment of cognition in schizophrenia: reliability, sensitivity, and comparison with a standard neurocognitive battery. Schizophr Res 68:283–297

    Article  PubMed  Google Scholar 

  • Keefe RSE, Bilder RM, Harvey PD et al (2006a) Baseline neurocognitive deficits in the CATIE schizophrenia trial. Neuropsychopharmacology 31:2033–2046

    Article  PubMed  Google Scholar 

  • Keefe RSE, Poe M, Walker TM et al (2006b) The schizophrenia cognition rating scale: an interview-based assessment and its relationship to cognition, real-world functioning, and functional capacity. Am J Psychiatry 163:426–432

    Article  PubMed  Google Scholar 

  • Keefe RSE, Fox KH, Harvey PD, Cucchiaro J, Siu C, Loebel A (2011) Characteristics of the MATRICS Consensus Cognitive Battery in a 29-site Antipsychotic Schizophrenia Clinical Trial. Schizophr Res 125:161–168

    Article  PubMed  Google Scholar 

  • Keefe RSE, Vinogradov S, Medalia A et al (2012) Feasibility and pilot efficacy results from the multi-site Cognitive Remediation in the Schizophrenia Trials Network (CRSTN) study. J Clin Psychiatry 73:1016–1022

    Article  PubMed Central  PubMed  Google Scholar 

  • Keshavan MS, Vinogradov S, Rumsey J et al (2014) Cognitive training in mental disorders: update and future directions. Am J Psychiatry 171:510–522

    Article  PubMed Central  PubMed  Google Scholar 

  • Leifker FR, Patterson TL, Bowie CR et al (2010) Psychometric properties of performance-based measurements of functional capacity. Schizophr Res 119:246–252

    Article  PubMed Central  PubMed  Google Scholar 

  • Leifker FR, Patterson TL, Heaton RK et al (2011) Validating measures of real-world outcome: the results of the VALERO Expert Survey and RAND Panel. Schizophr Bull 37:334–343

    Article  PubMed Central  PubMed  Google Scholar 

  • Lindenmayer JP, McGurk SR, Mueser KT et al (2008) A randomized controlled trial of cognitive remediation among inpatients with persistent mental illness. Psychiatr Serv 59:241–247

    Article  PubMed  Google Scholar 

  • Mausbach BT, Harvey PD, Goldman SR et al (2007) Development of a brief scale of everyday functioning in persons with serious mental illness. Schizophr Bull 33:1364–1372

    Article  PubMed Central  PubMed  Google Scholar 

  • Mausbach BT, Depp CA, Bowie CR et al (2011) Sensitivity and specificity of the UCSD performance-based skills assessment (UPSA-B) for identifying functional milestones in schizophrenia. Schizophr Res 132:165–170

    Article  PubMed Central  PubMed  Google Scholar 

  • McGurk SR, Mueser KT, Feldman K et al (2007) Cognitive training for supported employment: 2–3 year outcomes of a randomized controlled trial. Am J Psychiatry 164:437–441

    Article  PubMed  Google Scholar 

  • Nuechterlein KH, Barch DM, Gold JM et al (2004) Identification of separable cognitive factors in schizophrenia. Schizophr Res 72:29–39

    Article  PubMed  Google Scholar 

  • Nuechterlein KH, Green MF, Kern RS et al (2008) The MATRICS consensus cognitive battery, part 1: test selection, reliability, and validity. Am J Psychiatry 165:203–213

    Article  PubMed  Google Scholar 

  • Patterson TL, Goldman S, McKibbin CL et al (2001) UCSD performance-based skills assessment: development of a new measure of everyday functioning for severely mentally ill adults. Schizophr Bull 27:235–245

    Article  CAS  PubMed  Google Scholar 

  • Paulsen JS, Salmon DP, Monsch A et al (1995) Discrimination of cortical from subcortical dementias on the basis of memory and problem-solving tests. J Clin Psychol 51:48–58

    Article  CAS  PubMed  Google Scholar 

  • Risacher SL, Wang Y, Wishart HA et al (2013) Cholinergic enhancement of brain activation in mild cognitive impairment during episodic memory encoding. Front Psychiatry 4:105. doi:10.3389/fpsyt.2013.00105

    Article  PubMed Central  PubMed  Google Scholar 

  • Rosenheck R, Leslie D, Keefe R, CATIE Study Investigators Group et al (2006) Barriers to employment for people with schizophrenia. Am J Psychiatry 163:411–417

    Article  PubMed  Google Scholar 

  • Ruse SA, Davis VG, Atkins AS et al (2014) Development of a virtual reality assessment of everyday living skills. J Vis Exp 86. doi: 10.3791/51405

    Google Scholar 

  • Sabbag S, Twamley EW, Vella L et al (2011) Assessing everyday functioning in schizophrenia: not all informants seem equally informative. Schizophr Res 131:250–255

    Article  PubMed Central  PubMed  Google Scholar 

  • Sabbag S, Twamley E, Vella L et al (2012) Predictors of the accuracy of self-assessment of everyday functioning in people with schizophrenia. Schizophr Res 137:190–195

    Article  PubMed Central  PubMed  Google Scholar 

  • Silver JM, Koumaras B, Chen M et al (2006) The effects of rivastigmine on cognitive function in patients with traumatic brain injury. Neurology 67:748–755

    Article  CAS  PubMed  Google Scholar 

  • Silver JM, Koumaras B, Meng X et al (2009) Long-term effects of rivastigmine capsules in patients with traumatic brain injury. Brain Inj 23:123–132

    Article  PubMed  Google Scholar 

  • Sostek AJ, Buchsbaum MS, Rapoport JL (1980) Effects of amphetamine on vigilance performance in normal and hyperactive children. J Abnorm Child Psychol 8:491–500

    Article  CAS  PubMed  Google Scholar 

  • Strassnig M, Signorile J, Gonzalez C et al. (2014) Cognitive training in mental disorders: update and future directions. Schizophr Res Cog 1:112–121

    Article  Google Scholar 

  • Ventura J, Reise SP, Keefe RS et al (2013) The Cognitive Assessment Interview (CAI): reliability and validity of a brief-based measure of cognition. Schizophr Bull 39(3):583–591

    Article  PubMed Central  PubMed  Google Scholar 

  • Wechsler D (2008) Wechsler adult intelligence scale, 4th edn. Pearson Assessment, San Antonio, TX

    Google Scholar 

  • Wykes T, Huddy V, Cellard C et al (2011) A meta-analysis of cognitive remediation for schizophrenia: methodology and effect sizes. Am J Psychiatry 168:472–485

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Philip D. Harvey .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Harvey, P.D., Keefe, R.S.E. (2015). Methods for Delivering and Evaluating the Efficacy of Cognitive Enhancement. In: Kantak, K., Wettstein, J. (eds) Cognitive Enhancement. Handbook of Experimental Pharmacology, vol 228. Springer, Cham. https://doi.org/10.1007/978-3-319-16522-6_1

Download citation

Publish with us

Policies and ethics