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

Kaiming Zhuo,1 Yingying Tang,1,2 Zhenhua Song,1 Yingchan Wang,1 Junjie Wang,2 Zhenying Qian,2 Hui Li,2 Qiong Xiang,1 Tianyi Chen,1,3 Zhilei Yang,1,4 Yifeng Xu,1,5 Xiaoduo Fan,6 Jijun Wang,1–2,5 Dengtang Liu1,51First-episode Schizophrenia and Early Psychosis Program, Division of Psychotic D...

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Autores principales: Zhuo K, Tang Y, Song Z, Wang Y, Wang J, Qian Z, Li H, Xiang Q, Chen T, Yang Z, Xu Y, Fan X, Liu D
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Publicado: Dove Medical Press 2019
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spelling oai:doaj.org-article:58b7156d75fb4157b96be585f1a770282021-12-02T03:15:53ZRepetitive transcranial magnetic stimulation as an adjunctive treatment for negative symptoms and cognitive impairment in patients with schizophrenia: a randomized, double-blind, sham-controlled trial1178-2021https://doaj.org/article/58b7156d75fb4157b96be585f1a770282019-05-01T00:00:00Zhttps://www.dovepress.com/repetitive-transcranial-magnetic-stimulation-as-an-adjunctive-treatmen-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Kaiming Zhuo,1 Yingying Tang,1,2 Zhenhua Song,1 Yingchan Wang,1 Junjie Wang,2 Zhenying Qian,2 Hui Li,2 Qiong Xiang,1 Tianyi Chen,1,3 Zhilei Yang,1,4 Yifeng Xu,1,5 Xiaoduo Fan,6 Jijun Wang,1–2,5 Dengtang Liu1,51First-episode Schizophrenia and Early Psychosis Program, Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 2Department of EEG and Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 3Shanghai Hong Kou Mental Health Center, Shanghai, People’s Republic of China; 4Shanghai Jia Ding Mental Health Center, Division of Psychotic Disorders, Shanghai, People’s Republic of China; 5Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 6Psychotic Disorders Program, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA, USAPurpose: 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.Keywords: schizophrenia, negative symptoms, cognitive impairment, repetitive transcranial magnetic stimulation, rTMS, MCCBZhuo KTang YSong ZWang YWang JQian ZLi HXiang QChen TYang ZXu YFan XWang JLiu DDove Medical PressarticleSchizophreniaNegative symptomsCognitive impairmentRepetitive transcranial magnetic stimulation (rTMS)MCCBNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 15, Pp 1141-1150 (2019)
institution DOAJ
collection DOAJ
language EN
topic Schizophrenia
Negative symptoms
Cognitive impairment
Repetitive transcranial magnetic stimulation (rTMS)
MCCB
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
spellingShingle Schizophrenia
Negative symptoms
Cognitive impairment
Repetitive transcranial magnetic stimulation (rTMS)
MCCB
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
Zhuo K
Tang Y
Song Z
Wang Y
Wang J
Qian Z
Li H
Xiang Q
Chen T
Yang Z
Xu Y
Fan X
Wang J
Liu D
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
description Kaiming Zhuo,1 Yingying Tang,1,2 Zhenhua Song,1 Yingchan Wang,1 Junjie Wang,2 Zhenying Qian,2 Hui Li,2 Qiong Xiang,1 Tianyi Chen,1,3 Zhilei Yang,1,4 Yifeng Xu,1,5 Xiaoduo Fan,6 Jijun Wang,1–2,5 Dengtang Liu1,51First-episode Schizophrenia and Early Psychosis Program, Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 2Department of EEG and Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 3Shanghai Hong Kou Mental Health Center, Shanghai, People’s Republic of China; 4Shanghai Jia Ding Mental Health Center, Division of Psychotic Disorders, Shanghai, People’s Republic of China; 5Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 6Psychotic Disorders Program, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA, USAPurpose: 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.Keywords: schizophrenia, negative symptoms, cognitive impairment, repetitive transcranial magnetic stimulation, rTMS, MCCB
format article
author Zhuo K
Tang Y
Song Z
Wang Y
Wang J
Qian Z
Li H
Xiang Q
Chen T
Yang Z
Xu Y
Fan X
Wang J
Liu D
author_facet Zhuo K
Tang Y
Song Z
Wang Y
Wang J
Qian Z
Li H
Xiang Q
Chen T
Yang Z
Xu Y
Fan X
Wang J
Liu D
author_sort Zhuo K
title 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
title_short 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_sort 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
publisher Dove Medical Press
publishDate 2019
url https://doaj.org/article/58b7156d75fb4157b96be585f1a77028
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