Enhancing Cognitive Training Through Exercise Following a First Schizophrenia Episode
Condition: Schizophrenia; Schizophreniform Disorder; Schizoaffective Disorder
MeSH terms: Schizophrenia; Psychotic Disorders
Study type: Interventional

Summary: 
      This is a confirmatory randomized controlled trial of the efficacy of a novel intervention
      combining neuroplasticity-based cognitive training with aerobic exercise, compared to the
      same systematic cognitive training alone. Treatment occurs for 6 months after randomization,
      with a followup assessment at 12 months. The investigators hypothesize that combining
      neuroplasticity-based computerized cognitive training and neurotrophin-enhancing physical
      exercise will produce neurotrophin increases and cognitive and functional improvements, even
      relative to cognitive training alone. The investigators target the period shortly after a
      first episode of schizophrenia to maximize the generalization of cognitive improvement to
      functional outcome, before chronic disability is established.
    

Detailed description: 
      The Cognitive Training and Exercise intervention consists of 24 weeks of systematic
      computerized cognitive training, 4 hours per week, plus aerobic exercise, 150 minutes per
      week. The Cognitive Training Intervention includes the same systematic cognitive training.
      The first 12 weeks involve neurocognitive training, using training exercises from Posit
      Science Brain HQ. The second 12 weeks involves social cognitive training, using the Posit
      Science SocialVille modules. Aerobic exercise occurs as two 45-minute sessions at the clinic
      and two 30-minute sessions at home weekly. Intensity of aerobic exercise is tailored to
      maintain an individualized target heart rate zone and is monitored by a heart rate recorder.
      A weekly one-hour Bridging Skills Group with other members of the treatment condition is
      designed to aid generalization of training to everyday life situations. The immediate target
      is brain-derived neurotrophic factor. The primary treatment outcomes are overall cognitive
      deficit level and global functioning level.
    

Intervention name(s): Cognitive Training; Aerobic Exercise; Case management and supportive psychotherapy; Individual Placement and Support
Intervention type(s): Behavioral; Behavioral; Behavioral; Behavioral
Intervention description(s): 24 weeks of systematic computerized cognitive training, 4 hours per week. The first 12 weeks involves neurocognitive training, using auditory training exercises from Posit Science Brain HQ. The 2nd 12 weeks involves social cognitive training, using the Posit Science SocialVille modules. A weekly one-hour Bridging Skills Group is designed to aid generalization of training to everyday life situations.; Aerobic exercise occurs as two 45-minute sessions at the clinic and two 30-minute sessions at home weekly. Exercise involves an adaptation of interval training, including a variety of calisthenics that can be done without specialized equipment. Intensity of aerobic exercise is tailored to maintain an individualized target heart rate zone and is monitored by a heart rate recorder.; An individual therapist will provide weekly case management and therapy targeting the individual psychological problems and everyday functioning needs of the patient; An job/school specialist will use the Individual Placement and Support model to help participants return to school or work and provide ongoing outreach support.
Other intervention name(s): cognitive remediation; physical exercise; supported education/employment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: cognitive training; aerobic exercise; neurotrophic factors; randomized controlled trial; functional outcome