Mao Jiankai, Fan Kaili, Zhang Yaoyao, Wen Na, Fang Xinyu, Ye Xiangming, Chen Yi
Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, PR China.
Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, PR China.
Heliyon. 2023 Sep 9;9(9):e19912. doi: 10.1016/j.heliyon.2023.e19912. eCollection 2023 Sep.
Cognitive impairment in schizophrenia patients with auditory hallucinations is more prominent compared to those without. Our study aimed to investigate the cognitive improvement effects of 10 Hz repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) in schizophrenia with auditory hallucinations.
A total of 60 schizophrenic patients with auditory hallucinations in this study were randomly assigned to sham or active group. Both groups received 10 Hz or sham rTMS targeted in left DLPFC for 20 sessions. The Positive and Negative Syndrome Scale (PANSS), the Auditory Hallucination Rating Scale (AHRS), the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and the Udvalg for Kliniske Under-sogelser (UKU) side effect scale were used to measure psychiatric symptoms, auditory hallucinations, cognition, and side reaction, respectively.
Our results indicated that the active group experienced greater improvements in RBANS-total score ( = 0.043) and immediate memory subscale score ( = 0.001). Additionally, the PANSS-total score, negative and positive subscale score were obviously lower in the active group compared to the sham group (all < 0.050). Furthermore, our study found that the improvement of RBANS-total score was positively associated with the decline of positive factor score, and the improvement of language score in RBANS was positively associated with the reduction in PANSS-total scale, negative and positive subscale score in the real stimulation group (all < 0.050).
Our results demonstrated that a four-week intervention of 10 Hz rTMS over the left DLPFC can improve cognition (particularly immediate memory) among schizophrenia patients with auditory hallucinations. Future studies with larger sample size are needful to verify our preliminary findings.
与无幻听的精神分裂症患者相比,有幻听的精神分裂症患者认知障碍更为突出。我们的研究旨在探讨10赫兹重复经颅磁刺激(rTMS)作用于左侧背外侧前额叶皮质(DLPFC)对有幻听的精神分裂症患者认知改善的影响。
本研究中共有60例有幻听的精神分裂症患者被随机分为假刺激组或真刺激组。两组均接受以左侧DLPFC为靶点的10赫兹rTMS或假刺激,共20次。分别使用阳性与阴性症状量表(PANSS)、幻听评定量表(AHRS)、可重复性神经心理状态评估量表(RBANS)以及临床副作用评定量表(UKU)来测量精神症状、幻听、认知及副作用。
我们的结果表明,真刺激组在RBANS总分(P = 0.043)和即刻记忆分量表得分(P = 0.001)方面有更大改善。此外,与假刺激组相比,真刺激组的PANSS总分、阴性和阳性分量表得分明显更低(均P < 0.050)。此外,我们的研究发现,真刺激组中RBANS总分的改善与阳性因子得分的下降呈正相关,RBANS中语言得分的改善与PANSS总分、阴性和阳性分量表得分的降低呈正相关(均P < 0.050)。
我们的结果表明,对左侧DLPFC进行为期四周的10赫兹rTMS干预可改善有幻听的精神分裂症患者的认知(尤其是即刻记忆)。需要进一步开展更大样本量的研究来验证我们的初步发现。