Tikka Sai Krishna, Nizamie S Haque, Venkatesh Babu G M, Aggarwal Nidhi, Das Archana Kumari, Goyal Nishant
From the KS Mani Centre for Cognitive Neurosciences & Department of Psychiatry, Central Institute of Psychiatry, Jharkhand, India.
J ECT. 2017 Mar;33(1):43-51. doi: 10.1097/YCT.0000000000000343.
First-rank symptoms (FRS) in schizophrenia have been found to be associated with various cognitive and biological markers. Repetitive transcranial magnetic stimulation (rTMS) has been shown to modulate such factors. We hypothesized that rTMS adjunctive to antipsychotics will be safe and effective in treatment of FRS in schizophrenia.
Schizophrenia patients with FRS randomly received either active or sham-magnetic resonance imaging navigated continuous Θ burst stimulation (cTBS)-rTMS to right inferior parietal lobule for 2 weeks; assessments were repeated. While primary outcome variables were safety profile, FRS and overall psychopathology; secondary outcomes were γ oscillatory activity, brain-derived neurotrophic factor levels, and self-monitoring function.
No significant adverse events were reported in either group. None of the outcome measures showed sufficient power on the time by group analysis.
This study fails to demonstrate whether or not adjunctive cTBS to right inferior parietal lobule could significantly alleviate FRS. We also fail to provide evidence for whether this protocol has any effect on brain-derived neurotrophic factor levels, self-monitoring function, and right hemispheric γ oscillations.
精神分裂症的一级症状（FRS）已被发现与多种认知和生物学标志物相关。重复经颅磁刺激（rTMS）已被证明可调节这些因素。我们假设，抗精神病药物联合rTMS对精神分裂症FRS的治疗将是安全有效的。
患有FRS的精神分裂症患者被随机分为两组，分别接受主动或假磁共振成像引导的连续θ脉冲刺激（cTBS）-rTMS，刺激右侧顶下小叶，为期2周；重复进行评估。主要结局变量为安全性、FRS和总体精神病理学；次要结局为γ振荡活动、脑源性神经营养因子水平和自我监测功能。
两组均未报告显著不良事件。在组间分析中，所有结局指标在时间上均未显示出足够的效力。
本研究未能证明右侧顶下小叶辅助cTBS是否能显著缓解FRS。我们也未能提供证据证明该方案对脑源性神经营养因子水平、自我监测功能和右半球γ振荡是否有任何影响。
