药物初治精神分裂症患者眶额皮质刺激后异常的全脑皮质反应：一项经颅磁刺激-脑电图同步研究。

Abnormal Global Cortical Responses in Drug-Naïve Patients With Schizophrenia Following Orbitofrontal Cortex Stimulation: A Concurrent Transcranial Magnetic Stimulation-Electroencephalography Study.

机构信息

Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Med.-X Engineering Research Center, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.

Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Psychiatry, Zhenjiang Mental Health Center, Jiangsu, China.

出版信息

Biol Psychiatry. 2024 Sep 1;96(5):342-351. doi: 10.1016/j.biopsych.2024.05.024. Epub 2024 Jun 8.

DOI:10.1016/j.biopsych.2024.05.024

PMID:38852897

Abstract

BACKGROUND

Abnormalities in cortical excitability and plasticity have been considered to underlie the pathophysiology of schizophrenia. Transcranial magnetic stimulation combined with electroencephalography (TMS-EEG) can provide a direct evaluation of cortical responses to TMS. Here, we employed TMS-EEG to investigate cortical responses to orbitofrontal cortex (OFC) stimulation in schizophrenia.

METHODS

In total, we recruited 92 drug-naïve patients with first-episode schizophrenia and 51 age- and sex-matched healthy individuals. For each participant, one session of 1-Hz repetitive TMS (rTMS) was delivered to the right OFC, and TMS-EEG data were obtained to explore the change in cortical-evoked activities before and immediately after rTMS during the eyes-closed state. The MATRICS Consensus Cognitive Battery was used to assess neurocognitive performance.

RESULTS

The cortical responses indexed by global mean field amplitudes (i.e., P30, N45, and P60) were larger in patients with schizophrenia than in healthy control participants at baseline. Furthermore, after one session of 1-Hz rTMS over the right OFC, the N100 amplitude was significantly reduced in the healthy control group but not in the schizophrenia group. In the healthy control participants, there was a significant correlation between modulation of P60 amplitude by rTMS and working memory; however, this correlation was absent in patients with schizophrenia.

CONCLUSIONS

Aberrant global cortical responses following right OFC stimulation were found in patients with drug-naïve first-episode schizophrenia, supporting its significance in the primary pathophysiology of schizophrenia.

摘要

背景

皮质兴奋性和可塑性的异常被认为是精神分裂症病理生理学的基础。经颅磁刺激结合脑电图（TMS-EEG）可以直接评估皮质对 TMS 的反应。在这里，我们采用 TMS-EEG 研究了精神分裂症患者眶额皮层（OFC）刺激的皮质反应。

方法

我们共招募了 92 名未经药物治疗的首发精神分裂症患者和 51 名年龄和性别匹配的健康个体。对于每个参与者，在闭眼状态下，给予右 OFC 1Hz 重复经颅磁刺激（rTMS）一次，并获取 TMS-EEG 数据，以探索 rTMS 前后皮质诱发电活动的变化。采用 MATRICS 共识认知电池评估神经认知表现。

结果

在基线时，精神分裂症患者的皮质反应指标（即 P30、N45 和 P60 的全局平均场振幅）大于健康对照组。此外，在右 OFC 接受 1Hz rTMS 一次后，健康对照组的 N100 振幅显著降低，但精神分裂症组没有。在健康对照组中，rTMS 对 P60 振幅的调制与工作记忆之间存在显著相关性；然而，在精神分裂症患者中，这种相关性不存在。