Oral Cholinesterase Inhibitor Add-on Therapy for Cognitive Enhancement in Schizophrenia
Bibliographic record
Abstract
RATIONALE: Cognitive impairment in schizophrenia is associated with outcomes affecting social function and vocational performance. Cognitive enhancement is thus recognized as fundamental in the treatment of schizophrenia. Some clinical trials have used acetylcholinesterase inhibitors (AChEIs) add-on therapy to test the cognitive-enhancing effects of these kinds of medication, which is usually prescribed for indications other than schizophrenia. OBJECTIVE: To perform a quantitative systematic review of the effects of AChEI on various cognitive domains (attention, language, and motor and executive functions) in schizophrenia. DATA SOURCE: Exhaustive electronic search engines, hand searches, cross-referencing of studies, and contacts with investigators were carried out. DATA SELECTION: The studies included compared neurocognitive performance in patients with schizophrenia before and after AChEI treatment in randomized controlled trials and crossover and open trials of AChEI in people with schizophrenia. RESULTS: Our findings reveal a small, but significant, homogeneous effect estimate of AChEI on attention before and after treatment. A small nonsignificant heterogeneous effect estimate was yielded for motor performance after AChEI treatment. However, no significant change appears in language performance or executive functions after AChEI treatment, independently of the type of AChEI. After AChEI treatment, when patients were compared with control groups, no difference appears in attention and executive functions. Nevertheless, the analysis reveals that the control groups performed better on language tasks than patients after AChEI treatment but worse on motor tasks. CONCLUSIONS: Despite an extensive investigation of the electronic and gray literature, few data appropriate for the meta-analysis were found. The results reveal a small improvement in attention and a trend on motor tasks after AChEI medication in schizophrenia. No clear conclusion can yet be reached concerning the cognitive-enhancing effects of AChEI considering the small number of studies available. This finding needs to be substantiated by larger trials. This systematic review complements a meta-analysis focusing on memory, which showed a small improvement with a cocktail of antipsychotics and AChEIs.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.014 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".