Gao Xiaofeng, Ni Yanfei, Hu Weiming, Wang Guomin, He Xianyan
Psychiatry Department, The Third Hospital of Quzhou, No. 226 Baiyun North Avenue, Kecheng District, Quzhou, Zhejiang 324000, China.
Postgrad Med J. 2025 Feb 19;101(1193):203-211. doi: 10.1093/postmj/qgae119.
This study aims to compare the therapeutic effects of repetitive transcranial magnetic stimulation (rTMS) and continuous theta-burst stimulation (cTBS) treatment in schizophrenia patients with auditory verbal hallucinations (AVHs).
We enrolled 64 schizophrenia patients with AVHs who were treated with either rTMS (n = 32) or cTBS (n = 32), and we compared the clinical outcomes by evaluating parameters from motor evoked potentials, Positive and Negative Syndrome Scale (PANSS), Auditory Hallucination Rating Scale (AHRS), and MATRICS Consensus Cognitive Battery (MCCB), as well as the changes of serum neurotrophic factors before and after the treatment.
After the treatment, both treatments resulted in reduced PANSS scores, with the cTBS group showing more substantial symptom improvement across positive, negative, and general symptoms, highlighting the enhanced efficacy of cTBS. Cognitive functions assessed by MCCB also improved in both groups, with cTBS showing a generally higher therapeutic effect. Serum levels of brain-derived neurotrophic factor (BDNF) and glial cell line-derived neurotrophic factor (GDNF) increased following treatment in both groups, with a more notable increase after cTBS, while GABA and glutamate levels remained unchanged. Cardiovascular indices were unaffected by either treatment, suggesting no significant impact on cardiovascular health.
Our study found that both rTMS and cTBS treatment can exhibit therapeutic effects in the management of AVHs in patients with schizophrenia. However, cTBS treatment generally shows a higher therapeutic effect than rTMS treatment.
本研究旨在比较重复经颅磁刺激（rTMS）和连续θ波爆发刺激（cTBS）治疗对伴有幻听（AVH）的精神分裂症患者的疗效。
我们招募了64例伴有AVH的精神分裂症患者，分别接受rTMS治疗（n = 32）或cTBS治疗（n = 32），通过评估运动诱发电位、阳性和阴性症状量表（PANSS）、幻听评定量表（AHRS）、MATRICS共识认知成套测验（MCCB）的参数以及治疗前后血清神经营养因子的变化来比较临床结果。
治疗后，两种治疗方法均使PANSS评分降低，cTBS组在阳性、阴性和一般症状方面的症状改善更为显著，突出了cTBS增强的疗效。两组通过MCCB评估的认知功能也有所改善，cTBS总体显示出更高的治疗效果。两组治疗后血清脑源性神经营养因子（BDNF）和胶质细胞源性神经营养因子（GDNF）水平均升高，cTBS后升高更为显著，而γ-氨基丁酸（GABA）和谷氨酸水平保持不变。两种治疗方法均未影响心血管指标，表明对心血管健康无显著影响。
我们的研究发现，rTMS和cTBS治疗在精神分裂症患者AVH的管理中均能显示出治疗效果。然而，cTBS治疗总体显示出比rTMS治疗更高的治疗效果。
