When top-down meets bottom-up: Auditory training enhances verbal memory in schizophrenia

R. Alison Adcock, Corby Dale, Melissa Fisher, Stephanie Aldebot, Alexander Genevsky, Gregory V. Simpson, Srikantan Nagarajan, Sophia Vinogradov

Research output: Contribution to journalReview articlepeer-review

156 Scopus citations


A critical research priority for our field is to develop treatments that enhance cognitive functioning in schizophrenia and thereby attenuate the functional losses associated with the illness. In this article, we describe such a treatment method that is grounded in emerging research on the widespread sensory processing impairments of schizophrenia, as described elsewhere in this special issue. We first present the rationale for this treatment approach, which consists of cognitive training exercises that make use of principles derived from the past 2 decades of basic science research in learning-induced neuroplasticity; these exercises explicitly target not only the higher order or "top-down" processes of cognition but also the content building blocks of accurate and efficient sensory representations to simultaneously achieve "bottom-up" remediation. We then summarize our experience to date and briefly review our behavioral and serum biomarker findings from a randomized controlled trial of this method in outpatients with long-term symptoms of schizophrenia. Finally, we present promising early psychophysiological evidence that supports the hypothesis that this cognitive training method induces changes in aspects of impaired bottom-up sensory processing in schizophrenia. We conclude with the observation that neuroplasticity-based cognitive training brings patients closer to physiological patterns seen in healthy participants, suggesting that it changes the brain in an adaptive manner in schizophrenia.

Original languageEnglish (US)
Pages (from-to)1132-1141
Number of pages10
JournalSchizophrenia bulletin
Issue number6
StatePublished - Nov 2009


  • cognition
  • cognitive training
  • psychophysiology
  • schizophrenia


Dive into the research topics of 'When top-down meets bottom-up: Auditory training enhances verbal memory in schizophrenia'. Together they form a unique fingerprint.

Cite this