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CompletedNCT00431223fMRIUpdated Oct 6, 2020

Brain Activation Patterns in Schizophrenia After Computerized Cognitive Skills Training

An interventional study of Cognitive remediation therapy in Schizophrenia, sponsored by Manhattan Psychiatric Center. Completed at 1 site in United States. Open to male participants aged 18 Years to 55 Years. Per ClinicalTrials.gov, last updated 2020-10-06.

Sponsored by Manhattan Psychiatric Center · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
11
Allocation
Randomized
Ages
18 Years to 55 Years
Sex
Male
01

Study summary

This project is a novel exploratory research project to investigate changes in activation patterns of the dorsolateral prefrontal cortex (DLPFC) in inpatients with schizophrenia who received a 12-week computerized cognitive remediation (CRT) program. The hypothesis is that patients receiving CRT will show greater increase in activation patterns in the brain as compared to controls, and the degree of brain activation will correlate with improvements in working memory.

Read the detailed description

Abnormalities in the domains of attention, working memory (WM) and information processing are important features of schizophrenia. There is growing literature that cognitive remediation therapy (CRT) can produce modest improvements in cognitive functioning in schizophrenia, suggesting that systematic efforts at improving cognitive functioning are feasible. Cognitive improvement after CRT may correlate with changes in brain activation patterns in specific areas.

After screening, patients are randomized to a 12 week trial of CRT using COGPACK (Marker Software), or to a 12-week control condition. All patients attend 3 weekly 1-hour laboratory sessions, with 1 discussion session per week.

Patients continue their antipsychotic treatment with a typical or atypical antipsychotic during the CRT and 4 weeks prior to enrollment in the study (Phase A). Following Phase A they receive baseline evaluations, including an cognitive activation task (N-back visual-letter task) while being scanned for fMRI , MATRICS neuropsychological test battery, and psychiatric, social functioning, and symptoms assessment.

Patients then enter Phase B with randomization to control or CRT for 12 weeks (36 laboratory sessions). Upon successful completion of 36 sessions, endpoint evaluations include an N-back task while fMRI scan, MATRICS, psychiatric, and social functional assessments.

All baseline and endpoint fMRI scans are conducted at the Center for Advanced Brain Imaging (CABI) at Nathan Kline Institute for Psychiatric Research.

02

Conditions studied

  • Schizophrenia

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Keywords

  • fMRI
  • working memory
  • schizophrenia
  • treatment refractory
  • cognitive skills training
  • dorsolateral prefrontal cortex
  • cognitive remediation
  • treatment refractory schizophrenia of > 5 years duration
03

In context

Schizophrenia

3,563 studies on the registry are indexed under Schizophrenia; 491 are open to participants now.

This study's enrollment of 11 is below the median of 71 across 2,944 interventional studies indexed under Schizophrenia.

Browse Schizophrenia studies →

Lead sponsor

Manhattan Psychiatric Center is the lead sponsor of 9 studies on the registry; 1 is open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 55 Years
Sexes eligible
Male
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Inpatient status
  • Age 18 - 55
  • Male gender (females are enrolled but will not be scanned)
  • diagnosis of schizophrenia (all subtypes) and schizoaffective disorder
  • illness duration > 5 years
  • score > 24 (inclusive) at screening
  • Stable dose of oral atypical antipsychotic for at least 4 weeks prior to study entry
  • Total PANSS score > 60 at screening
  • Capacity and willingness to give written
  • Patients deemed not ready to be discharged within the next 12 weeks

Exclusion criteria

Exclusion Criteria:

  • Inability to read or speak English
  • Documented disease of the central nervous system
  • History of intellectual impairment pre-dating onset of symptoms of psychosis (e.g. mental retardation)
  • or unstable cardiovascular, renal, hepatic, gastrointestinal, pulmonary, or hematological conditions; positive
  • Any medical condition rendering the subject unable to receive an fMRI scan
Terms in these criteria, in plain language(5)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

DSM diagnostic criteria

The American Psychiatric Association’s manual of mental health diagnoses. DSM-5 (2013, revised as DSM-5-TR in 2022) replaced DSM-IV, and some studies still name the older edition. “Meets DSM criteria for …” means diagnosed by that edition’s diagnostic criteria, usually by a clinician in an interview.

MMSE and MoCA

Short tests of memory and thinking, each scored out of 30. Lower scores suggest more difficulty; criteria give a range, either to include people with memory problems or to leave them out.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

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Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
11 participants (actual)

Study arms

  • Active comparator
    Active Group

    7 patients were assigned to Cognitive Remediation Therapy..

    Behavioral: Cognitive remediation therapy

  • No intervention
    Control Group

    4 patients were assigned to Control group or no cognitive remediation therapy.

Interventions

  • BehavioralCognitive remediation therapy

    36 sessions of computerized cognitive skills training over a 12 week duration. 7 patients were assigned to cognitive remediation therapy or CRT Group.

    Also known as: CRT Group

06

What researchers measure

Primary outcomes

  1. Brain activation changes after stimulation with a neurocognitive task in the dorso-lateral prefrontal cortex (DLPFC)

    Time frame: 12 weeks

Secondary outcomes

  1. Examine the relationship of changes in DLPFC activation patterns in relation to improvement on neurocognitive tests

    Time frame: 12 weeks

07

Study locations

1 site
  • Manhattan Psychiatric Center
    New York, New York 10035, United States
08

References and documents

Publications

  • Wykes T, Reeder C, Corner J, Williams C, Everitt B. The effects of neurocognitive remediation on executive processing in patients with schizophrenia. Schizophr Bull. 1999;25(2):291-307. doi: 10.1093/oxfordjournals.schbul.a033379. PubMed 10416732 ↗
09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Oct 6, 2020, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT00431223
Lead sponsor
Manhattan Psychiatric Center
Collaborators
Nathan Kline Institute for Psychiatric Research
Responsible party
Jean-Pierre Lindenmayer (Clinical Director, Manhattan Psychiatric Center) — Principal investigator
First posted
Feb 5, 2007
Start date
Sep 2006
Primary completion
Sep 2008
Completion
Sep 2008
Last update
Oct 6, 2020

Study contacts

Saurabh Kaushik, MD
principal investigator · Manhattan Psychaitric Center
Jean-Pierre Lindenmayer, MD
study chair · Manhattan Psychiatric Center
Susan McGurk, PhD
study chair · Dartmouth College, Hanover
Craig A. Branch, PhD
study chair · Center for Advanced Brain Imaging, NKI

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Oct 2020. You cannot join it, but the record below documents what was studied.

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