Schizophrenia patients suffer from severe cognitive deficits, such as impaired reality monitoring. Reality monitoring is the ability to distinguish the source of internal experiences from outside reality. During reality monitoring tasks, schizophrenia patients make errors identifying " I made it up" items, and even during accurate performance, they show abnormally low activation of the medial prefrontal cortex (mPFC), a region that supports self-referential cognition. We administered 80 hr of computerized training of cognitive processes to schizophrenia patients and found improvement in reality monitoring that correlated with increased mPFC activity. In contrast, patients in a computer games control condition did not show any behavioral or neural improvements. Notably, recovery in mPFC activity after training was associated with improved social functioning 6 months later. These findings demonstrate that a serious behavioral deficit in schizophrenia, and its underlying neural dysfunction, can be improved by well-designed computerized cognitive training, resulting in better quality of life. Video Abstract: Schizophrenia patients suffer from an impaired inability to distinguish internal information from external experience. Subramaniam et al. find computerized cognitive training in schizophrenics improves this reality monitoring with increased mPFC activity, predicting better social function 6 months later.
Bibliographical noteFunding Information:
This research was supported by the National Institute of Mental Health through grant R01MH068725 to Sophia Vinogradov and R01 grants DC4855 and DC6435 to Srikantan Nagarajan. Gregory Simpson is a Senior Scientist at Brain Plasticity Institute, Inc., and Sophia Vinogradov is a consultant to Brain Plasticity Institute, Inc., which has a financial interest in computerized cognitive training programs. We thank Kasper Winther Jorgensen, Stephanie Sacks, Arul Thangavel, Adelaide Hearst, Coleman Garrett, Mary Vertinski, Christine Holland, Alexander Genevsky, Christine Hooker, Daniel H. Mathalon, Michael M. Merzenich, and Gary H. Glover for their assistance and input on this project.