Standardization, Integration, and Sharing—Leveraging Research Investments

Abstract

Cognitive impairment has been recognized as a significant cause of disability in schizophrenia for more than 20 years ( 1 Green M.F. What are the functional consequences of neurocognitive deficits in schizophrenia?. Am J Psychiatry. 1996; 153: 321-330 PubMed Google Scholar , 2 Green M.F. Kern R.S. Braff D.L. Mintz J. Neurocognitive deficits and functional outcome in schizophrenia: Are we measuring the “Right Stuff”?. Schizophr Bull. 2000; 26: 119-136 Crossref PubMed Scopus (2398) Google Scholar ), but the development of effective treatments for cognitive impairment in schizophrenia has been slow to advance. The National Institute of Mental Health (NIMH) Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative ( 3 Marder S.R. Fenton W. Measurement and treatment research to improve cognition in schizophrenia: NIMH MATRICS initiative to support the development of agents for improving cognition in schizophrenia. Schizophr Res. 2004; 72: 5-9 Abstract Full Text Full Text PDF PubMed Scopus (327) Google Scholar ) brought together members of academia, the pharmaceutical industry, and the US Food and Drug Administration to increase the viability of drug development by establishing consensus guidelines for study methodology, identifying promising targets for further investigation, and developing a standardized cognitive battery for use as end points in clinical trials. The resulting MATRICS Consensus Cognitive Battery (MCCB; 4 Nuechterlein K.H. Green M.F. Kern R.S. Baade L.E. Barch D.M. Cohen J.D. et al. The MATRICS Consensus Cognitive Battery, part 1: Test selection, reliability, and validity. Am J Psychiatry. 2008; 165: 203-213 Crossref PubMed Scopus (1544) Google Scholar , 5 Kern R.S. Nuechterlein K.H. Green M.F. Baade L.E. Fenton W.S. Gold J.M. et al. The MATRICS Consensus Cognitive Battery, part 2: Co-norming and standardization. Am J Psychiatry. 2008; 165: 214-220 Crossref PubMed Scopus (496) Google Scholar ) is a valuable tool that has been rapidly adopted and implemented in clinical research. However, instruments included in the MCCB are based on traditional neuropsychological measures developed more than 3 decades ago and tend to engage multiple cognitive functions simultaneously. This presents a significant disadvantage when testing treatments aimed at discrete cognitive processes, where “signal” for improved functioning might be obscured within a multi-component test of cognitive performance. With the revolution in cognitive science over the past decade ( 6 Cohen J.D. Insel T.R. Cognitive neuroscience and schizophrenia: Translational research in need of a translator. Biol Psychiatry. 2008; 64: 2-3 Abstract Full Text Full Text PDF PubMed Scopus (17) Google Scholar ), the time is right to translate experimental cognitive neuroscience tasks into finer-grained clinical measures for use in the development of procognitive drugs. Transcranial Magnetic Stimulation: A Neuroscientific Probe of Cortical Function in SchizophreniaBiological PsychiatryVol. 70Issue 1PreviewTranscranial magnetic stimulation (TMS) is a neuropsychiatric tool that can serve as a useful method to better understand the neurobiology of cognitive function, behavior, and emotional processing. The purpose of this article is to examine the utility of TMS as a means to measure neocortical function in neuropsychiatric disorders in general, and schizophrenia in particular, for the Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia initiative. When incorporating TMS paradigms in research studies, methodologic considerations include technical aspects of TMS, cohort selection and confounding factors, and subject safety. Full-Text PDF Using Brain Imaging Measures in Studies of Procognitive Pharmacologic Agents in Schizophrenia: Psychometric and Quality Assurance ConsiderationsBiological PsychiatryVol. 70Issue 1PreviewThe first phase of the Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia (CNTRICs) initiative focused on the identification of cognitive constructs from human and animal neuroscience that were relevant to understanding cognitive deficits in schizophrenia, as well as promising task paradigms that could be used to assess these constructs behaviorally. The current phase of CNTRICs has the goal of expanding this initial work by including measures of brain function that can augment these behavioral tasks as biomarkers to be used in drug development processing. Full-Text PDF Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia II: Developing Imaging Biomarkers to Enhance Treatment Development for Schizophrenia and Related DisordersBiological PsychiatryVol. 70Issue 1PreviewThe Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia (CNTRICS) initiative, funded by an R13 from the National Institute of Mental Health, seeks to enhance translational research in treatment development for impaired cognition in schizophrenia by developing tools from cognitive neuroscience into useful measures of treatment effects on behavior and brain function. An initial series of meetings focused on the selection of a new set of tasks from cognitive neuroscience for the measurement of treatment effects on specific cognitive and neural systems. Full-Text PDF