Jin Ying, Tong Jie, Huang Ying, Shi Dianhong, Zhu Na, Zhu Minghuan, Liu Minjia, Liu Haijun, Sun Xirong
Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China.
Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China.
Psychiatry Res. 2023 Feb;320:115033. doi: 10.1016/j.psychres.2022.115033. Epub 2022 Dec 25.
BACKGROUND: Social cognitive and negative symptoms impairment may increase the risk of mental disability in individuals with schizophrenia. However, randomized controlled studies on the effectiveness of accelerated intermittent theta burst stimulation (iTBS) for social cognition and negative symptoms in individuals with schizophrenia are very limited. METHODS: A total of 125 individuals with schizophrenia were recruited, 66 of whom were randomly divided into an active iTBS group (n=34) and sham iTBS group (n=32) by stratified sampling. Participants received either active iTBS or sham iTBS targeting the left dorsolateral prefrontal cortex (DLPFC) 20 sessions for 4 weeks under navigation. The Facial Emotion Recognition Test (FERT), Hinting Task (HT), and Positive and Negative Syndrome Scale (PANSS) were measured at baseline, 2 weeks, and 4 weeks. The trial protocol was registered with the Chinese Clinical Trial Registry (ChiCTR2100051984). RESULTS: Sixty patients (90.90%) completed the intervention and the 4-week follow-up, including 29 women (43.94%) and 37 men (56.06%) with a mean (SD) age of 47.53 (10.17) years. The primary outcomes showed FERT scores (week 2; 0.27 [95% CI, 0.09 to 0.45]; P< .01; ES 0.14) (week 4; 0.63 [95% CI, 0.45 to 0.80]; P< .001; ES 0.47) and HT scores (week 2; 1.00 [95% CI, -0.02 to 1.98]; P< .05; ES 0.67) (week 4; 2.13 [95% CI, 1.21 to 3.06]; P< .001; ES 0.27) in the active iTBS group were significantly different from those in the sham iTBS group at 2 and 4 weeks of follow-up. The secondary outcome showed that the negative symptom score (-3.43 [95% CI, -4.85 to -2.01]; P< .001; ES 0.29) of the active iTBS group was significantly different from that of the sham iTBS group at the 4th week of follow-up. CONCLUSIONS: Accelerated iTBS can effectively ameliorate the social cognition and negative symptoms of individuals with schizophrenia. These results suggest that accelerated iTBS may be a safe and effective neuromodulation technique to improve the overall functional recovery of individuals with schizophrenia, and has a good clinical application prospect.
背景：社会认知和阴性症状损害可能会增加精神分裂症患者出现精神残疾的风险。然而，关于加速间歇性theta波爆发刺激（iTBS）对精神分裂症患者社会认知和阴性症状有效性的随机对照研究非常有限。 方法：共招募了125名精神分裂症患者，其中66名通过分层抽样随机分为主动iTBS组（n = 34）和假iTBS组（n = 32）。参与者在导航引导下接受针对左侧背外侧前额叶皮质（DLPFC）的主动iTBS或假iTBS，共20次治疗，为期4周。在基线、2周和4周时测量面部表情识别测试（FERT）、暗示任务（HT）和阳性与阴性症状量表（PANSS）。该试验方案已在中国临床试验注册中心注册（ChiCTR2100051984）。 结果：60名患者（90.90%）完成了干预和4周随访，其中包括29名女性（43.94%）和37名男性（56.06%），平均（标准差）年龄为47.53（10.17）岁。主要结果显示，在随访的第2周和第4周，主动iTBS组的FERT评分（第2周；0.27[95%CI，0.09至0.45]；P <.01；效应量0.14）（第4周；0.63[95%CI，0.45至0.80]；P <.001；效应量0.47）和HT评分（第2周；1.00[95%CI，-0.02至1.98]；P <.05；效应量0.67）（第4周；2.13[95%CI，1.21至3.06]；P <.001；效应量0.27）与假iTBS组有显著差异。次要结果显示，在随访第4周时，主动iTBS组的阴性症状评分（-3.43[95%CI，-4.85至-2.01]；P <.001；效应量0.29）与假iTBS组有显著差异。 结论：加速iTBS可有效改善精神分裂症患者的社会认知和阴性症状。这些结果表明，加速iTBS可能是一种安全有效的神经调节技术，可改善精神分裂症患者的整体功能恢复，具有良好的临床应用前景。
Schizophrenia (Heidelb). 2025-6-11
Medicina (Kaunas). 2024-12-14
JAMA Netw Open. 2024-10-1
J Clin Med. 2024-9-23
Zotero 插件