***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: OBJECTIVE Schizophrenia is treated with medications that raise serum anticholinergic activity and are known to adversely affect cognition . The authors examined the relationship between serum anticholinergic activity and baseline cognitive performance and response to computerized cognitive training in out patients with schizophrenia . METHOD Fifty-five patients were r and omly assigned to either computerized cognitive training or a computer games control condition . A neurocognitive battery based on the Measurement and Treatment Research to Improve Cognition in Schizophrenia ( MATRICS ) initiative was performed at baseline and after the intervention . Serum anticholinergic activity , measured at study entry by radioreceptor assay , was available for 49 patients . RESULTS Serum anticholinergic activity showed a significant negative correlation with baseline performance in verbal working memory and verbal learning and memory , accounting for 7 % of the variance in these measures , independent of age , IQ , or symptom severity . Patients in the cognitive training condition ( N=25 ) showed a significant gain in global cognition compared to those in the control condition , but this improvement was negatively correlated with anticholinergic burden . Serum anticholinergic activity uniquely accounted for 20 % of the variance in global cognition change , independent of age , IQ , or symptom severity . CONCLUSIONS Serum anticholinergic activity in schizophrenia patients shows a significant association with impaired performance in MATRICS-based measures of verbal working memory and verbal learning and memory and is significantly associated with a lowered response to an intensive course of computerized cognitive training . These findings underscore the cognitive cost of medications that carry a high anticholinergic burden . The findings also have implication s for the design and evaluation of cognitive treatments for schizophrenia An emerging body of research has shown that computer-assisted cognitive remediation , consisting of training in attention , memory , language and /or problem-solving , produces improvement in neurocognitive function that generalizes to untrained neurocognitive tests and may also impact symptoms and work functioning in patients with schizophrenia . The active ingredient of these interventions , however , remains unknown as control groups in these studies have typically included few , if any , of the elements of these complex behavioral treatments . This study compared the effects of an extended ( 12-month ) , st and ardized , computer-assisted cognitive remediation intervention with those of a computer-skills training control condition that consisted of many of the elements of the experimental intervention , including hours spent on a computer , interaction with a clinician and non-specific cognitive stimulation .  Forty-two patients with schizophrenia were r and omly assigned to one of two conditions and were assessed with a comprehensive neuropsychological test battery before and after treatment . Results revealed that cognitive-remediation training produced a significant improvement in working memory , relative to the computers-skills training control condition , but that there was overall improvement in both groups on measures of working memory , reasoning/executive-function , verbal and spatial episodic memory , and processing speed . Taken together , these findings suggest that specific practice in neurocognitive exercises targeted at attention , memory and language , produce improvements in neurocognitive function that are not solely attributable to non-specific stimulation associated with working with a computer , interacting with a clinician or cognitive challenge , but that non-specific stimulation has a salutary effect on neurocognition as well The effectiveness of cognitive remediation therapy ( CRT ) for the neuropsychological deficits seen in schizophrenia is supported by meta- analysis . However , a recent method ologically rigorous trial had negative findings . In this study , 130 chronic schizophrenic patients were r and omly assigned to computerized CRT , an active computerized control condition ( CC ) or treatment as usual ( TAU ) . Primary outcome measures were 2 ecologically valid batteries of executive function and memory , rated under blind conditions ; other executive and memory tests and a measure of overall cognitive function were also employed . Carer ratings of executive and memory failures in daily life were obtained before and after treatment . Computerized CRT was found to produce improvement on the training tasks , but this did not transfer to gains on the primary outcome measures and most other neuropsychological tests in comparison to either CC or TAU conditions . Nor did the intervention result in benefits on carer ratings of daily life cognitive failures . According to this study , computerized CRT is not effective in schizophrenia . The use of both active and passive CCs suggests that nature of the control group is not an important factor influencing results Cognitive deficits are rate limiters on recovery in schizophrenia that respond poorly to pharmacotherapy . Cognitive remediation therapy ( CRT ) , a novel psychological therapy , has produced promising outcomes for cognition . However , little is known about the biological mechanisms that might underlie individual differences in CRT response . Catechol-O-Methyltransferase ( COMT ) is associated specifically with prefrontal cognition . The COMT Val158Met polymorphism is known to have a functional effect on the rate of dopamine degradation , which may be related to cognitive treatment response . This study aim ed to determine whether COMT genotype influences cognitive improvement following CRT in schizophrenia . Participants with schizophrenia were recruited from three r and omised controlled trials of CRT compared to treatment as usual , and one CRT treatment only trial , each providing 40 CRT sessions .  Eighty-seven participants ( 40 % ) agreed to participate in the genetic study , and provided DNA for COMT genotyping . Cognitive function and psychopathology were assessed at baseline , post-treatment and 3 - 6-month follow-up . People with the COMT Val/Met genotype performed more poorly on categories achieved at baseline on the Wisconsin Card Sorting Test ( WCST ) than those homozygous for the Val or Met allele . Cognitive function improved with CRT but there was no association between this cognitive improvement and COMT genotype , either in the CRT group or in the total sample . The COMT val158Met polymorphism does not appear to be a clinical ly useful biomarker of cognitive improvement following CRT in schizophrenia . A complex set of factors may influence cognitive change , however , such that the COMT genotype might still have a subtle effect on response to CRT or similar interventions INTRODUCTION Schizophrenic patients present cognitive dysfunctions which are regarded to be one of endophenotypical markers predisposing to schizophrenia . Currently , schizophrenia can be treated as a neurodegenerative and neurodeveloping disease with genetic background . OBJECTIVE Assessment of the possible positive effect of neuropsychological rehabilitation in schizophrenia , in patients presenting cognitive dysfunctions . An additional aim was to verify the hypothesis that some genetic polymorphisms can be a prognostic factor for success in neuropsychological rehabilitation . MATERIAL AND METHODS 41 participants and 40 control subjects were r and omly selected . Both groups had the diagnosis of paranoid schizophrenia .  Cognitive functions were checked with the  Wisconsin Card Sorting Test , Trail Making Test , and Stroop Test at the beginning and end of the experiment . In the research group , each patient trained with the rehabilitation programme RehaCom , whereas the control group did not receive such training . Genes COMT rs4680 and BDNF rs6265 were analysed in the genetic part of study . RESULTS RehaCom procedures appear to be useful in the neuropsychological rehabilitation of cognitive dysfunctions in patients diagnosed with schizophrenia . The research group showed a moderate improvement in the training programmes . Analysis of parameters obtained in the neuropsychological tests showed a slight improvement in both groups . At the present time , analysis of the polymorphisms of genes can not be treated as a prognostic factor for the success of neuropsychological rehabilitation because statistical analyses showed few dependences with little statistical significance . CONCLUSIONS Cognitive rehabilitation produces moderate improvement in cognitive functioning The goal of this study was to investigate the impact of Attention Process Training ( APT ) on cognitive functioning in schizophrenia . Twenty-four patients with schizophrenia were r and omly assigned to one of the two following conditions : training by means of APT or no training . The dependent variables included measures of attention , memory and executive functions derived from a cancellation task , dichotic listening , dual task , Trail Making Test , Paced Auditory Serial Addition Task , Everyday Attention Question naire , Spain-Complutense Verbal Learning Test and Wisconsin Card Sorting Test ( WCST ) . All participants were also rated on measures of positive and negative symptoms . The tasks were administrated to all participants at baseline . Participants in the training group received individual intensive APT twice a week , whereas the control group did not receive training . All participants were subsequently retested on the same tests . Although , contrary to expectations , neither group improved on clinical and information-processing measures of attention and memory , patients in the trained group had a significantly higher performance on executive function ( as measured by the WCST ) than did the control group . We conclude that it is feasible to use practice in attention to remediate executive function deficits in schizophrenia Background Current method ological guidelines provide advice about the assessment of sub-group analysis within RCTs , but do not specify explicit criteria for assessment . Our objective was to provide research ers with a set of criteria that will facilitate the grading of evidence for moderators , in systematic review s. Method We developed a set of criteria from method ological manuscripts ( n = 18 ) using snowballing technique , and electronic data base search es . Criteria were review ed by an international Delphi panel ( n = 21 ) , comprising authors who have published method ological papers in this area , and research ers who have been active in the study of sub-group analysis in RCTs . We used the Research ANd Development/University of California Los Angeles appropriateness method to assess consensus on the quantitative data . Free responses were coded for consensus and disagreement . In a subsequent round additional criteria were extracted from the Cochrane Review ers ' H and book , and the process was repeated . Results The recommendations are that meta-analysts report both confirmatory and exploratory findings for sub-groups analysis . Confirmatory findings must only come from studies in which a specific theory/ evidence based a-priori statement is made . Exploratory findings may be used to inform future/subsequent trials . However , for inclusion in the meta- analysis of moderators , the following additional criteria should be applied to each study : Baseline factors should be measured prior to r and omisation , measurement of baseline factors should be of adequate reliability and validity , and a specific test of the interaction between baseline factors and interventions must be presented . Conclusions There is consensus from a group of 21 international experts that method ological criteria to assess moderators within systematic review s of RCTs is both timely and necessary . The consensus from the experts result ed in five criteria divided into two groups when synthesis ing evidence : confirmatory findings to support hypotheses about moderators and exploratory findings to inform future research . These recommendations are discussed in reference to previous recommendations for evaluating and reporting moderator studies OBJECTIVE The relationship between psychopathology and cognitive functioning in schizophrenia is of interest , both for an underst and ing of the nature of the disease , and for comprehensive treatment planning . The aim of this study was to investigate how psychiatric symptoms affect , and are affected by , cognitive remediation . METHOD Fifty-four psychiatric in patients received either cognitive remediation exercises ( remediation group ) or no cognitive intervention ( control group ) . The subjects ' scores on tests of cognition and on the Positive and Negative Symptoms Scale ( PANSS ) were measured before , after the 10 session treatment , and again 4 weeks post treatment . RESULTS Only the remediation group showed significant and persistent improvement on all three PANSS Subscales as well as on the Positive Symptoms and Depression Factors . There were no significant between-group differences on any PANSS pre/posttreatment change scores . Baseline measures of psychopathology did not correlate meaningfully with amount of change made on cognitive measures after rehabilitation . CONCLUSIONS A brief 10-session course of cognitive remediation is sufficient to benefit cognition and has some positive effects on psychopathology as measured by the PANSS , but does not add significantly to the effects of st and ard psychiatric treatment on psychopathology . Furthermore , psychiatric symptom profile is not predictive of the degree to which cognitive symptoms respond to cognitive remediation . The differential impact of cognitive remediation on cognition and psychopathology may imply that psychopathology and cognitive functioning follow fairly independent treatment courses BACKGROUND Cognitive remediation ( CR ) therapy in its various disguises can be helpful for people with schizophrenia but it is not clear if patient characteristics are likely to interfere with its effectiveness . METHODOLOGY This paper describes the assessment of one putative moderating variable , age , on the outcome of CRT in a rigorous r and omised control trial with memory , cognitive flexibility and planning as primary outcomes and social behaviour , symptoms and self-esteem as secondary outcomes . Calendar age was divided into younger ( < 40 ; N55 ) and older ( 40 or more years ; N30 ) . There were no differences between the groups at baseline in their cognitive , social or demographic data except on predicted variables . RESULTS Younger people benefited more from cognitive remediation in two of the three cognitive domains tested . In the memory domain both groups benefited . Only negative symptoms showed a moderating effect of age on CRT , where again the younger group showed improvements in the context of CRT but the older group did not . When older people did show a cognitive advantage in memory following therapy this cognitive improvement benefited social behaviour . CONCLUSION CRT needs some modification to increase the benefits to older participants . However , any cognitive improvements do still seem to have a beneficial effect The impact of limited insight is a crucial consideration in the treatment of individuals with psychiatric illness . In the context of psychosis , both clinical and cognitive insight have been described . This study aim ed to evaluate the relationships between clinical and cognitive insight and neuropsychological functioning , psychiatric symptom severity , 
    Output:
    
A strong trend was found for baseline cognition , with reasoning and problem solving and working memory being strongly predictive of within-domain improvement .
Training task progress was the most notable cross-domain predictor of cognitive outcome .
Conclusion : It remains unclear why a large proportion of participants fail to realise cognitive benefit from cognitive remediation therapy .