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连续theta爆发刺激对首发未用药精神分裂症患者抗精神病药物所致体重增加的影响:一项双盲、随机、假刺激对照的可行性试验。

The effect of continuous theta burst stimulation on antipsychotic-induced weight gain in first-episode drug-naive individuals with schizophrenia: a double-blind, randomized, sham-controlled feasibility trial.

作者信息

Kang Dongyu, Song Chuhan, Peng Xingjie, Yu Guo, Yang Ye, Chen Chuwei, Long Yujun, Shao Ping, Wu Renrong

机构信息

Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, 410011, Changsha, Hunan, China.

出版信息

Transl Psychiatry. 2024 Jan 25;14(1):61. doi: 10.1038/s41398-024-02770-w.

Abstract

Antipsychotic intake may induce weight gain in drug-naive individuals with schizophrenia, leading to poor compliance in clinical management. However, there is still a lack of effective approaches to treat or prevent this side-effect. Therefore, we conducted this pilot study to investigate the effect of continuous theta burst stimulation (cTBS), a non-invasive magnetic stimulation technique, on preventing olanzapine-induced weight gain. Thirty-nine first-episode drug-naive individuals with schizophrenia were randomly assigned to receive either the active or sham cTBS intervention for 25 sessions (5 times per day for 5 consecutive days). The primary outcomes were changes in body weight and body mass index (BMI). Secondary outcomes included psychiatric symptoms, eating behavior scales, behavior tasks, and metabolic measures. For the result, the body weight and BMI increased significantly in the sham group but not in the active group, with a significant group effect. The active group exhibited a selective increase in the cognitive restraint domain in the Three-Factor Eating Questionnaire (TFEQ-CR) and a decrease in stop-signal reaction time compared to the sham group. The effect of cTBS on body weight was mediated by TFEQ-CR. Our findings demonstrated the feasibility that cTBS intervention could be a potential method for preventing olanzapine-induced weight gain in drug-naive first-episode schizophrenia patients through enhancing cognitive restraint to food. Trial registration: clinical trial registered with clinicaltrials.gov (NCT05086133).

摘要

在未服用过抗精神病药物的精神分裂症患者中,服用抗精神病药物可能会导致体重增加,进而导致临床管理中的依从性较差。然而,目前仍缺乏治疗或预防这种副作用的有效方法。因此,我们开展了这项初步研究,以调查连续theta爆发刺激(cTBS)(一种非侵入性磁刺激技术)对预防奥氮平引起的体重增加的效果。39名首次发作、未服用过药物的精神分裂症患者被随机分配接受主动或假cTBS干预,共25次(连续5天,每天5次)。主要结局是体重和体重指数(BMI)的变化。次要结局包括精神症状、饮食行为量表、行为任务和代谢指标。结果显示,假刺激组的体重和BMI显著增加,而主动刺激组则未增加,两组间存在显著差异。与假刺激组相比,主动刺激组在三因素饮食问卷(TFEQ-CR)的认知抑制领域有选择性增加,停止信号反应时间缩短。cTBS对体重的影响是由TFEQ-CR介导的。我们的研究结果表明,cTBS干预通过增强对食物的认知抑制,可能是预防未服用过药物的首次发作精神分裂症患者奥氮平引起体重增加的一种潜在方法。试验注册:在clinicaltrials.gov注册的临床试验(NCT05086133)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0ec/10810827/3007a5ab28b3/41398_2024_2770_Fig1_HTML.jpg

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