Development of cognitive rehabilitation and the basic study in patients with schizophrenia

The first purpose of this study was to examine characteristics of cognitive deficits and learning potential in patients with schizophrenia. Especially, we focused on feature of structure of social knowledge and memory learning. Second, we investigated brain function during cognitive tasks as to verify effects of cognitive rehabilitation. For this, we have established validity of methodology with normal people. Finally, we have developed original methods of cognitive rehabilitation based on the above studies, administered it to patients with schizophrenia and examined the effects. All patients met ICD-10 criteria for schizophrenia and were not during acute phase, and were relatively stable. Before sessions of cognitive rehabilitation, Neuropsychological tests were individually administered to patients and the results were referred to method of individual cognitive rehabilitation. The patients attended individual therapy sessions of 40 min each once a week during 3 months. The program included remediation training for deficits of organization of social knowledge and driving exercise using the imitation machine, involving attention and executive function. Neuopsychological assessments, evaluation of clinical symptoms and brain function measurement by near-infrared spectroscopy (NIRS) were administered at baseline and after 3-months intervention, and after 3-months follow-up. As a result, patients showed better performance on the social knowledge task (script), the tests of executive function and verbal fluency test after 3-months intervention than at baseline. Furthermore, their effects were kept until 3-months follow-up. In addition, score of bizarre behavior out of positive symptoms was lower after 3-months intervention than at baseline. Activation in prefrontal area during the cognitive task using NIRS tended to show change in patients with schizophrenia after intervention.