Carolus, Almut

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Carolus
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Almut
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Veröffentlichung

The impact of cognitive training on spontaneous gamma oscillations in schizophrenia

2018-04-06, Popova, Petia, Rockstroh, Brigitte, Miller, Gregory A, Wienbruch, Christian, Carolus, Almut, Popov, Tzvetan G.

Schizophrenia patients exhibit less gamma-frequency EEG/MEG activity (>30 Hz), a finding interpreted as evidence of poor temporal neural organization and functional network communication. Research has shown that neuroplasticity-oriented training can improve task-related oscillatory dynamics, indicating some reorganization capacity in schizophrenia. Demonstrating a generalization of such task training effects to spontaneous oscillations at rest would not only enrich understanding of this neuroplastic potential but inform the interpretation of spontaneous gamma oscillations in the service of normal cognitive function. In the present study, neuromagnetic resting-state oscillatory brain activity and cognitive performance were assessed before and after training in 61 schizophrenia patients, who were randomly assigned to 4 weeks of neuroplasticity-oriented targeted cognitive training or treatment as usual (TAU). Gamma power of 40-90 Hz increased after training, but not after TAU, in a frontoparietal network. Across two types of training, this increase was related to improved cognitive test performance. These results indicate that abnormal oscillatory dynamics in schizophrenia patients manifested in spontaneous gamma activity can be changed with neuroplasticity-oriented training parallel to cognitive performance.

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Kognitive Defizite bei Schizophren Erkrankten : Einfluss von Training

2015, Carolus, Almut, Popova, Petia, Rockstroh, Brigitte

Theoretischer Hintergrund:
Kognitive Funktionseinschränkungen sind zentrales Merkmal schizophrener Erkrankungen und werden entsprechend im Behandlungskonzept berücksichtigt. Kognitive Remediationsprogramme gelten als wirksam, Effektstärken als moderat. Trainingsvarianten werden zur Effektoptimierung erprobt.

Fragestellung:
Ist gezieltes Funktionstraining in neuroplastizitäts-orientiertem Lernkontext effektiver als breitgefächertes Behandlungsprogramm und werden Effekte durch das Erkrankungsstadium moduliert?

Methode:
Bei 59 chronisch und 31 ersthospitalisierten schizophren Erkrankten wurden kognitive Defizite über Testleistungen der MATRICS Consensus Cognitive Test Battery gegenüber 25 gesunder Kontrollpersonen erfasst. Testleistungen vor, nach 4-wöchiger Interventionsphase mit zwei spezifischen Trainings oder Standardbehandlung und 3-monatiger Katamnese prüften den Einfluss von Interventionstypus und Erkrankungsstadium auf Leistungsverbesserung.

Ergebnisse:
Sowohl chronische wie erstmals behandelte Patienten aller Behandlungsgruppen verbesserten sich signifikant über die Messzeitpunkte, obwohl Defizite relativ zu Kontrollen fortbestanden.

Schlussfolgerungen:
Spezifisches Training verbessert kognitive Funktionen nicht über Zeit/Remissionseffekte hinaus.

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Veröffentlichung

Functional cognitive and cortical abnormalities in chronic and first-admission schizophrenia

2014, Carolus, Almut, Schubring, David, Popov, Tzvetan G., Popova, Petia, Miller, Gregory A., Rockstroh, Brigitte

Evoked and induced event-related neural oscillations have recently been proposed as a key mechanism supporting higher-order cognition. Cognitive decay and abnormal electromagnetic sensory gating reliably distinguish schizophrenia (SZ) patients and healthy individuals, demonstrated in chronic (CHR) and first-admission (FA) patients. Not yet determined is whether altered event-related modulation of oscillatory activity is manifested at early stages of SZ, thus reflects and perhaps embodies the development of psychopathology, and provides a mechanism for the gating deficit. The present study compared behavioral and functional brain measures in CHR and FA samples. Cognitive test performance (MATRICS Consortium Cognitive Battery, MCCB), neuromagnetic event-related fields (M50 gating ratio), and oscillatory dynamics (evoked and induced modulation of 8–12 Hz alpha) during a paired-click task were assessed in 35 CHR and 31 FA patients meeting the criteria for ICD-10 diagnoses of schizophrenia as well as 28 healthy comparison subjects (HC). Both patient groups displayed poorer cognitive performance, higher M50 ratio (poorer sensory gating), and less induced modulation of alpha activity than did HC. Induced alpha power decrease in bilateral posterior regions varied with M50 ratio in HC but not SZ, whereas orbitofrontal alpha power decrease was related to M50 ratio in SZ but not HC. Results suggest disruption of oscillatory dynamics at early stages of illness, which may contribute to deficient information sampling, memory updating, and higher cognitive functioning.