Cognitive neuroscience-based approaches to measuring and improving treatment effects on cognition in schizophrenia: The CNTRICS initiative

The goal of this article is to discuss ways to further improve the search for potentially procognitive agents that could be used to enhance cognition and functional outcome in schizophrenia. In particular, we focus on the potential advantages to this process of using a contemporary, cognitive neuroscience-based approach to measuring cognitive function in clinical trials of procognitive agents in schizophrenia. These tools include computer-administered tasks that measure specific cognitive systems (such as attention, working memory, long-term memory, cognitive control) as well as the component cognitive processes that comprise these more overarching systems. The advantages of using these tools include the ability to identify and use homologous animal and human models in the drug discovery and testing process and the ability to incorporate noninvasive functional imaging measures into clinical trial contexts at several different phases of the drug development process. However, despite the clear potential advantages to using such methods, a number of barriers exist to their translation from basic science tools to tools for drug discovery. We discuss the development and implementation of a new project, Cognitive Neuroscience Treatment to Improve Cognition in Schizophrenia, designed to identify and overcome these barriers to the translation of cognitive neuroscience measures and methods into regular use in the drug discovery and development process of cognition-enhancing agents for use in schizophrenia.