Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang 325005, China.
Department of Electrophysiology, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
Chin Med J (Engl). 2018 Feb 5;131(3):301-306. doi: 10.4103/0366-6999.223846.
Repetitive transcranial magnetic stimulation (rTMS) and event-related potentials (ERPs) are a noninvasive technique that widely used in neurophysiological field. Although rTMS has shown clinical utility for a number of neurological conditions, Recently,there was little understanding of the the efficacy of rTMS on Schizophrenia(SZ) and the change of ERP between before and after rTMS treatment. The objective of this study was to investigate the characteristics of N400, mismatch negativity (MMN), and P300 before and after treatment with rTMS in SZ.
One hundred and twenty-seven SZ patients hospitalized in Shanghai Mental Health Center from March 2015 to July 2017, divided into two groups (85 patients were recruited as rTMS group and 42 were recruited as sham rTMS [ShrTMS] group) and 76 normal controls (NCs) who were the staff and refresher staff in our hospital were recruited at the same time. A Chinese-made rTMS and a Runjie WJ-1 ERPs instrument were used in the present experiment. N400 was elicited by congruent and noncongruent Chinese idioms. After rTMS treatment, N400, P300, and MMN characteristics were compared with those before treatment and NC group.
Compared with NC, the SZ patients exhibited delays in N400, P300, and MMN latency and decreased N400, P300, and MMN amplitudes in their frontal area (P < 0.05). After 25 rTMS treatments, N400 amplitudes in the frontal area (elicited by idioms with same phonic and different shape and meaning and with different phonic, shape, and meaning) were increased in the SZ patients (P < 0.05). However, there was no significant change in N400 before and after treatment with ShrTMS in SZ patients (P > 0.05). Amplitudes for MMN and target P300 also increased in SZ patients after rTMS treatment (P < 0.05).
Based on our preliminary findings, we believe that the combined usage of N400, MMN, and P300 could be a valuable index and an electrophysiological reference in evaluating the effects of rTMS treatment in SZ patients.
重复经颅磁刺激（rTMS）和事件相关电位（ERPs）是一种非侵入性技术，广泛应用于神经生理学领域。尽管 rTMS 已显示出对许多神经疾病的临床疗效，但最近对于 rTMS 对精神分裂症（SZ）的疗效以及 rTMS 治疗前后 ERP 的变化知之甚少。本研究的目的是探讨 rTMS 治疗前后 SZ 患者 N400、失匹配负波（MMN）和 P300 的特征。
2015 年 3 月至 2017 年 7 月期间，上海市精神卫生中心收治的 127 例 SZ 患者分为两组（85 例为 rTMS 组，42 例为假 rTMS [ShrTMS] 组），同时招募 76 名正常对照者（NC）作为我院工作人员和进修人员。本实验采用国产 rTMS 和润捷 WJ-1 ERPs 仪器。采用一致和不一致的汉语成语诱发 N400。rTMS 治疗后，与治疗前和 NC 组比较 N400、P300 和 MMN 特征。
与 NC 相比，SZ 患者在前额区表现出 N400、P300 和 MMN 潜伏期延长，N400、P300 和 MMN 振幅降低（P <0.05）。25 次 rTMS 治疗后，SZ 患者前额区（由同音不同形、同音异形和不同音、形、义的成语诱发）N400 振幅增加（P <0.05）。然而，SZ 患者 ShrTMS 治疗前后 N400 无明显变化（P >0.05）。rTMS 治疗后，SZ 患者 MMN 和靶 P300 的振幅也增加（P <0.05）。
基于我们的初步发现，我们认为 N400、MMN 和 P300 的联合使用可能是评估 rTMS 治疗 SZ 患者效果的有价值的指标和电生理参考。
