Efficacy of different types of cognitive enhancers for patients with schizophrenia:a meta-analysis

Cognitive impairment is a core feature of schizophrenia, which is predictive for functional outcomes and is, therefore, a treatment target in itself. Yet, literature on efficacy of different pharmaco-therapeutic options is inconsistent. This quantitative review provides an overview of studies that investigated potential cognitive enhancers in schizophrenia. We included pharmacological agents, which target different neurotransmitter systems and evaluated their efficacy on overall cognitive functioning and seven separate cognitive domains. In total, 93 studies with 5630 patients were included. Cognitive enhancers, when combined across all different neurotransmitter systems, which act on a large number of different mechanisms, showed a significant (yet small) positive effect size of 0.10 (k = 51, p = 0.023; 95% CI = 0.01 to 0.18) on overall cognition. Cognitive enhancers were not superior to placebo for separate cognitive domains. When analyzing each neurotransmitter system separately, agents acting predominantly on the glutamatergic system showed a small significant effect on overall cognition (k = 29, Hedges' g = 0.19, p = 0.01), as well as on working memory (k = 20, Hedges' g = 0.13, p = 0.04). A sub-analysis of cholinesterase inhibitors (ChEI) showed a small effect on working memory (k = 6, Hedges' g = 0.26, p = 0.03). Other sub-analyses were positively nonsignificant, which may partly be due to the low number of studies we could include per neurotransmitter system. Overall, this meta-analysis showed few favorable effects of cognitive enhancers for patients with schizophrenia, partly due to lack of power. There is a lack of studies involving agents acting on other than glutamatergic and cholinergic systems, especially of those targeting the dopaminergic system.</p

Efficacy of different types of cognitive enhancers for patients with schizophrenia:a meta-analysis

Cognitive impairment is a core feature of schizophrenia, which is predictive for functional outcomes and is, therefore, a treatment target in itself. Yet, literature on efficacy of different pharmaco-therapeutic options is inconsistent. This quantitative review provides an overview of studies that investigated potential cognitive enhancers in schizophrenia. We included pharmacological agents, which target different neurotransmitter systems and evaluated their efficacy on overall cognitive functioning and seven separate cognitive domains. In total, 93 studies with 5630 patients were included. Cognitive enhancers, when combined across all different neurotransmitter systems, which act on a large number of different mechanisms, showed a significant (yet small) positive effect size of 0.10 (k = 51, p = 0.023; 95% CI = 0.01 to 0.18) on overall cognition. Cognitive enhancers were not superior to placebo for separate cognitive domains. When analyzing each neurotransmitter system separately, agents acting predominantly on the glutamatergic system showed a small significant effect on overall cognition (k = 29, Hedges' g = 0.19, p = 0.01), as well as on working memory (k = 20, Hedges' g = 0.13, p = 0.04). A sub-analysis of cholinesterase inhibitors (ChEI) showed a small effect on working memory (k = 6, Hedges' g = 0.26, p = 0.03). Other sub-analyses were positively nonsignificant, which may partly be due to the low number of studies we could include per neurotransmitter system. Overall, this meta-analysis showed few favorable effects of cognitive enhancers for patients with schizophrenia, partly due to lack of power. There is a lack of studies involving agents acting on other than glutamatergic and cholinergic systems, especially of those targeting the dopaminergic system

Preparation and characterization of ultrathin layers of substituted oligo- and poly(p-phenylene)s and mixed layers with octadecanethiol on gold and copper

Substituted poly(p-phenylene)s were adsorbed from solution onto gold and copper and oligo(p-phenylene)s onto gold. The layers were investigated with IR spectroscopy at grazing incidence reflection, XPS, NEXAFS, ToF-SIMS, surface profilometry, AFM, SEM, optical microscopy, ellipsometry, and contact angle measurements to examine their formation and structure. The structure and the properties of the investigated layers depend not only on the chemical structure of the polymer but also on the type of substrate. On gold, the polymers form layers of 15-25 angstroms in thickness and the oligomers of ca. 5 angstroms in thickness. On copper, `thick' layers of up to 900 angstroms were also observed. The oligomers have a lower affinity to gold than the polymers. Mixed octadecanethiol-polymer layers were prepared by immersion of polymer-coated substrates in an octadecanethiol solution or by exposure of self-assembled monolayers of octadecanethiol to polymer solutions. The structure of the mixed layers depends on the sequence of the exposure of the two components and on the chemical structure of the polymer. In the mixed layers, structures that protrude above the surroundings were frequently detected at the surface.</p

Preparation and characterization of ultrathin layers of substituted oligo- and poly(p-phenylene)s and mixed layers with octadecanethiol on gold and copper

Substituted poly(p-phenylene)s were adsorbed from solution onto gold and copper and oligo(p-phenylene)s onto gold. The layers were investigated with IR spectroscopy at grazing incidence reflection, XPS, NEXAFS, ToF-SIMS, surface profilometry, AFM, SEM, optical microscopy, ellipsometry, and contact angle measurements to examine their formation and structure. The structure and the properties of the investigated layers depend not only on the chemical structure of the polymer but also on the type of substrate. On gold, the polymers form layers of 15-25 angstroms in thickness and the oligomers of ca. 5 angstroms in thickness. On copper, `thick' layers of up to 900 angstroms were also observed. The oligomers have a lower affinity to gold than the polymers. Mixed octadecanethiol-polymer layers were prepared by immersion of polymer-coated substrates in an octadecanethiol solution or by exposure of self-assembled monolayers of octadecanethiol to polymer solutions. The structure of the mixed layers depends on the sequence of the exposure of the two components and on the chemical structure of the polymer. In the mixed layers, structures that protrude above the surroundings were frequently detected at the surface.</p

Efficacy of different types of cognitive enhancers for patients with schizophrenia: a meta-analysis

Cognitive impairment is a core feature of schizophrenia, which is predictive for functional outcomes and is, therefore, a treatment target in itself. Yet, literature on efficacy of different pharmaco-therapeutic options is inconsistent. This quantitative review provides an overview of studies that investigated potential cognitive enhancers in schizophrenia. We included pharmacological agents, which target different neurotransmitter systems and evaluated their efficacy on overall cognitive functioning and seven separate cognitive domains. In total, 93 studies with 5630 patients were included. Cognitive enhancers, when combined across all different neurotransmitter systems, which act on a large number of different mechanisms, showed a significant (yet small) positive effect size of 0.10 (k = 51, p = 0.023; 95% CI = 0.01 to 0.18) on overall cognition. Cognitive enhancers were not superior to placebo for separate cognitive domains. When analyzing each neurotransmitter system separately, agents acting predominantly on the glutamatergic system showed a small significant effect on overall cognition (k = 29, Hedges’ g = 0.19, p = 0.01), as well as on working memory (k = 20, Hedges’ g = 0.13, p = 0.04). A sub-analysis of cholinesterase inhibitors (ChEI) showed a small effect on working memory (k = 6, Hedges’ g = 0.26, p = 0.03). Other sub-analyses were positively nonsignificant, which may partly be due to the low number of studies we could include per neurotransmitter system. Overall, this meta-analysis showed few favorable effects of cognitive enhancers for patients with schizophrenia, partly due to lack of power. There is a lack of studies involving agents acting on other than glutamatergic and cholinergic systems, especially of those targeting the dopaminergic system