Recognition of cognitive impairment in schizophrenia

It’s good to see some progress being made towards the recognition of cognitive impairment in schizophrenia and looking at possible treatment options:

http://www.needrecognition.com

Cognitive symptoms, which may include deficits in memory, attention, working memory, processing speed, and problem solving

  • Can be present prior to the onset of illness
  • Persist during periods of psychotic symptom remission
  • Are highly predictive of outcome and functioning

Despite the availability of effective antipsychotic therapy, cognitive impairment remains an important unmet treatment need


Patients With Schizophrenia Demonstrate Impairment in a Broad Range of Cognitive Domains vs Healthy Individuals

Cognitive domains impaired by schizophrenia

Proposed Mechanisms of Cognitive Impairment in Schizophrenia

Conversations on Cognition

Interventions:

  • Cognitive remediation
  • The MATRICS team identified drug mechanisms of interest, including cholinergic, dopaminergic, and glutamatergic approaches
  • Of the cholinergic approaches, the α7 was identified as a top target of investigation

Potential Mechanistic Targets for Treatment of Cognitive Impairment in Schizophrenia

CHOLINERGIC
  • α7 receptor
  • muscarinic M1 MAChR
DOPAMINERGIC
  • dopamine D1 receptor
GLUTAMATERGIC
  • AMPA glutamatergic receptor
  • NMDA glutamatergic receptor
  • Metabotropic glutamate receptor
  • Glycine reuptake
OTHER
  • α2 adrenergic receptor
  • GABAA R subtype

See more:

Pharmacological Treatment of Cognitive Symptoms

The Magic of Movement; the Potential of Exercise to Improve Cognition (2015)

Effects of glutamate positive modulators on cognitive deficits in schizophrenia: a systematic review and meta-analysis of double-blind randomized controlled trials. (2015)

Cognitive enhancing agents in schizophrenia and bipolar disorder (2015)

Drug repurposing and emerging adjunctive treatments for schizophrenia (2015)

Sex hormones and oxytocin augmentation strategies in schizophrenia: A quantitative review (2015)

Adjunctive Minocycline in Clozapine-Treated Schizophrenia Patients With Persistent Symptoms (2015)

A critical review of pro-cognitive drug targets in psychosis: convergence on myelination and inflammation

Psychopharmacological treatment of neurocognitive deficits in people with schizophrenia: a review of old and new targets.

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