Military Medical Psychology School, Fourth Military Medical University, Xi'an, China.
Department of Radiology, Fourth Military Medical University, Xi'an, China.
Transl Psychiatry. 2024 Sep 28;14(1):393. doi: 10.1038/s41398-024-03106-4.
Low-frequency repetitive transcranial magnetic stimulation (rTMS) has emerged as an effective intervention for alleviating symptoms of psychiatric disorders, particularly schizophrenia characterized by persistent auditory verbal hallucinations (AVH). However, the underlying mechanism of its action remain elusive. This study employed a randomized controlled design to investigate the impact of low-frequency rTMS on the neural connectivity at the stimulate site, specifically left temporoparietal junction (TPJ), in schizophrenia patients with suffering from AVH. Using Dynamic Causal Modeling (DCM), this study assessed changes in directed connectivity patterns and their correlations with clinical symptomatology. The results demonstrated significant improvements in AVH. Notably, significant changes in connectivity were observed, including both abnormal functional connectivity and effective connectivity among multiple brain regions. Particularly, the inhibition effects from the left precentral gyrus and left medial superior frontal gyrus to the left TPJ were closely associated with improvements in AVH. These findings underscore the potential of rTMS to effectively modulate neural pathways implicated in hallucinations in schizophrenia, thereby providing a neurobiological foundation for its therapeutic effects.
低频重复经颅磁刺激（rTMS）已成为一种有效的干预手段，可减轻精神疾病症状，特别是以持续听觉言语幻觉（AVH）为特征的精神分裂症。然而，其作用的潜在机制仍不清楚。本研究采用随机对照设计，探讨低频 rTMS 对精神分裂症患者听觉言语幻觉刺激部位（左颞顶联合区，TPJ）神经连接的影响。使用动态因果建模（DCM）评估了定向连接模式的变化及其与临床症状的相关性。结果显示 AVH 症状显著改善。值得注意的是，观察到连接性发生了显著变化，包括多个脑区之间的异常功能连接和有效连接。特别是，左中央前回和左内侧额上回对左 TPJ 的抑制作用与 AVH 的改善密切相关。这些发现强调了 rTMS 有效调节精神分裂症幻觉相关神经通路的潜力，为其治疗效果提供了神经生物学基础。
