Community-Based Cognitive Training in Early Schizophrenia

? DESCRIPTION (provided by applicant): The purpose of this competing supplement is to perform state-of-the-art magnetoencephalography imaging (MEGI) to determine neural system plasticity in young patients with recent-onset schizophrenia who are participating in our recently initiated randomized controlled trial (RCT) of two distinct forms of cognitive training vs. treatmet as usual. The parent study is being performed in three community mental health centers with specialized Early Intervention Services. The two forms of cognitive training are browser-based, delivered via iPads, and performed at home. In the study proposed here, we will leverage the resources, infrastructure, and unique participant population of our RCT to investigate high-impact questions regarding training-related brain plasticity and the relationship of both baseline neural signature as well as specific neural changes to individual treatment response. Our specific aims are: 1. to use MEGI to examine functional brain plasticity in young individuals early in the course of schizophrenia, induced by two distinct forms of intensive cognitive training; and to investigate the association of plasticity to behavioral gains after training and at 6-month follow-up. 2. to determine the prognostic value of baseline neural network functional integrity for predicting responsiveness to two distinct different forms of cognitive training. 3. as an exploratory aim, we will also investigate structural brain plasticity in our three subject groups, using voxel-based morphometry (VBM) and diffusion tensor imaging (DTI), to determine structural brain changes that are associated with training. The findings from this study will generate high-impact data on neuroplasticity responses to specific forms of training in early schizophrenia and their association with enduring behavioral gains; it will also delineate the relationship of baseline neural signature to the response to each form of training. Such knowledge is critical if we are to develop optimally effective personalized treatments that pre-empt cognitive deterioration and promote recovery in schizophrenia.