***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: We investigated whether intensive computerized cognitive training in schizophrenia could improve working memory performance and increase signal efficiency of associated middle frontal gyri ( MFG ) circuits in a functionally meaningful manner . Thirty schizophrenia participants and 13 healthy comparison participants underwent fMRI scanning during a letter N-back working memory task . Schizophrenia participants were then r and omly assigned to either 80 h ( 16 weeks ) of cognitive training or a computer games control condition . After this intervention , participants completed a second fMRI N-back scanning session . At baseline , during 2-back working memory trials , healthy participants showed the largest and most significant activation in bilateral MFG , which correlated with task performance . Schizophrenia participants showed impaired working memory , hypoactivation in left MFG , and no correlation between bilateral MFG signal and task performance . After training , schizophrenia participants improved their 2-back working memory performance and showed increased activation in left MFG . They also demonstrated a significant association between enhanced task performance and right MFG signal , similar to healthy participants . Both task performance and brain activity in right MFG after training predicted better generalized working memory at 6-month follow-up . Furthermore , task performance and brain activity within bilateral MFG predicted better occupational functioning at 6-month follow-up . No such findings were observed in the computer games control participants . Working memory impairments in schizophrenia and its underlying neural correlates in MFG can be improved by intensive computerized cognitive training ; these improvements generalize beyond the trained task and are associated with enduring effects on cognition and functioning 6 months after the intervention This study examined the link between executive function and functional outcome in schizophrenia to identify useful psychological intervention targets and explore how executive function changes affect social functioning and symptoms . Participants from two r and omized controlled trials ( n = 63 ) with poor social functioning , positive and negative symptoms , and cognitive impairment completed seven measures of executive function . Three cognitive factors were extracted : verbal working memory , response inhibition speed , and stimulus-driven responding . Participants received individual cognitive remediation therapy ( CRT ) ( n = 18 ) , a control therapy ( occupational therapy activities ) ( n = 14 ) , or treatment as usual ( n = 19 ) . Only the CRT group improved on verbal working memory . No group improved on the other factors . Although verbal working memory was significantly associated with social functioning and symptom severity 3 months after baseline , change in this factor did not predict change in either functional outcome . There was a significant interaction between group and the stimulus-driven responding factor , and for the CRT group only , a change to a more externally focused responding style was associated with reduced social problems and symptoms . Regardless of treatment type , increased response inhibition speed was associated with reduced negative symptoms . Stimulus-driven responding and response inhibition speed may therefore make useful targets for intervention BACKGROUND This paper investigates the durability of the effects of cognitive remediation therapy ( CRT ) . In a r and omised control trial , CRT was compared with a control therapy ( intensive occupational therapy activities ) , matched for length of therapist contact . The main three cognitive outcomes , ( i ) number of categories achieved on the Wisconsin Card Sort Test , ( ii ) age-scaled score on the Digit Span subtest of the WAIS-R , and ( iii ) mean number of moves on the Tower of London test , were chosen because they are known to be problematic in schizophrenia . In addition , a wide variety of other outcomes ( symptoms , social functioning , self-esteem and cognition ) were assessed . At the end of treatment , CRT conferred a benefit to people with schizophrenia in cognition and self-esteem [ Schizophr . Bull . 25 ( 1999 ) 291 ] . This study investigates these outcomes 6 months after the therapies were withdrawn . METHOD Participants were assessed at baseline , posttreatment and 6-month follow-up ( n=17 for the CRT group ; n=16 for the control therapy group ) . In addition to the functioning measures , data on use of services and cost of therapy were collected . RESULTS The effects of CRT on cognition were still apparent at follow-up , particularly in the memory domain . When these cognitive improvements reached a criterion threshold , there were also improvements in social behaviour and symptoms . The gains made in self-esteem disappeared following the withdrawal of therapy . The economic analysis showed overall reductions in the care packages of both patient groups but there was a significant increase in day-care costs for patients who have received CRT . This additional use of day care may confer further advantages to the  CRT group , such as improved social functioning and quality of life . CONCLUSIONS The overall results of this first trial of a novel CRT approach have produced encouraging results which merit further investigation Cognitive remediation training has been shown to improve both cognitive and social cognitive deficits in people with schizophrenia , but the mechanisms that support this behavioral improvement are largely unknown . One hypothesis is that intensive behavioral training in cognition and /or social cognition restores the underlying neural mechanisms that support targeted skills . However , there is little research on the neural effects of cognitive remediation training . This study investigated whether a 50 h ( 10-week ) remediation intervention which included both cognitive and social cognitive training would influence neural function in regions that support social cognition . Twenty-two stable , outpatient schizophrenia participants were r and omized to a treatment condition consisting of auditory-based cognitive training ( AT ) [ Brain Fitness Program/auditory module ~60 min/day ] plus social cognition training ( SCT ) which was focused on emotion recognition [ ~5 - 15 min per day ] or a placebo condition of non-specific computer games ( CG ) for an equal amount of time . Pre and post intervention assessment s included an fMRI task of positive and negative facial emotion recognition , and st and ard behavioral assessment s of cognition , emotion processing , and functional outcome . There were no significant intervention-related improvements in general cognition or functional outcome . fMRI results showed the predicted group-by-time interaction . Specifically , in comparison to CG , AT+SCT participants had a greater pre-to-post intervention increase in post central gyrus activity during emotion recognition of both positive and negative emotions . Furthermore , among all participants , the increase in post central gyrus activity predicted behavioral improvement on a st and ardized test of emotion processing ( MSCEIT : Perceiving Emotions ) . Results indicate that combined cognition and social cognition training impacts neural mechanisms that support social cognition skills BACKGROUND The ratio of scalp-recorded brain responses occurring 50 msec after paired clicks ( S2-evoked P50/S1-evoked P50 ) serves as a measure of sensory gating . An abnormally large ratio is commonly found in schizophrenia and is considered as a sign of reduced sensory gating or otherwise dysfunctional organization of the auditory/verbal system as a factor contributing to psychopathology and cognitive dysfunction in schizophrenia . This initial r and omized clinical trial compared the efficacy of two 4-week , computer-based cognitive training methods that emphasize either auditory discrimination and verbal memory or a broader range of cognitive functions in schizophrenia . METHODS Thirty-nine schizophrenia patients ( ICD-F20.0 diagnosis ) were assigned to Cognitive Exercises ( CE ) or Cognitive Package ( Cogpack ) . The M50 , the  magnetoencephalographic analogue of electroencephalographic P50  , and performance on verbal learning and memory tests were used to evaluate training effects . RESULTS As expected , patients exhibited higher pretreatment gating ratios than 28 age-matched healthy comparison participants .  Gating ratios decreased after CE but not after Cogpack .  Cognitive test performance improved more after CE than after Cogpack . CONCLUSIONS Appropriately specific psychological training changes the neural performance in schizophrenia , normalizing sensory and cognitive function Blinding embodies a rich history spanning over two centuries . Most research ers worldwide underst and blinding terminology , but confusion lurks beyond a general comprehension . Terms such as single blind , double blind , and triple blind mean different things to different people . Moreover , many medical research ers confuse blinding with allocation concealment . Such confusion indicates misunderst and ings of both . The term blinding refers to keeping trial participants , investigators ( usually health-care providers ) , or assessors ( those collecting outcome data ) unaware of the assigned intervention , so that they will not be influenced by that knowledge . Blinding usually reduces differential assessment of outcomes ( information bias ) , but can also improve compliance and retention of trial participants while reducing biased supplemental care or treatment ( sometimes called co-intervention ) . Many investigators and readers naïvely consider a r and omised trial as high quality simply because it is double blind , as if double-blinding is the sine qua non of a r and omised controlled trial . Although double blinding ( blinding investigators , participants , and outcome assessors ) indicates a strong design , trials that are not double blinded should not automatically be deemed inferior . Rather than solely relying on terminology like double blinding , research ers should explicitly state who was blinded , and how . We recommend placing greater credence in results when investigators at least blind outcome assessment s , except with objective outcomes , such as death , which leave little room for bias . If investigators properly report their blinding efforts , readers can judge them . Unfortunately , many articles do not contain proper reporting . If an article cl aims blinding without any accompanying clarification , readers should remain sceptical about its effect on bias reduction OBJECTIVE The early application of cognitive rehabilitation may afford long-term functional benefits to patients with schizophrenia . This study examined the two-year effects of an integrated neurocognitive and social-cognitive rehabilitation program , cognitive enhancement therapy ( CET ) , on cognitive and functional outcomes in early-course schizophrenia . METHODS Early-course out patients ( mean+/-SD illness duration = 3.19+/-2.24 years ) with schizophrenia or schizoaffective disorder were r and omly assigned to CET ( N=31 ) or enriched supportive therapy ( EST ) ( N=27 ) , an illness management intervention utilizing psychoeducation and applied coping strategies , and treated for two years . Multivariate composite indexes of cognitive , social adjustment , and symptom domains were derived from assessment batteries administered annually by computer-based tests and raters not blind to treatment assignment . RESULTS Of the 58 participants who were r and omly assigned and treated , 49 and 46 completed one year and two years of treatment , respectively . Intent-to-treat analyses showed significant differential effects favoring CET on social cognition , cognitive style , social adjustment , and symptomatology composites during the first year of treatment . After two years , moderate effects ( d=.46 ) were observed favoring CET for enhancing neurocognitive function . Strong differential effects ( d>1.00 ) on social cognition , cognitive style , and social adjustment composites remained at year 2 and also extended to measures of symptomatology , particularly negative symptoms . CONCLUSIONS CET appears to be an effective approach to the remediation of cognitive deficits in early schizophrenia that may help reduce disability in this population . The remediation of such deficits should be an integral component of early intervention programs treating psychiatrically stable schizophrenia out patients Effects of both domain-specific and broader cognitive remediation protocol s have been reported for neural activity and overt performance in schizophrenia ( SZ ) . Progress is limited by insufficient knowledge of relevant neural mechanisms . Addressing neuronal signal resolution in the auditory system as a mechanism contributing to cognitive function and dysfunction in schizophrenia , the present study compared effects of two neuroplasticity-based training protocol s targeting auditory – verbal or facial affect discrimination accuracy and a st and ard rehabilitation protocol on magnetoencephalographic ( MEG ) oscillatory brain activity in an auditory paired-click task . SZ were r and omly assigned to either 20 daily 1-hour sessions over 4 weeks of auditory – verbal training ( N = 19 ) , similarly intense facial affect discrimination training ( N = 19 ) , or 4 weeks of treatment as usual ( TAU , N = 19 ) . Pre-training , the 57 SZ showed smaller click-induced posterior alpha power modulation than did 28 healthy comparison participants , replicating Popov et al. ( 2011b ) . Abnormally small alpha decrease 300–800 ms around S2 improved more after targeted auditory – verbal training than after facial affect training or TAU . The improvement in oscillatory brain dynamics with training correlated with improvement on a measure of verbal learning . Results replicate previously reported effects of neuroplasticity-based psychological training on oscillatory correlates of auditory stimulus differentiation , encoding , and updating and indicate specificity of cortical training effects Background In a previous report we showed that cognitive training fostering auditory-verbal discrimination and working memory normalized magnetoencephalographic ( MEG ) M50 gating ratio in schizophrenia patients . The present analysis addressed whether training effects on M50 ratio and task performance are mediated by changes in brain oscillatory activity . Such evidence should improve underst and ing of the role of oscillatory activity in phenomena such as M50 ratio , the role of dysfunctional oscillatory activity in processing abnormalities in schizophrenia , and mechanisms of action of cognitive training . Methodology /Principal Findings Time-locked and non-time-locked oscillatory activity was measured together with M50 ratio in a paired-click design before and after a 4-week training of 36 patients r and omly assigned to specific cognitive exercises ( CE ) or st and ard ( comparison ) cognitive training ( CP ) .  Patient data were compared to those of 15 healthy controls who participated in two MEG measurements 4 weeks apart without training . Training led to more time-locked gamma-b and response and more non-time-locked alpha-b and desynchronization , moreso after CE than after CP . Only after CE , increased alpha desynchronization was associated with normalized M50 ratio and with improved verbal memory performance . Thus , both types 
    Output:
    
Cognitive remediation therapy seems to provide a neurobiological enhancing effect in schizophrenia .
Several studies provide evidence of an improved functional connectivity after cognitive training , suggesting a neuroplastic effect of therapy through mechanisms of functional reorganization .
Neurocognitive and social-cognitive training may have a cumulative effect on neural networks involved in social cognition .
The variety of proposed programs , imaging tasks , and techniques may explain the heterogeneity of observed neural improvements .