顶叶间歇性θ波爆发刺激对精神分裂症患者额顶叶网络静息态有效连接性的影响：一项功能磁共振成像研究。
Effects of parietal iTBS on resting-state effective connectivity within the frontoparietal network in patients with schizophrenia: An fMRI study.
作者信息
Li Li, Wang Lina, Wu Han, Li Bing, Pan Weigang, Jin Wenqing, Wang Wen, Ren Yanping, Liu Chaomeng, Ma Xin
机构信息
Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, PR China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, PR China.
Hebei Provincial Mental Health Center, Baoding, PR China; Hebei Key Laboratory of Major Mental and Behavioral Disorders, Baoding, PR China; The Sixth Clinical Medical College of Hebei University, Baoding, PR China.
出版信息
Neuroimage Clin. 2025;45:103715. doi: 10.1016/j.nicl.2024.103715. Epub 2024 Nov 26.
BACKGROUND
Although intermittent theta burst stimulation (iTBS) has shown effectiveness in addressing working memory (WM) deficits in individuals with schizophrenia (SZ), the current body of evidence is limited and the specific mechanisms involved remain unclear. Therefore, this pilot fMRI study aimed to examine the efficacy of parietal iTBS in ameliorating WM impairments and explore its influence on the resting-state effective connectivity within the frontoparietal network in patients with SZ.
METHOD
A total of 48 patients diagnosed with SZ were randomly assigned to an active or sham iTBS group and underwent 20 sessions of active or sham iTBS over 4 weeks. Subsequently, all patients underwent cognitive tests, clinical symptom assessments, and resting-state functional MRI (rs-fMRI) scans. The effective connectivity between the frontal and parietal brain regions during the rs-fMRI scans was analyzed using a spectral dynamic causal modeling approach. Additionally, this trial was registered at the Chinese Clinical Trial Registry in November 2022 (registry number: ChiCTR2200057286).
RESULTS
iTBS treatment improved the positive symptoms, negative symptoms, general psychopathology, and WM deficits. Following the iTBS intervention, the active group demonstrated a significant increase in connectivity strengths from the right MFG to the right SPL (p = 0.031) and from the left SPL to the left MFG (p = 0.010) compared to the pre-treatment levels. Additionally, compared to the sham group, the active group displayed a significantly higher connectivity strength from the right MFG to the right SPL (p = 0.042) after iTBS treatment.
CONCLUSION
All these findings suggest that iTBS targeting the parietal region may influence the resting-state effective connectivity within the frontoparietal network, thereby offering promising therapeutic implications for alleviating the cognitive deficits in SZ.
背景
尽管间歇性θ波爆发刺激（iTBS）已显示出对改善精神分裂症（SZ）患者的工作记忆（WM）缺陷有效，但目前的证据有限，具体涉及的机制仍不清楚。因此，这项功能性磁共振成像（fMRI）试点研究旨在检验顶叶iTBS改善WM损伤的疗效，并探讨其对SZ患者额顶网络内静息态有效连接性的影响。
方法
共有48名被诊断为SZ的患者被随机分配到主动或假iTBS组，并在4周内接受20次主动或假iTBS治疗。随后，所有患者均接受认知测试、临床症状评估和静息态功能磁共振成像（rs-fMRI）扫描。使用频谱动态因果模型方法分析rs-fMRI扫描期间额叶和顶叶脑区之间的有效连接性。此外，该试验于2022年11月在中国临床试验注册中心注册（注册号：ChiCTR2200057286）。
结果
iTBS治疗改善了阳性症状、阴性症状、一般精神病理学和WM缺陷。与治疗前水平相比，iTBS干预后，主动组从右侧额中回（MFG）到右侧顶上小叶（SPL）以及从左侧SPL到左侧MFG的连接强度显著增加（p = 0.031和p = 0.010）。此外，与假手术组相比，主动组在iTBS治疗后从右侧MFG到右侧SPL的连接强度显著更高（p = 0.042）。
结论
所有这些发现表明，针对顶叶区域的iTBS可能会影响额顶网络内的静息态有效连接性，从而为缓解SZ患者的认知缺陷提供有前景的治疗意义。
Zotero 插件