| Objective:To investigate the effect of the repetitive transcranial magnetic stimulation(rTMS)with theta burst stimulation(TBS)paradigm on cognitive function and sensory gating P50 in patients with chronic schizophrenia.Method:This is a randomized,sham-controlled,double-blinded trial.Sixty-three patients with chronic schizophrenia on stable antipsychotic treatment were randomly assigned to an active rTMS treatment group(n=32)or a sham rTMS treatment group(n=31).Each patient in an active rTMS treatment group received 20 rTMS sessions over 4 weeks(5 days per week)that delivered theta burst stimulation(TBS),while 31 patients were subjected to sham rTMS treatment.Both groups received antipsychotic treatment and maintained the same type and dose of antipsychotic drugs during the study period.All subjects were assessed by sensory gating P50,Wisconsin Card Sorting Test(WCST),Wechsler memory scale(WMS),Positive and Negative Syndrome Scale(PANSS),Treatment Emergent Symptom Scale(TESS)at baseline and the end of 4 weeks.Result:A total of 63 chronic schizophrenia patients were collected and three patients were dropped out in this study.1.Comparison of PANSS score between the two groups at baseline and the end of 4 weeks:There was no significant difference between the two groups in PANSS-total score、PANSS-negative score、PANSS-positive score and the general psychopathology score at baseline(P>0.05).AT the end of 4 weeks,the PANSS-total score and PANSS-negative score in TBS group were significantly lower than those in sham rTMS treatment group(P<0.05).There was no significant difference between the PANSS-positive score and the general psychopathology score(P>0.05).2.Comparison of cognitive function between the two groups at baseline and the end of 4 weeks:There was no significant difference between the two groups in WCST and WMS scores at baseline(P>0.05).AT the end of 4 weeks,the number of Categories Completed and corrects were increased,while the number of errors and perseverative errors were decreased in TBS group(P<0.05).The scores of WMS items were improved in varying degrees,and the difference was statistically significant(P<0.05).Compared with the sham rTMS group,the difference between the two groups was statistically significant(P<0.05).3.Comparison of the sensory gating P50 in two groups at baseline and the end of 4 weeks:There was no significant difference in the of S1Amp-P50,S2Amp-P50,S2/S1,S1-S2 and 100(1-S2/S1)of Cz locus between the two groups at baseline(P>0.05).AT the end of 4 weeks,there was also no significant difference between the two groups(P>0.05).4.Correlation between PANSS-negative reduction and WCST and WMS changes in TBS group before and after treatment:According to the Pearson correlation test,the PANSS-negative reduction was negatively correlated with the changes of the number of Categories Completed and corrects in WCST,and was positively correlated with the number of perseverative errors,and positively correlated with the difference of persistent errors;the PANSS-negative reduction was negatively correlated with the changes of Memory quotient in WMS.Conclusion:1.The rTMS with TBS paradigm can improve the negative symptoms in patients with chronic schizophrenia.2.The rTMS with TBS paradigm can improve the cognitive function of chronic schizophrenia,and the improvement of cognitive function is related to the improvement of negative symptoms.3.The rTMS with TBS paradigm can not improve abnormal auditory sensory gating P50 in chronic schizophrenia.4.The rTMS with TBS paradigm is safe for patients with chronic schizophrenia. |
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