In silico therapy for schizophrenia?

Brain Plasticity, Inc. (BPI) of California is spearheading the Cognitive Adaptive E-treatment in Schizophrenia-diagnosed Adults (e-CAeSAR) clinical trial in collaboration with the National Institute of Mental Health (NIMH) to evaluate a computer-based brain-plasticity program.

BPI was awarded a $3m grant from the Biomedical Research, Development and Growth to Spur the Acceleration of New Technologies Pilot Program (BRDG-SPAN), which is a program through the American Recovery & Reinvestment Act of 2009. The grant is being used to develop a software program used for cognitive remediation treatment in schizophrenia patients.

An unmet need in schizophrenia therapy is the treatment of cognitive impairment, as it is a debilitating aspect of the disease and a symptom of the illness. Cognitive function is needed to execute everyday activities such as: the ability to process information in order to make rational decisions, known as executive function; paying attention; and working memory, or the ability to use information immediately after learning it. The dysfunction of these processes can disrupt normal life and lead to emotional distress.

Brain-plasticity programs were originally developed and proven by Posit Science, located in California. BPI is designing its program based on the proven technology designed by Posit, which incorporates programs that increase the quantity of sensory information the brain absorbs, and improves the processes the brain follows in order to record the new information. By performing these exercises in the right way, brain function is strengthened, whether by expanding or shrinking, which essentially is known as brain plasticity.

The e-CAeSAR study is currently recruiting adult schizophrenic patients for a multicenter, double-blind, randomized and controlled clinical trial to evaluate the safety and efficacy of plasticity-based, adaptive, computerized-based cognitive remediation therapy versus a computer-based control. The theory is that if cognitive remediation therapy is successful, patients will likely be able to regain their cognitive functions, which can lead to independence, re-entry into the workforce and increased social relationships, all of which can be extremely difficult for some patients to maintain without treatment.

The National Institutes of Health (NIH) has projected it will spend close to $265m in research dollars by the end of 2012 for schizophrenia studies. The estimate for 2013 is much the same, as the NIH figures it will spend roughly the same amount of money by the end of that year. However, global research dollars are estimated to decline over the next several years.

If this is an accurate projection, the mental health research industry is likely to seek more non-invasive, drug-free therapies that aim at retraining specific brain processes such as cognitive function – an area also found to be impaired in other mental illnesses such as anxiety disorders, dementia, depression and Alzheimer’s disease. 

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