Zhou Dan, Xie Hongtao, Chen Liqun, Zhu Zhipei, Zhang Chunyan, Jiang Jiangling
Shanghai Putuo Mental Health Center, 211 Zhi Dan Road, 200065 Shanghai, China.
Department of Psychiatry, Tongji Hospital of Tongji University, 389 Xincun Road, 200065 Shanghai, China.
Psychiatry Res. 2024 Feb;332:115672. doi: 10.1016/j.psychres.2023.115672. Epub 2023 Dec 13.
Cognitive impairments are a core symptom of schizophrenia. Although low-intensity repetitive transcranial magnetic stimulation (rTMS) also has cognitive improving effect like the commonly used high-intensity rTMS, it has not been applied in schizophrenia yet. To fill this gap, inpatients with schizophrenia were randomized to receive 20 sessions of daily adjunctive active low-intensity rTMS in 4 weeks, or sham treatment. At baseline, 4 weeks, and 6 months, the Positive and Negative Syndrome Scale (PANSS) was used to assess psychotic symptom severity, while the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the Stroop Color and Word Test (SCWT) were used to assess cognitive functions. Compared to the sixty-nine patients receiving sham treatment, those fifty-nine patients receiving active rTMS performed better in all cognitive domains at post-treatment with small to large effect sizes. This superiority of active rTMS over sham treatment remained significant at 6-month follow-up, with small to large effect sizes, except for visuospatial function and delayed memory. The reduction in PANSS scores were not correlated with cognitive improvements. Our findings provide evidence for using low-intensity rTMS to ameliorate cognitive impairments in schizophrenia. More research are needed to determine the optimal intensity for each domain of cognitive functions.
认知障碍是精神分裂症的核心症状。尽管低强度重复经颅磁刺激(rTMS)与常用的高强度rTMS一样具有改善认知的作用,但尚未应用于精神分裂症的治疗。为填补这一空白,将精神分裂症住院患者随机分为两组,一组在4周内每天接受20次辅助性主动低强度rTMS治疗,另一组接受假治疗。在基线、4周和6个月时,使用阳性和阴性症状量表(PANSS)评估精神病性症状的严重程度,同时使用可重复性神经心理状态评估量表(RBANS)和斯特鲁普颜色和文字测验(SCWT)评估认知功能。与69名接受假治疗的患者相比,59名接受主动rTMS治疗的患者在治疗后所有认知领域的表现均更好,效应大小从小到中等。主动rTMS治疗相对于假治疗的这种优势在6个月随访时仍然显著,效应大小从小到中等,但视觉空间功能和延迟记忆除外。PANSS评分的降低与认知改善无关。我们的研究结果为使用低强度rTMS改善精神分裂症的认知障碍提供了证据。需要更多的研究来确定每个认知功能领域的最佳强度。
Schizophrenia (Heidelb). 2025-4-28