LVR-Klinikum Düsseldorf Hospital of the Heinrich-Heine University ...

Brain-imaging correlates of therapeutic
changes in affect recognition in schizophrenia
W. Wölwer, M. Streit, N. Frommann, J. Brinkmeyer in
cooperation with U. Habel and F. Schneider (both RWTH
Aachen)
Project period: 2000–2004
Financing: FMER funding 01 GI 9932 and Departmental
research budget
Whereas several cross-sectional studies of brainfunctional
correlates of impaired facial affect recognition
in schizophrenia have been reported in the literature,
longitudinal studies are still missing. This project, in addition
to the aforementioned treatment evaluation, investigated
possible improvements in facial affect decoding and its
neurofunctional correlates in schizophrenia during the
course of the above mentioned TAR training. Ten patients
each under TAR (Training of Affect Recognition) and under
TAU (Treatment As Usual control group) were investigated
twice in a pre-post design, at the start and after the end
of the six-week treatment phase, and compared with 10
healthy controls. An fMRI assessment during a facial affect
recognition test was used to investigate changes in the
brain activation pattern and its relationship to changes in
performance after the training period. Increased activations,
associated with the training-specific improvements in facial
affect recognition following the training phase, were found in
the left middle and upper occipital lobes, in the right lower
and upper parietal cortex and bilaterally in the lower frontal
cortex under TAR as compared with TAU patients. This was
one of the first investigations in this area describing the
neurobiological correlates of a successful social-cognitive
rehabilitation training for people with schizophrenia.
ReseaRch
Effects of repetitive transcranial magnetic stimulation
(rTMS) on facial affect decoding in schizophrenia
Sub-project of the study “Repetitive transcranial magnetic
stimulation for the treatment of negative symptoms in
chronic schizophrenia” (Principal investigator: J. Cordes),
M. Streit, W. Wölwer, J. Brinkmeyer in cooperation with the
“Transcranial magnetic stimulation” research group
(J. Cordes)
Project period: 2002–2005
Financing: Departmental research budget
Since impairments in affect decoding have been found
to be unaffected by traditional treatment, alternative
treatment approaches need to be investigated. Within a
larger treatment study with a randomised pre-post control
group design, which primarily compared clinical effects of
dorsolateral/prefrontal 10 Hz rTMS applied in 10 sessions
over two weeks with those of a sham stimulation, effects
on facial affect decoding were also investigated in 36
patients with chronic schizophrenia. Alongside significant
clinical improvements under verum stimulation, specific
improvements could also be found in facial affect decoding.
If these findings should prove to be replicable within the
context of the current multi-centre RESIS clinical study (see
“Transcranial magnetic stimulation” research group), in
addition to function-specific cognitive rehabilitation, rTMS
could also be a way to improve social-cognitive function
impairments in the future.
Generalisation and duration of the effects
of facial affect recognition training
W. Wölwer, N. Frommann
Project period: 2006–2009
Financing: FMER funding 01 GI 0532
On the one hand this project serves to replicate the positive
effects on facial affect recognition of the Training of Affect
Recognition (TAR) developed in the above described project.
On the other hand it will investigate the sustainability of
the effects beyond the end of the training and possible
generalisations to prosodic affective recognition, theory
of mind abilities and social competence. Until now, 2 x
19 patients with schizophrenia have been included in the
ongoing randomised, controlled pre-post study and treated
over six weeks with one of two cognitive rehabilitation
programmes, i.e. TAR or basic-cognitive remediation
training (CRT).
77