NHS Choices helps improve brain health and science literacy by reporting findings in context — as seen in this brain training & schizophrenia example

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Video game-based ‘brain train­ing’ may help peo­ple with schiz­o­phre­nia (NHS Choices):

“Peo­ple with schiz­o­phre­nia can be trained by play­ing a video game to con­trol the part of the brain linked to ver­bal hal­lu­ci­na­tions,” BBC News reports…

(Con­clu­sion offered by NHS Choic­es) This study showed some promis­ing ini­tial find­ings for a new way of man­ag­ing audi­to­ry hal­lu­ci­na­tions in peo­ple with schizophrenia.

It may be pos­si­ble for peo­ple to be able to learn how to bet­ter con­trol and cope with the sounds they hear by using a process of com­put­er feedback.

But this was only a pilot study and was­n’t designed to ful­ly eval­u­ate the effec­tive­ness of the treatment.

To do this would require:

  • A much larg­er num­ber of par­tic­i­pants to see whether the effects could be con­sis­tent­ly detect­ed and not down to chance.
  • A con­trol group. It may be help­ful to com­pare the results with a sham fMRI scan-com­put­er inter­ven­tion to see whether this was­n’t just a place­bo effect. It would then be help­ful to move on to com­pare the find­ings with a con­trol group of patients who received a more con­ven­tion­al range of sup­port and treatment.
  • Longer fol­low-up of the par­tic­i­pants to see whether the effects of under­tak­ing this train­ing could be main­tained over time.
  • Whether the effects of the inter­ven­tion make a mean­ing­ful dif­fer­ence to the per­son­’s dai­ly life and functioning.
  • Whether the effects vary by the type of symp­toms the per­son has – for exam­ple, whether it’s dif­fer­ent in peo­ple who get oth­er types of hal­lu­ci­na­tions, not just hear­ing voices.
  • Mak­ing sure the inter­ven­tion did­n’t have any poten­tial harms.

This study is a good start­ing point for the researchers to con­tin­ue their inves­ti­ga­tions. But it’s far too ear­ly to be able to tell whether this inter­ven­tion will ever be intro­duced into clin­i­cal prac­tice in the future.”

The Study:

Real-time fMRI neu­ro­feed­back to down-reg­u­late supe­ri­or tem­po­ral gyrus activ­i­ty in patients with schiz­o­phre­nia and audi­to­ry hal­lu­ci­na­tions: a proof-of-con­cept study (Trans­la­tion­al Psychiatry).

  • From the abstract: Neu­rocog­ni­tive mod­els and pre­vi­ous neu­roimag­ing work posit that audi­to­ry ver­bal hal­lu­ci­na­tions (AVH) arise due to increased activ­i­ty in speech-sen­si­tive regions of the left pos­te­ri­or supe­ri­or tem­po­ral gyrus (STG). Here, we exam­ined if patients with schiz­o­phre­nia (SCZ) and AVH could be trained to down-reg­u­late STG activ­i­ty using real-time func­tion­al mag­net­ic res­o­nance imag­ing neu­ro­feed­back (rtfM­RI-NF). We also exam­ined the effects of rtfM­RI-NF train­ing on func­tion­al con­nec­tiv­i­ty between the STG and oth­er speech and lan­guage regions…Post- train­ing, patients showed increased func­tion­al con­nec­tiv­i­ty between the left STG, the left infe­ri­or pre­frontal gyrus (IFG) and the infe­ri­or pari­etal gyrus. The post-train­ing increase in func­tion­al con­nec­tiv­i­ty between the left STG and IFG was asso­ci­at­ed with a reduc­tion in AVH symp­toms over the train­ing peri­od. The speech-sen­si­tive region of the left STG is a suit­able tar­get region for rtfM­RI-NF in patients with SCZ and treat­ment-refrac­to­ry AVH. Suc­cess­ful down-reg­u­la­tion of left STG activ­i­ty can increase func­tion­al con­nec­tiv­i­ty between speech motor and per­cep­tion regions. These find­ings sug­gest that patients with AVH have the abil­i­ty to alter activ­i­ty and con­nec­tiv­i­ty in speech and lan­guage regions, and raise the pos­si­bil­i­ty that rtfM­RI-NF train­ing could present a nov­el ther­a­peu­tic inter­ven­tion in SCZ.

The Study in Context: