Aiming to Improve Schizophrenia Treatment Through the NIMH CNTRICS Initiative

Reports from the First CNTRICS Meeting

Philadelphia, PA, July 14, 2008Biological Psychiatry is particularly proud to announce the publication of an issue dedicated to the product of the National Institute of Mental Health (NIMH) Cognitive Neuroscience Approaches to the Treatment of Impaired Cognition in Schizophrenia, or CNTRICS, initiative. This July 1, 2008 issue includes eight articles on CNTRICS: one commentary, one overview paper of the CNTRICS meeting, and six review papers on the ideas developed at the first of the three scheduled CNTRICS meetings.

John H. Krystal, M.D., Editor of Biological Psychiatry and one of the authors on the overview paper, highlights the importance of this venture: “Schizophrenia is a disabling illness despite the emergence of a second generation of antipsychotic treatments. To develop better medications, we first need a better understanding of the brain and how it goes awry in schizophrenia.” He explains that the CNTRICS initiative aims “to better define the cognitive processes and the neural circuits that carry out these processes that will be the focus for schizophrenia research now and in the future.” Thomas R. Insel, M.D., Director of the NIMH and co-author of the commentary, adds: "Cognitive neuroscience has made enormous strides in the past two decades by mapping the brain's rules and routes for information processing. CNTRICS endeavors to translate the tools and insights from cognitive neuroscience into better treatments for schizophrenia."

In the overview paper, the authors describe the background, organization and results of the meeting, which brought together academic and industry experts from basic and clinical cognitive neuroscience and drug development. Cameron Carter, M.D., Deputy Editor of Biological Psychiatry and lead author of the overview paper adds that, “In embracing basic cognitive and affective neuroscience as a translational bridge linking cellular and molecular neuroscience with clinical symptoms, and by bringing together basic and clinical scientists with those focused on treatment development, the CNTRICS process […] presents us with a new paradigm for how we go about treatment development in psychiatry.” The experts sought to develop a consensus building process on which aspects of impaired cognition in schizophrenia should be targeted for new treatment development. The perspectives of the experts, results of discussions and recommendations for cognitive treatment targets are summarized in the six related review papers that comprise the major products of this first CNTRICS meeting.

One of the review papers, by Kevin Ochsner, Ph.D., focuses on the deficits in social and emotional functioning that are hallmarks of schizophrenia. As Dr. Ochsner explains, “The emerging disciplines of social cognitive and affective neuroscience offer new methods to study these abilities and their breakdown in schizophrenia. This paper synthesizes recent advances in these disciplines and proposes a framework for understanding the neural organization of five key social and emotional abilities.” Dr. Carter notes that “by bringing a modern social cognitive neuroscience perspective to this aspect of schizophrenia and outlining a novel and informative model of human social and emotional processing, Ochsner has provided the field an opportunity for a fresh start as well as a powerful set of tools to inform future research and treatment development.”

Charan Ranganath and colleagues, in another of the review papers, focused on addressing episodic memory impairment, which limits the daily function of individuals with schizophrenia, and is an important target for treatment development. Specifically, the CNTRICS panel nominated item-specific and relational memory tasks for immediate translational development and this paper summarizes the significant progress that cognitive neuroscience has made in understanding the cognitive and neural underpinnings of these processes. Dr. Carter comments that “Ranganath et al. provide the reader with a state of the art systems view of human memory and use this as a context for how we might advance our understanding of disabling memory deficits in schizophrenia and the abnormal brain functioning underlying them.”

The authors of the Carter et al. paper comment, “As the CNTRICS process unfolds, we hope to bring the full force of the new knowledge and technology that is cognitive neuroscience to bear on the effort to develop effective therapies for impaired cognition in schizophrenia.” Biological Psychiatry is pleased to be the home for the presentation of this work, as the field of psychiatry looks to the ideas that develop out of CNTRICS to further inform and improve schizophrenia treatment.

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Notes to Editors:
The CNTRICS overview article is “Identifying Cognitive Mechanisms Targeted for Treatment Development in Schizophrenia: An Overview of the First Meeting of the Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia Initiative” by Cameron S. Carter, Deanna M. Barch, Robert W. Buchanan, Ed Bullmore, John H. Krystal, Jonathan Cohen, Mark Geyer, Michael Green, Keith H. Nuechterlein, Trevor Robbins, Steven Silverstein, Edward E. Smith, Milton Strauss, Til Wykes, and Robert Heinssen. Dr. Carter is affiliated with the Department of Psychiatry, University of California, Davis, California. Dr. Barch is affiliated with the Department of Psychiatry, Washington University, St. Louis, Missouri. Dr. Buchanan is with the Maryland Psychiatric Research Center, Baltimore, Maryland. Dr. Bullmore is from the Department of Psychiatry, while Dr. Robbins is with the Department of Psychology, both at the University of Cambridge, Cambridge, United Kingdom. Dr. Krystal is affiliated with the Department of Psychiatry, Yale University, and the VA Connecticut Healthcare System, New Haven, Connecticut. Dr. Cohen is with the Department of Psychology, Princeton University Princeton, New Jersey. Dr. Geyer is from the Department of Psychiatry, University of California at San Diego, San Diego California. Drs. Green and Nuechterlein are affiliated with the Department of Psychiatry, University of California at Los Angeles and Dr. Green is also with the VA Greater Los Angeles Healthcare System, Los Angeles, California. Dr. Silverstein is affiliated with the University of Medicine and Dentistry of New Jersey, New Brunswick, New Jersey. Dr. Smith is with the Department of Psychology, Columbia University, New York, New York. Dr. Strauss is from the Department of Psychology, University of New Mexico, Albuquerque, New Mexico. Dr. Wykes is affiliated with the Institute of Psychiatry, London, England. Dr. Heinssen is with the National Institute of Mental Health, Bethesda, Maryland.

The referenced article by Kevin N. Ochsner is “The social-emotional processing stream: Five core constructs and their translational potential for schizophrenia and beyond.” Dr. Ochsner is affiliated with the Department of Psychology, Columbia University, New York, New York.

The third referenced article is “The Cognitive Neuroscience of Memory Function and Dysfunction in Schizophrenia” by Charan Ranganath, Michael Minzenberg and J. Daniel Ragland. Dr. Ranganath is affiliated with the Center for Neuroscience and Department of Psychology, while Drs. Minzenberg and Ragland are with the Department of Psychiatry and Behavioral Sciences, all at University of California at Davis, Davis, California.

All of the referenced articles appear in Biological Psychiatry, Volume 64, Issue 1 (July 1, 2008), published by Elsevier.

The authors’ disclosures of financial and conflicts of interests are available in the relevant articles.

Full text of the article mentioned above is available upon request. Contact Jayne M. Dawkins at (215) 239-3674 or ja.dawkins@elsevier.com to obtain a copy or to schedule an interview.

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