The Effects of Repetitive Transcranial Magnetic Stimulation in Patients with Chronic Schizophrenia: Insights from EEG Microstates

Pan, Zhilin; Xiong, Dongsheng; Xiao, Huisi; Li, Jiahui; Huang, Yuanyuan; Zhou, Jing; Li, Xiaobo; Ning, Yuping; Wu, Fengchun; Wu, Kai

doi:10.1016/j.psychres.2021.113866

Cited by 19 publications

(17 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additionally, certain microstates predicted clinical response in J o u r n a l P r e -p r o o f patients with treatment resistant depression who underwent both magnetic seizure therapy (MST) and electroconvulsive therapy (ECT) (14). Data describing effects of TMS on microstates are limited to one study of patients with schizophrenia (15); changes in two microstates' durations were interpreted as normalization of networks associated with symptoms. We investigated microstates in treatment-resistant MDD patients undergoing a standard, six-week rTMS therapy course in a naturalistic setting to evaluate possible microstate changes associated with rTMS and their relationship to treatment outcomes.…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

Large-scale EEG neural network changes in response to therapeutic TMS

et al. 2022

View full text Add to dashboard Cite

This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

show abstract

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

Large-scale EEG neural network changes in response to therapeutic TMS

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Hence, 24 articles were excluded due to non-available data [39-62]. In total, the search yielded 45 includable studies, with 51 comparisons as a result of studies including multiple interventions [11-19, 31-38, 63-90]. No additional studies were found in citations or in the database of clinicaltrials.gov.…”

Section: Resultsmentioning

confidence: 99%

“…No additional studies were found in citations or in the database of clinicaltrials.gov. Summary data was available from 14 studies reviewed by Wang and colleagues [10] from non-English reports, [87-89, 91-101], of which 3 was studies found through the database search, leaving a total of 56 studies and 62 comparisons [11-19, 31-38, 62-101].…”

Section: Resultsmentioning

confidence: 99%

“…The means and standard deviations of PANSS-N was the most common missing piece of information (i.e., from studies where only the total PANSS scores were reported). From these 35 studies, three author groups provided data [13,18,31], and data were extracted from graphs in an additional eight studies [19,[32][33][34][35][36][37][38]. Hence, 24 articles were excluded due to non-available data .…”

Section: Study Selectionmentioning

confidence: 99%

“…Transcranial magnetic stimulation (TMS) is a non-invasive treatment modality, which has been pursued in schizophrenia to treat both positive and negative symptoms, although with different methodologies and targets. Since the most recent reviews and meta-analyses studies on this topic [8][9][10], several new trials have emerged [11][12][13][14][15][16][17][18][19], with some using novel stimulation parameters as well as neuronavigation to better target key neurological structures, thereby possibly improving treatment outcomes. Here, we synthesize this literature in an up-to-date systematic review and quantitative meta-analysis of double-blind randomized controlled trials reporting on the efficacy of rTMS in the treatment of negative symptoms among patients with schizophrenia.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The efficacy of transcranial magnetic stimulation (TMS) for negative symptoms in schizophrenia: A systematic review and meta-analysis

Lorentzen

Nguyen

McGirr

et al. 2021

Preprint

View full text Add to dashboard Cite

Several trials have shown preliminary evidence for the efficacy of Transcranial Magnetic Stimulation (TMS) as a treatment for negative symptoms in schizophrenia. Here, we synthesize this literature in a systematic review and quantitative meta-analysis of double-blind randomized controlled trials of TMS in patients with schizophrenia. Specifically, MEDLINE, EMBASE, Web of Science, and PsycINFO were searched for sham-controlled, randomized trials of TMS among patients with schizophrenia. The standardized mean difference (SMD, Cohen’s d) with 95% confidence intervals (CI) was calculated for each study (TMS vs. sham) and pooled across studies using an inverse variance random effects model. We identified 56 studies with a total of 2550 participants that were included in the meta-analysis. The pooled analysis showed statistically significant superiority of TMS (SMD=0.37, 95%CI: 0.23; 0.52, p-value <0.00001), corresponding to a number needed to treat of 5. Furthermore, stratified analyses suggested that TMS targeting the left dorsolateral prefrontal cortex, using a stimulation frequency >1 Hz, and a stimulation intensity at or above the motor threshold, was most efficacious. There was, however, substantial heterogeneity and high risk of bias among the included studies. In conclusion, TMS appears to be an efficacious treatment option for patients with schizophrenia suffering from negative symptoms, but the optimal TMS parameters have yet to be resolved.

show abstract

Assessment of Noninvasive Brain Stimulation Interventions for Negative Symptoms of Schizophrenia

et al. 2022

View full text Add to dashboard Cite

IMPORTANCENegative symptoms have a detrimental impact on functional outcomes and quality of life in people with schizophrenia, and few therapeutic options are considered effective for this symptomatic dimension. Studies have suggested that noninvasive brain stimulation (NIBS) interventions may be effective in treating negative symptoms. However, the comparative efficacy of different NIBS protocols for relieving negative symptoms remains unclear.OBJECTIVE To compare the efficacy and acceptability of different NIBS interventions for treating negative symptoms.DATA SOURCES The ClinicalKey, Cochrane CENTRAL, Embase, ProQuest, PubMed, ScienceDirect, ClinicalTrials.gov, and Web of Science electronic databases were systematically searched from inception through December 7, 2021.STUDY SELECTION A frequentist model network meta-analysis was conducted to assess the pooled findings of trials that evaluated the efficacy of repetitive transcranial magnetic stimulation (rTMS), theta-burst stimulation, transcranial random noise stimulation, transcutaneous vagus nerve stimulation, and transcranial direct current stimulation on negative symptoms in schizophrenia. Randomized clinical trials (RCTs) examining NIBS interventions for participants with schizophrenia were included. DATA EXTRACTION AND SYNTHESISThe Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline was followed. Data were independently extracted by multiple observers. The pair-wise meta-analytic procedures were conducted using a random-effects model. MAIN OUTCOMES AND MEASURESThe coprimary outcomes were changes in the severity of negative symptoms and acceptability (ie, dropout rates owing to any reason). Secondary outcomes were changes in positive and depressive symptoms. RESULTS Forty-eight RCTs involving 2211 participants (mean [range] age, 38.7 [24.0-57.0] years; mean [range] proportion of female patients, 30.6% [0%-70.0%]) were included. Compared with sham control interventions, excitatory NIBS strategies (standardized mean difference [SMD]: high-definition transcranial random noise stimulation, −2.19 [95% CI, −3.36 to −1.02]; intermittent theta-burst stimulation, −1.32 [95% CI, −1.88 to −0.76]; anodal transcranial direct current stimulation, −1.28 [95% CI, −2.55 to −0.02]; high-frequency rTMS, −0.43 [95% CI, −0.68 to −0.18]; extreme high-frequency rTMS, −0.45 [95% CI, −0.79 to −0.12]) over the left dorsolateral prefrontal cortex with or without other inhibitory stimulation protocols in the contralateral regions of the brain were associated with significantly larger reductions in negative symptoms. Acceptability did not significantly differ between the groups.CONCLUSIONS AND RELEVANCE In this network meta-analysis, excitatory NIBS protocols over the left dorsolateral prefrontal cortex were associated with significantly large improvements in the severity of negative symptoms. Because relatively few studies were available for inclusion, additional well-designed, large-scale RCTs are warranted.

show abstract

The Effects of Repetitive Transcranial Magnetic Stimulation in Patients with Chronic Schizophrenia: Insights from EEG Microstates

Cited by 19 publications

References 52 publications

Large-scale EEG neural network changes in response to therapeutic TMS

Large-scale EEG neural network changes in response to therapeutic TMS

The efficacy of transcranial magnetic stimulation (TMS) for negative symptoms in schizophrenia: A systematic review and meta-analysis

Assessment of Noninvasive Brain Stimulation Interventions for Negative Symptoms of Schizophrenia

Contact Info

Product

Resources

About