Li Jing, Mo Xian, Jiang Dan, Huang Xinyu, Wang Xiao, Xia Tingting, Zhang Wei
Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
Big Data Center, Sichuan University, Chengdu, China.
Front Psychiatry. 2025 Jan 3;15:1500113. doi: 10.3389/fpsyt.2024.1500113. eCollection 2024.
This study aims to evaluate the intervention effect of intermittent Theta burst stimulation (iTBS) on bilateral dorsomedial prefrontal cortex (DMPFC) for negative symptoms in schizophrenia using functional near-infrared spectroscopy (fNIRS) to confirm the therapeutic significance of DMPFC in treating negative symptoms and provide new evidence for schizophrenia treatment and research.
Thirty-nine schizophrenia patients with negative symptoms and mild cognitive impairment were randomly divided into a treatment group (n=20) and a control group (n=19). The treatment group received iTBS in bilateral DMPFC. The control group received the sham treatment. Negative symptoms, cognitive function, emotional state, and social function were assessed at pre-treatment, post-treatment, 4-, 8-, and 12-week follow-ups. Brain activation in regions of interest (ROIs) was evaluated through verbal fluency tasks. Changes in scale scores were analyzed by repeated measures ANOVA.
After 20 sessions of iTBS, the Scale for the Assessment of Negative Symptoms (SANS) total and sub-scale scores significantly improved in the treatment group, with statistically significant differences. SANS scores differed significantly between pre- and post-treatment in both groups, with post-treatment scores markedly lower than pre-treatment and better efficacy in the treatment group. However, there was no significant difference in cognitive function, emotional state, and social function. ROIs did not differ significantly between groups before intervention. After treatment, prefrontal cortex activation was significantly higher in the treatment group than in controls, with a statistically significant difference. Regarding functional connectivity, the small-world properties Sigma and Gamma were enhanced.
iTBS on bilateral DMPFC can effectively alleviate negative symptoms and enhance prefrontal cortex activation and the small-world properties in patients of schizophrenia.
本研究旨在利用功能近红外光谱技术（fNIRS）评估间歇性θ波爆发刺激（iTBS）对精神分裂症阴性症状患者双侧背内侧前额叶皮质（DMPFC）的干预效果，以证实DMPFC在治疗阴性症状中的治疗意义，并为精神分裂症的治疗和研究提供新的证据。
将39例伴有阴性症状和轻度认知障碍的精神分裂症患者随机分为治疗组（n = 20）和对照组（n = 19）。治疗组接受双侧DMPFC的iTBS治疗。对照组接受假治疗。在治疗前、治疗后、4周、8周和12周随访时评估阴性症状、认知功能、情绪状态和社会功能。通过言语流畅性任务评估感兴趣区域（ROIs）的脑激活情况。采用重复测量方差分析分析量表评分的变化。
20次iTBS治疗后，治疗组阴性症状评定量表（SANS）总分及各分量表评分显著改善，差异有统计学意义。两组治疗前后SANS评分差异均有统计学意义，治疗后评分均显著低于治疗前，且治疗组疗效更佳。然而，在认知功能、情绪状态和社会功能方面无显著差异。干预前两组ROIs无显著差异。治疗后，治疗组前额叶皮质激活显著高于对照组，差异有统计学意义。在功能连接方面，小世界属性Sigma和Gamma增强。
双侧DMPFC的iTBS可有效减轻精神分裂症患者的阴性症状，增强前额叶皮质激活及小世界属性。
