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Background: The ability to manage emotions is an important social-cognitive domain impaired in schizophrenia and linked to functional outcome. The goal of our study was to examine the impact of cognitive enhancement therapy (CET) on the ability to manage emotions and brain functional connectivity in early-course schizophrenia. Methods: Participants were randomly assigned to CET (n = 55) or an enriched supportive therapy (EST) control group (n = 45). The resting-state functional magnetic resonance imaging scans and measures of emotion management performances were collected at baseline, 9, and 18 months follow-up. The final sample consisted of 37 CET and 25 EST participants, including 19 CET and 12 EST participants with imaging data. Linear mixed-effects models investigated the impact of treatment on emotion management and functional connectivity from the amygdala to ventrolateral and dorsolateral prefrontal cortex (dlPFC). Results: The CET group showed significant improvement over time in emotion management compared to EST. Neither functional connectivity changes nor main group differences were observed following treatment. However, a significant between-group interaction showed that improved emotion management ability was associated with increased functional connectivity between the left amygdala and the left dlPFC in the CET group exclusively. Conclusion: Our results replicate the previous work demonstrating that CET is effective at improving some aspects of social cognition in schizophrenia. We found evidence that improvement in emotion management may be associated with a change in amygdala-dlPFC connectivity. This fronto-limbic circuit may provide a mechanistic link between the biology of emotion management processes that can be enhanced in individuals with schizophrenia. [ABSTRACT FROM AUTHOR]

Background: Cognitive impairments are a core feature of schizophrenia. Although cognitive impairments have consistently shown to have negative impacts on functional outcomes among individuals with schizophrenia, assessing and treating these symptoms in clinical settings remains a difficult challenge. Interestingly, the growing potential of new digital technologies, such as smartphone applications and virtual reality, hold great promise in alleviating these impairments. Methods: This presentation will introduce results from two recent studies using digital technologies to assess and treat cognitive symptoms in schizophrenia. In the first study, smartphone versions of the pen-and-paper Trail Making Tests A and B were developed. These cognitive tests measure speed of processing and cognitive flexibility. We assessed the validity of the smartphone versions of both Trail Making Tests in measuring these cognitive domains in in 37 healthy controls and 26 individuals with schizophrenia. Following the initial assessment, participants were asked to complete the two smartphone cognitive tests once a week for three months. This served as a measure of cognitive performance over time Results: Results showed that it was feasible to measure cognition using a smartphone application in schizophrenia. Performances on both smartphone cognitive tests were significantly and positively correlated with the pen-and-paper versions (Parts A: r = 0.65, p < .001; Parts B: r= 0.44, p= .01). Additionally, significant differences were observed between controls and individuals with schizophrenia on both smartphone tests (Part A: t = -3.88, p = .004; Part B: t = -3.29, p = .002). Moreover, longitudinal results showed no significant effect of practice over time on the smartphone cognitive tests. Discussion: Digital technologies have the potential to optimize cognitive assessments, monitoring, and care in schizophrenia. Our findings support the feasibility and efficacy of using digital technologies to measure and treat cognitive impairments in schizophrenia. Our research also highlights the importance of including scientists, clinicians, and content experts with schizophrenia in the development of these tools to ensure their validity and facilitate clinical implementation. [ABSTRACT FROM AUTHOR]