Gao Chunying, Li Guangjian, Wang Zhou, Jiang Qingwei, He Rongrong, Sun Jingjing, You Yangyang, Zhu Yingzhi, Zhao Jing, Zhang Xiangrong, Zhou Chao
Department of Geriatric Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China; Department of Psychiatry, Changzhou Dean Hospital, Changzhou, China.
Department of Psychiatry, Changzhou Dean Hospital, Changzhou, China.
J Psychiatr Res. 2025 Jan;181:484-491. doi: 10.1016/j.jpsychires.2024.12.010. Epub 2024 Dec 7.
To explore the efficacy of theta burst stimulation (TBS) on the negative symptoms in patients with chronic schizophrenia, and to investigate the alterations of local brain activity using functional near-infrared spectroscopy (fNIRS).
100 patients with chronic schizophrenia were enrolled and divided into the real group (50 subjects) and sham group (50 subjects). The real group was given real stimulation of TBS for 4 weeks, and the sham group was sham-stimulated with the same site. The Positive and Negative Symptom Scale (PANSS) and the Scale for Assessment of Negative Symptoms (SANS) were used to assess the clinical symptoms. fNIRS was used to detect the amplitude of low frequency fluctuation (ALFF) of cortical hemoglobin before and after TBS. Repeated analysis of variance (ANOVA) was used to compare the changes in clinical features between the two groups. Correlation analysis was used to explore the associations between altered ALFF and clinical features.
Repeated ANOVA revealed that the interaction effect of group∗time showed significant influence on the scores of PANSS-total, PANSS-negative, and SANS in the two groups of patients. Test of within-subjects effects showed that significant reductions in scores of PANSS-total, PANSS-negative, and SANS were found between the real group and sham group after TBS, as well as in the real group before and after TBS. fNIRS revealed that the normalized ALFF (zALFF) of deoxyhemoglobin in the left dorsolateral prefrontal cortex was decreased in the real group after TBS. Furthermore, the zALFF of oxyhemoglobin was increased in the right and left frontal pole regions, and decreased in the right superior temporal gyrus in the real group compared to the sham group after TBS. Correlation analysis showed that the alterations of zALFF in frontal regions after treatment were associated with the improvement of negative symptoms in chronic schizophrenia patients.
Short-term TBS is effective in the improvement of negative symptoms of chronic schizophrenia. fNIRS could reveal the changes in brain activity after TBS treatment, providing an effective technique for exploring the efficacy of TBS in schizophrenia.
探讨theta爆发刺激（TBS）对慢性精神分裂症患者阴性症状的疗效，并使用功能近红外光谱（fNIRS）研究局部脑活动的变化。
招募100例慢性精神分裂症患者，分为真刺激组（50例）和假刺激组（50例）。真刺激组接受4周的TBS真刺激，假刺激组在相同部位进行假刺激。采用阳性与阴性症状量表（PANSS）和阴性症状评定量表（SANS）评估临床症状。fNIRS用于检测TBS前后皮质血红蛋白低频波动幅度（ALFF）。采用重复方差分析（ANOVA）比较两组临床特征的变化。相关性分析用于探讨ALFF改变与临床特征之间的关联。
重复ANOVA显示，组×时间的交互作用对两组患者的PANSS总分、PANSS阴性分和SANS评分有显著影响。组内效应检验显示，TBS后真刺激组与假刺激组之间以及真刺激组TBS前后PANSS总分、PANSS阴性分和SANS评分均显著降低。fNIRS显示，TBS后真刺激组左侧背外侧前额叶皮质脱氧血红蛋白的标准化ALFF（zALFF）降低。此外，与假刺激组相比，TBS后真刺激组左右额极区氧合血红蛋白的zALFF升高，右侧颞上回降低。相关性分析表明，治疗后额叶区域zALFF的改变与慢性精神分裂症患者阴性症状的改善相关。
短期TBS对改善慢性精神分裂症的阴性症状有效。fNIRS可揭示TBS治疗后脑活动的变化，为探索TBS在精神分裂症中的疗效提供了一种有效的技术。
