Xie Yuanjun, Li Yijun, Guan Muzhen, Zhang Tian, Ma Chaozong, Wang Zhongheng, Ma Zhujing, Fang Peng, Wang Huaning, Li Chenxi
Medical Innovation Center, Sichuan University of Science and Engineering, Zigong, China; Military Medical Psychology School, Air Force Military Medical University, Xi'an, China.
Military Medical Psychology School, Air Force Military Medical University, Xi'an, China.
Clin Neurophysiol. 2025 Jul;175:2110752. doi: 10.1016/j.clinph.2025.2110752. Epub 2025 May 17.
Entropy is a critical measure for assessing the complexity and irregularity of brain signals. Understanding how brain entropy can be influenced by non-invasive neurostimulation in psychiatric patients remains a clinically relevant issue.
This study aims to explore whether low-frequency repetitive transcranial magnetic stimulation (rTMS) can modulate brain entropy in schizophrenia patient with auditory verbal hallucinations (AVH).
A case-control design was employed in this study. Low-frequency (1 Hz) rTMS targeting at left temporoparietal junction was administered to schizophrenia patients with AVH. Brain entropy (sample entropy) was calculated from resting-state functional magnetic resonance imaging (fMRI) data. Comparisons of sample entropy were made between the schizophrenia patients and healthy controls, as well as within the patient group pre- and post-rTMS.
Following rTMS treatment, patients showed a reduction in clinical symptoms, including positive symptoms and AVH. Neurocognitive improvements were also observed in domains such as verbal and visual memory. Furthermore, patients exhibited increased sample entropy in regions including the prefrontal cortices and temporal lobes compared to healthy controls. However, this elevated entropy was reduced post-rTMS, particularly in areas associated with AVH. The language network and default model network, initially showing high mean sample entropy, demonstrated a significant decrease after rTMS treatment. These changes in brain entropy were correlated with clinical improvements.
This modulation of neural activity complexity induced by the low-frequency rTMS may underlie the observed clinical and cognitive improvement in schizophrenia.
熵是评估脑信号复杂性和不规则性的关键指标。了解精神科患者的脑熵如何受到非侵入性神经刺激的影响仍然是一个具有临床相关性的问题。
本研究旨在探讨低频重复经颅磁刺激（rTMS）是否能调节伴有幻听（AVH）的精神分裂症患者的脑熵。
本研究采用病例对照设计。对伴有AVH的精神分裂症患者施加低频（1赫兹）rTMS，刺激靶点为左侧颞顶叶交界处。根据静息态功能磁共振成像（fMRI）数据计算脑熵（样本熵）。比较精神分裂症患者与健康对照之间以及患者组rTMS治疗前后的样本熵。
rTMS治疗后，患者的临床症状有所减轻，包括阳性症状和AVH。在言语和视觉记忆等领域也观察到神经认知功能改善。此外，与健康对照相比，患者前额叶皮质和颞叶等区域的样本熵增加。然而，这种升高的熵在rTMS治疗后降低，尤其是在与AVH相关的区域。最初显示出高平均样本熵的语言网络和默认模式网络在rTMS治疗后显著降低。脑熵的这些变化与临床改善相关。
低频rTMS诱导的神经活动复杂性调节可能是精神分裂症患者观察到的临床和认知改善的基础。
