Department of Psychiatry, Indiana University School of Medicine, 355 W. 16th St., Suite 4800, Indianapolis, IN, 46202, USA.
Prevention and Recovery Center for Early Psychosis, Eskenazi Health Midtown Community Mental Health Center, 720 Eskenazi Avenue, Outpatient Care Center, Lower Level, Indianapolis, IN, 46202, USA.
Brain Imaging Behav. 2019 Jun;13(3):852-861. doi: 10.1007/s11682-018-9902-4.
Cognitive dysfunction is a core facet of schizophrenia that is present early in the course of the illness and contributes to diminished functioning and outcomes. Repetitive transcranial magnetic stimulation (rTMS) is a relatively new neuropsychiatric intervention. Initially used in treatment resistant depression, investigators are now studying rTMS for other psychiatric diseases such as schizophrenia. In this study we examined the effect of high frequency rTMS on cognitive function in a group of individuals with early phase psychosis. Twenty subjects were randomized (1:1) in double-blind fashion to rTMS or sham condition. Over two weeks subjects underwent ten sessions of high frequency, bilateral, sequential rTMS targeting the dorsolateral prefrontal cortex (DLPFC). Prior to beginning and following completion of study treatment, subjects completed a cognitive assessment and magnetic resonance imaging. Subjects receiving rTMS, compared to sham treatment, displayed improvement on a standardized cognitive battery both immediately following the course of study treatment and at follow-up two weeks later. Imaging results revealed that left frontal cortical thickness at baseline was correlated with treatment response. The study treatment was found to be safe and well tolerated. These results suggest that rTMS may hold promise for the treatment of cognitive dysfunction in the early phase of psychosis, and that MRI may provide biomarkers predicting response to the treatment.
认知功能障碍是精神分裂症的核心特征之一，在疾病早期就存在，并导致功能下降和预后不良。重复经颅磁刺激（rTMS）是一种相对较新的神经精神干预手段。最初用于治疗抵抗性抑郁症，现在研究人员正在研究 rTMS 治疗其他精神疾病，如精神分裂症。在这项研究中，我们研究了高频 rTMS 对一组早期精神病患者认知功能的影响。20 名受试者以 1:1 的比例随机（双盲）分为 rTMS 组或假刺激组。在两周内，受试者接受了 10 次高频、双侧、序贯 rTMS 治疗，目标是背外侧前额叶皮质（DLPFC）。在开始研究治疗之前和完成研究治疗之后，受试者完成了认知评估和磁共振成像。与假刺激治疗相比，接受 rTMS 治疗的受试者在研究治疗结束后立即和两周后的随访中，在标准化认知测试中表现出改善。影像学结果显示，基线时左额皮质厚度与治疗反应相关。研究治疗被发现是安全且耐受良好的。这些结果表明，rTMS 可能有望治疗早期精神病的认知功能障碍，而 MRI 可能提供预测治疗反应的生物标志物。
