Department of Psychiatry and Psychotherapy, Heinrich-Heine University, Düsseldorf, Germany.
Pharmacopsychiatry. 2010 May;43(3):110-7. doi: 10.1055/s-0029-1242824. Epub 2010 Feb 2.
The purpose of this study was to assess tolerability and safety of high-frequency rTMS with regard to cognitive performance when conducted as "add-on" treatment in chronic schizophrenia in-patients (n=32).
Patients, who were on stable antipsychotic treatment, were randomly assigned to verum or sham condition (double-blind). In the verum group, ten sessions of 10 Hz rTMS with a total of 10 000 stimuli were applied over the left dorsolateral prefrontal cortex (PFC) at 110% of motor threshold over a period of two weeks. The sham group received corresponding sham stimulation. RTMS effects on cognitive performance were assessed with a neuropsychological test battery consisting of the following tests: trail making test A and B (TMT), Wisconsin card sorting test (WCST), D2 attention task and the "short test of general intelligence" (KAI).
No statistically significant deterioration of cognitive performance was observed as a result of rTMS treatment. Moreover it was shown that in the verum group patients with a less favourable performance on the WCST at baseline tend to improve after rTMS treatment with regard to psychopathology as opposed to patients in the control group.
The stability of cognitive function suggests good tolerability of rTMS treatment in schizophrenia. The absence of evidence for cognitive deterioration could be due to low and short stimulation parameters.
本研究旨在评估高频 rTMS 在慢性精神分裂症住院患者中作为“附加”治疗时对认知表现的耐受性和安全性（n=32）。
接受稳定抗精神病药物治疗的患者被随机分配至真刺激或假刺激条件（双盲）。在真刺激组中，患者在左背外侧前额叶皮层（PFC）接受 10 赫兹 rTMS 刺激，共 10000 次刺激，强度为运动阈值的 110%，为期两周。假刺激组接受相应的假刺激。使用包含以下测试的神经心理学测试工具包评估 rTMS 对认知表现的影响：连线测试 A 和 B（TMT）、威斯康星卡片分类测试（WCST）、D2 注意力任务和“简短通用智力测试”（KAI）。
rTMS 治疗并未导致认知表现的统计学显著恶化。此外，与对照组患者相比，在真刺激组中，基线 WCST 表现较差的患者在 rTMS 治疗后在精神病学方面表现出改善。
认知功能的稳定性表明 rTMS 治疗在精神分裂症中具有良好的耐受性。认知恶化的证据不足可能是由于刺激参数较低且较短。
