Evidence map›Paper›PMID 19570929›Full record

Trial reportThe American journal of psychiatry2009

The cognitive cost of anticholinergic burden: decreased response to cognitive training in schizophrenia.

Sophia Vinogradov, Melissa Fisher, Heather Warm, Christine Holland, Margaret A Kirshner, Bruce G Pollock

Abstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The American journal of psychiatry, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 91 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
91citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

91 citing papers in PubMed, 8 syntheses or guidelines pooled it.

  1. Pooled it
  2. Video games for people with schizophrenia.The Cochrane database of systematic reviews · 2021
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31 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Sophia VinogradovDepartment of Psychiatry, Langley Porter Psychiatric Institute, University of California, San Francisco, CA, USA. sophia.vinogradov@ucsf.edu
Melissa Fisher
Heather Warm
Christine Holland
Margaret A Kirshner
Bruce G Pollock

Funding

UCSF CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTEUL1RR024131 · NCRR · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI JOHNSTON, S. CLAIBORNE · 2006 to 2011
$111.2M
Cognitive Remediation of Schizophrenia in a Community Mental Health SettingR01MH068725 · NIMH · NORTHERN CALIFORNIA INSTITUTE RES &EDUC · PI VINOGRADOV, SOPHIA · 2004 to 2014
$4.9M
NCRR NIH HHS UL1 RR024131NIMH NIH HHS R01 MH068725NIMH NIH HHS R01 MH068725-01A1
6 · The paper itself

Abstract

objectiveSchizophrenia 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 outpatients with schizophrenia.

methodFifty-five patients were randomly 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.

resultsSerum 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.

conclusionsSerum 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 implications for the design and evaluation of cognitive treatments for schizophrenia.

Indexed as

AdultAnimalsAtropineCholinergic AntagonistsCognition DisordersCognitive Behavioral TherapyFemaleGames, ExperimentalHumansMaleMiddle AgedNeuronal PlasticityNeuropsychological TestsPsychiatric Status Rating ScalesRadioligand AssayRatsAtropineCholinergic Antagonists

Identifiers

PMID19570929
PMCPMC3735363

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.