High frequency rTMS in the treatment of negative symptoms of schizophrenia: double blind randomised study
| Authors | |
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| Year of publication | 2007 |
| Type | Article in Periodical |
| Magazine / Source | Schizophrenia Bulletin |
| MU Faculty or unit | |
| Citation | |
| Field | Psychiatry, sexuology |
| Keywords | rTMS; negative; symptoms; schizophrenia; treatment |
| Description | Objective: To verify whether highfrequency rTMS applied above the area of the left prefrontal cortex including in total 15 stimulation sessions with maximum stimulation intensity is able to modify the negative symptoms of schizophrenia in the single blinded, randomized study settings. Methods: Twentytwo schizophrenic patients on stable antipsychotic medication with prominent negative symptoms were included in the trial. They were divided into two groups: eleven of them were treated with effective rTMS and eleven with ineffective sham rTMS. The ineffectiveness of the sham rTMS was achieved through the stimulation coil position. Stimulation was applied to the left dorsolateral prefrontal cortex. The stimulation frequency was 10Hz. Stimulation intensity was 110 of the motor threshold intensity. Each patient received 15 rTMS sessions on 15 consecutive working days. Each daily session consisted of 15 applications of 10 second duration and 30 second intervals between sequences. There were 1500 stimuli per session. Results: During real rTMS treatment a statistical significant decrease of negative symptoms was determined (about 29 in negative subscale PANSS and 50 in SANS). No adverse events occurred during therapy except for a mild headache. In sham rTMS treatment a decrease of negative symptoms was also identified, but to a lesser extent than in real rTMS (about 7% in negative subscale PANSS and 13 in SANS). The change in SANS achieved statistical significance. Mutual comparison revealed a greater decrease of negative symptoms in favor of real rTMS in contrast to sham rTMS. Conclusion: The augmentation of rTMS enabled patients to experience a significant decrease in the severity of the negative symptoms. The explanation for this can be seen in the ability of the rTMS to influence the pathophysiologic basis of negative symptoms in a different way than is achieved by antipsychotics. Our results support the therapeutic potential of rTMS at higher frequency for negative symptoms of schizophrenia. |
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