<p>Repetitive transcranial magnetic stimulation as an adjunctive treatment for negative symptoms and cognitive impairment in patients with schizophrenia: a randomized, double-blind, sham-controlled trial</p>

Abstract

Purpose: Effective treatment options for negative symptoms and cognitive impairment in patients with schizophrenia are still to be developed. The present study was to examine potential benefits of repetitive transcranial magnetic stimulation (rTMS) to improve negative symptoms and cognition in this patient population. Methods: The study was a 4-week, randomized, double-blind sham-controlled trial. Patients with schizophrenia were treated with adjunctive 20-Hz rTMS for 4 weeks or sham condition to the left dorsolateral prefrontal cortex (DLPFC). Negative symptoms were measured using the Scale for the Assessment of Negative Symptoms (SANS) and the Positive and Negative symptom scale (PANSS) negative subscale at baseline and week 4. Cognitive function was measured using the MATRICS Consensus Cognitive Battery (MCCB) at the same two time points. In addition, possible moderators for rTMS treatment efficacy were explored. Results: Sixty patients (33 in the treatment group, 27 in the sham group) completed the study. There was a significant decrease in negative symptoms after 4-week rTMS treatment as measured by the SANS total score and the PANSS negative symptom subscale score. However, there was no significant improvement in cognition with rTMS treatment. Stepwise multiple linear regression analysis suggested that the baseline severity of positive symptoms may predict poorer improvement in negative symptoms at week 4. Conclusion: Twenty-Hz rTMS stimulation over left DLPFC as an adjunctive treatment might be beneficial in improving negative symptoms of schizophrenia. Future studies with a longer treatment duration and a larger sample size are needed. Clinical trial ID: NCT01940939.

<p>Alterations Of Glycerophospholipid And Fatty Acyl Metabolism In Multiple Brain Regions Of Schizophrenia Microbiota Recipient Mice</p>

“…We showed that dysbiosis of the gut microbiota could significantly affect the metabolic phenotypes of the cortex, cerebellum and striatum in schizophrenia microbiota recipient mice. Consistent with these findings, previous neuroimaging studies have shown that these regions are highly correlated with the onset of schizophrenia 27–30. Additionally, at a functional level, alterations of lipid, amino acid and carbohydrate metabolism were also observed in schizophrenia microbiota recipient mice 16.…”

Effects of High-Frequency rTMS on Negative Symptoms and Cognitive Function in Hospitalized Patients With Chronic Schizophrenia: A Double-Blind, Sham-Controlled Pilot Trial

“…Further, a recent study not only showed negative symptom improvement after 4 weeks of 10 Hz rTMS over the DLPFC, but this effect was maintained at the 24-week follow up (43). Most previous studies that treated schizophrenia patients with 20 Hz rTMS over the left DLPFC also showed significant improvements in negative symptoms (44)(45)(46). What we know is that higher frequencies of rTMS (frequencies of 5 Hz and greater) have been shown to have excitatory effects on neurons in the stimulated cortex (47).…”

The effect of bilateral high frequency repetitive transcranial magnetic stimulation on cognitive functions in schizophrenia

“…In a neuroimaging study with perfusion SPECT on healthy people, 20 Hz rTMS targeted the left DLPFC region has been resulted in increased blood flow in dorsolateral prefrontal, anterior cingulate and orbitofrontal cortices ( George et al, 1999 ). With high frequency rTMS on DLPFC, although, some studies reported an improvement in selective attention ( Martis et al, 2003 ; Rektorova et al, 2005 ), some found no difference of cognitive functions ( Boggio et al, 2005 ; Huang et al, 2004 ; Zhuo et al, 2019 ). In another study, Barr et al have shown a significant improvement in working memory by applying bilateral 20 Hz rTMS on DLPFC sequentially ( Barr et al, 2013 ).…”