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Book ; Thesis: Effect of prefrontal high frequency repetitive transcranial magnetic stimulation (rTMS) on psychopathology and working memory in patients with schizophrenia and healthy controls

Guse, Birgit

2013

Abstract: ... in schizophrenic patients and healthy controls is presented. - (1) Cordes, J., Falkai, P., Guse, B., Hasan ... 1007/s00406-009-0060-y. (2) Guse, B., Falkai, P., & Wobrock, T. (2010). Cognitive effects of high ... 117(1), 105-22. DOI: 10.1007/s00702-009-0333-7. (3) Guse, B., Falkai, P,. Gruber, O., Whalley, H ...

Title translation	Auswirkungen von präfrontaler hochfrequenter transkranieller Magnetstimulation auf Psychopathologie und Arbeitsgedächtnis von schizophrenen Patienten und gesunden Kontrollpersonen
Abstract	A cumulative dissertation with three contributions investigating the effects of prefrontal high-frequency repetitive transcranial magnetic stimulation on psychopathology and working memory in schizophrenic patients and healthy controls is presented. - (1) Cordes, J., Falkai, P., Guse, B., Hasan, A., Schneider-Axmann, T., Arends, M., Winterer, G., Wölwer, W., Ben Sliman, E., Ramacher, M., Schmidt-Kraepelin, C., Ohmann, C., Langguth, B., Landgrebe, M., Eichhammer, P., Frank, E., Burge, J., Hajak, G,. Rietschel, M., & Wobrock, T. (2009). Repetitive transcranial magnetic stimulation for the treatment of negative symptoms in residual schizophrenia: Rationale and design of a sham-controlled, randomized multicentre study. European Archives of Psychiatry and Clinical Neuroscience 259 (Suppl 2), 189-197. DOI: 10.1007/s00406-009-0060-y. (2) Guse, B., Falkai, P., & Wobrock, T. (2010). Cognitive effects of high-frequency repetitive transcranial magnetic stimulation: A systematic review. Journal of Neural Transmission 117(1), 105-22. DOI: 10.1007/s00702-009-0333-7. (3) Guse, B., Falkai, P,. Gruber, O., Whalley, H., Gibson, L., Hasan, A., Obst, K., Dechent, P., McIntosh, A., Suchan, B., & Wobrock, T. (2013). The effect of long-term high frequency repetitive transcranial magnetic stimulation on working memory in schizophrenia and healthy controls - A randomized placebo-controlled, double-blind fMRI study. Behavioural Brain Research, Jan 15, 237, 300-307. DOI: 10.1016/j.bbr.2012.09.034.
Keywords	Cognitive Ability ; Gedächtnis ; Kognitive Fähigkeiten ; Memory ; Positiv- und Negativsymptomatik ; Positive and Negative Symptoms ; Prefrontal Cortex ; Präfrontaler Kortex ; Psychopathologie ; Psychopathology ; Schizophrenia ; Schizophrenie ; Therapieergebnisse ; Transcranial Magnetic Stimulation ; Transkranielle Magnetstimulation ; Treatment Outcomes
Language	English
Size	93 pp.
Publisher	Universität, Fakultät für Psychologie
Publishing place	Bochum
Document type	Book ; Thesis
Note	Kumulative Dissertation
Database	PSYNDEX

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Book ; Online ; Thesis: Effect of prefrontal high frequency repetitive Transcranial Magnetic Stimulation (rTMS) on psychopathology and working memory in patients with schizophrenia and healthy controls

Guse, Birgit [Verfasser] / Suchan, Boris [Gutachter] / Wobrock, Thomas [Gutachter]

2013

Author's details	Birgit Guse ; Gutachter: Boris Suchan, Thomas Wobrock ; Fakultät für Psychologie
Keywords	Psychologie ; Psychology
Subject code	sg150
Language	English
Publisher	Ruhr-Universität Bochum
Publishing place	Bochum
Document type	Book ; Online ; Thesis
Database	Digital theses on the web

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Article ; Online: Cognitive effects of high-frequency repetitive transcranial magnetic stimulation: a systematic review.

Guse, Birgit / Falkai, Peter / Wobrock, Thomas

Journal of neural transmission (Vienna, Austria : 1996)

2009 Volume 117, Issue 1, Page(s) 105–122

Abstract: Transcranial magnetic stimulation (TMS) was introduced as a non-invasive tool for the investigation of the motor cortex. The repetitive application (rTMS), causing longer lasting effects, was used to study the influence on a variety of cerebral functions. ...

Abstract	Transcranial magnetic stimulation (TMS) was introduced as a non-invasive tool for the investigation of the motor cortex. The repetitive application (rTMS), causing longer lasting effects, was used to study the influence on a variety of cerebral functions. High-frequency (>1 Hz) rTMS is known to depolarize neurons under the stimulating coil and to indirectly affect areas being connected and related to emotion and behavior. Researchers found selective cognitive improvement after high-frequency (HF) stimulation specifically over the left dorsolateral prefrontal cortex (DLPFC). This article provides a systematic review of HF-rTMS studies (1999-2009) stimulating over the prefrontal cortex of patients suffering from psychiatric/neurological diseases or healthy volunteers, where the effects on cognitive functions were measured. The cognitive effect was analyzed with regard to the impact of clinical status (patients/healthy volunteers) and stimulation type (verum/sham). RTMS at 10, 15 or 20 Hz, applied over the left DLPFC, within a range of 10-15 successive sessions and an individual motor threshold of 80-110%, is most likely to cause significant cognitive improvement. In comparison, patients tend to reach a greater improvement than healthy participants. Limitations concern the absence of healthy groups in clinical studies and partly the absence of sham groups. Thus, future investigations are needed to assess cognitive rTMS effects in different psychiatric disorders versus healthy subjects using an extended standardized neuropsychological test battery. Since the pathophysiological and neurobiological basis of cognitive improvement with rTMS remains unclear, additional studies including genetics, experimental neurophysiology and functional brain imaging are necessary to explore stimulation-related functional changes in the brain.
MeSH term(s)	Cognition/physiology ; Humans ; Mental Disorders/physiopathology ; Prefrontal Cortex/physiology ; Transcranial Magnetic Stimulation/methods
Language	English
Publishing date	2009-10-27
Publishing country	Austria
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	184163-4
ISSN	1435-1463 ; 0300-9564
ISSN (online)	1435-1463
ISSN	0300-9564
DOI	10.1007/s00702-009-0333-7
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Article: Planum temporale asymmetry to the right hemisphere in first-episode schizophrenia.

Hasan, Alkomiet / Kremer, Lisa / Gruber, Oliver / Schneider-Axmann, Thomas / Guse, Birgit / Reith, Wolfgang / Falkai, Peter / Wobrock, Thomas

Psychiatry research

2011 Volume 193, Issue 1, Page(s) 56–59

Abstract: In schizophrenia patients reduced cerebral asymmetry is an important finding and this may reflect a disturbance in cortical development. We investigated planum temporale (PT) volume and asymmetry in 23 first-episode schizophrenia patients compared to ... ...

Abstract	In schizophrenia patients reduced cerebral asymmetry is an important finding and this may reflect a disturbance in cortical development. We investigated planum temporale (PT) volume and asymmetry in 23 first-episode schizophrenia patients compared to healthy controls and found for the first time an in vivo volume asymmetry of PT to the right hemisphere.
MeSH term(s)	Adult ; Analysis of Variance ; Brain Mapping ; Cerebral Cortex/pathology ; Female ; Functional Laterality/physiology ; Humans ; Magnetic Resonance Imaging ; Male ; Psychiatric Status Rating Scales ; Schizophrenia/pathology ; Schizophrenia/physiopathology ; Young Adult
Language	English
Publishing date	2011-07-30
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	445361-x
ISSN	1872-7123 ; 1872-7506 ; 0165-1781 ; 0925-4927
ISSN (online)	1872-7123 ; 1872-7506
ISSN	0165-1781 ; 0925-4927
DOI	10.1016/j.pscychresns.2011.02.008
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Article ; Online: Dysfunctional long-term potentiation-like plasticity in schizophrenia revealed by transcranial direct current stimulation.

Hasan, Alkomiet / Nitsche, Michael A / Rein, Bettina / Schneider-Axmann, Thomas / Guse, Birgit / Gruber, Oliver / Falkai, Peter / Wobrock, Thomas

Behavioural brain research

2011 Volume 224, Issue 1, Page(s) 15–22

Abstract: Neural and cortical plasticity represent the ability of the brain to reorganize its function in response to a challenge. Plasticity involves changing synaptic activity and connectivity. Long-term-potentiation is one important mechanism underlying these ... ...

Abstract	Neural and cortical plasticity represent the ability of the brain to reorganize its function in response to a challenge. Plasticity involves changing synaptic activity and connectivity. Long-term-potentiation is one important mechanism underlying these synaptic changes. Disturbed neuronal plasticity is considered to be part of the pathophysiology of schizophrenia and has been linked to the different clinical features of this severe illness. The aim of the present study was to investigate nonfocal cortical plasticity and cortical excitability in recent-onset and multi-episode schizophrenia compared with healthy subjects. Nonfocal cortical plasticity can be induced in the motor cortex of healthy subjects with anodal transcranial direct current stimulation. Animal and human research indicates that this long-term-potentiation-like plasticity is glutamate-dependent and that these plasticity shifts can last for several hours. Transcranial direct current stimulation-induced plasticity was monitored by transcranial magnetic stimulation-generated motor evoked potentials. Well-characterized transcranial magnetic stimulation protocols were applied to determine the physiological basis of plasticity changes. Multi-episode schizophrenia patients showed significantly reduced long-term-potentiation-like plasticity compared to recent-onset schizophrenia patients and healthy controls. All schizophrenia patients demonstrated reduced cortical inhibition. Our results indicate that the long-term-potentiation-like plasticity deficit in schizophrenia patients is related to the disease course. Disturbances of N-methyl-d-aspartate, gamma-aminobutyric acid and dopamine receptors may account for this plasticity deficit. LTP-like plasticity deficits might be related to disturbed information processing in schizophrenia patients.
MeSH term(s)	Adult ; Analysis of Variance ; Antipsychotic Agents/therapeutic use ; Case-Control Studies ; Chi-Square Distribution ; Electromyography ; Evoked Potentials, Motor/physiology ; Female ; Humans ; Long-Term Potentiation/physiology ; Male ; Middle Aged ; Motor Cortex/physiopathology ; Reaction Time/physiology ; Schizophrenia, Paranoid/drug therapy ; Schizophrenia, Paranoid/pathology ; Transcranial Magnetic Stimulation/methods
Chemical Substances	Antipsychotic Agents
Language	English
Publishing date	2011-10-10
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	449927-x
ISSN	1872-7549 ; 0166-4328
ISSN (online)	1872-7549
ISSN	0166-4328
DOI	10.1016/j.bbr.2011.05.017
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Article ; Online: Hippocampal integrity and neurocognition in first-episode schizophrenia: a multidimensional study.

Hasan, Alkomiet / Wobrock, Thomas / Falkai, Peter / Schneider-Axmann, Thomas / Guse, Birgit / Backens, Martin / Ecker, Ullrich K H / Heimes, Janina / Galea, Joseph Michael / Gruber, Oliver / Scherk, Harald

The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry

2014 Volume 15, Issue 3, Page(s) 188–199

Abstract: Objectives: Impairments in memory and executive function are key components of schizophrenia. These disturbances have been linked to several subcortical and cortical networks. For example, anatomical and functional changes in the hippocampus have been ... ...

Abstract	Objectives: Impairments in memory and executive function are key components of schizophrenia. These disturbances have been linked to several subcortical and cortical networks. For example, anatomical and functional changes in the hippocampus have been linked to deficits in these cognitive domains. However, the association between hippocampal morphometry, neurochemistry and function is controversial. Therefore, we aimed to investigate the relationship between hippocampal anomalies and their functional relevance. Methods: Fifty-seven first-episode schizophrenia patients (FE-SZ) and 61 healthy control subjects (HC) participated in this study. Hippocampal volumes were investigated using structural magnetic resonance imaging (sMRI) and hippocampal neurochemistry was determined using proton magnetic resonance spectroscopy (1H MRS). Verbal memory was used as a hippocampus-dependent cognitive task whereas working memory and cognitive flexibility assessed frontal lobe function. Results: FE-SZ presented smaller volumes of the left hippocampus, with a significant correlation between left hippocampal volume and verbal memory performance (immediate recall). There was also an inverse correlation between neurochemical ratios (NAA/Cho and Cho/Cr) and verbal memory (delayed recognition). Tests of cognitive flexibility and working memory were not correlated with MRI and 1H MRS values. Compared to HC, FE-SZ demonstrated reduced performance in all of the assessed neurocognitive domains. Conclusions: These results point to a relationship between verbal memory and hippocampal integrity in schizophrenia patients which might be independent from deficits in other memory domains. Disturbed verbal memory functions in FE-SZ might be linked specifically to hippocampal function.
MeSH term(s)	Adult ; Case-Control Studies ; Cognition Disorders/pathology ; Cognition Disorders/psychology ; Executive Function ; Female ; Hippocampus/pathology ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Male ; Memory Disorders/pathology ; Memory Disorders/psychology ; Middle Aged ; Organ Size ; Schizophrenia/diagnosis ; Schizophrenia/pathology ; Schizophrenia, Paranoid/diagnosis ; Schizophrenia, Paranoid/pathology ; Schizophrenia, Paranoid/psychology ; Schizophrenic Psychology ; Young Adult
Language	English
Publishing date	2014-04
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2051402-5
ISSN	1814-1412 ; 1562-2975
ISSN (online)	1814-1412
ISSN	1562-2975
DOI	10.3109/15622975.2011.620002
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Article ; Online: Promoting stigma coping and empowerment in patients with schizophrenia and depression: results of a cluster-RCT.

Gaebel, Wolfgang / Zäske, Harald / Hesse, Klaus / Klingberg, Stefan / Ohmann, Christian / Grebe, Jürgen / Kolbe, Henrike / Icks, Andrea / Schneider, Frank / Backes, Volker / Wolff-Menzler, Claus / Guse, Birgit / Gallinat, Jürgen / Bock, Thomas / Jockers-Scherübl, Maria-Christiane / Krüger, Timo / Jessen, Frank / Bechdolf, Andreas / Kircher, Tilo /

Konrad, Carsten / Falkai, Peter / Schaub, Annette / Rudolph, Matthias / Köllner, Volker / Schmid-Ott, Gerhard / Linden, Michael / Lieberei, Barbara / Stuhlinger, Monika / Sommerfeld, Sebastian / Schumacher, Albrecht / Krenge, Sabine / Gereke, Stephanie / Mönter, Norbert / Navarro-Urena, Alicia / Frosch, Günter / Kuhlbusch, Franz-Josef / Cleveland, Helen / Riesbeck, Mathias

European archives of psychiatry and clinical neuroscience

2019 Volume 270, Issue 5, Page(s) 501–511

Abstract: There is a need for interventions supporting patients with mental health conditions in coping with stigma and discrimination. A psycho-educational group therapy module to promote stigma coping and empowerment (STEM) was developed and tested for efficacy ... ...

Abstract	There is a need for interventions supporting patients with mental health conditions in coping with stigma and discrimination. A psycho-educational group therapy module to promote stigma coping and empowerment (STEM) was developed and tested for efficacy in patients with schizophrenia or depression. 30 clinical centers participated in a cluster-randomized clinical trial, representing a broad spectrum of mental health care settings: in-patient (acute treatment, rehabilitation), out-patient, and day-hospitals. As randomized, patients in the intervention group clusters/centers received an illness-specific eight sessions standard psychoeducational group therapy plus three specific sessions on stigma coping and empowerment ('STEM'). In the control group clusters the same standard psychoeducational group therapy was extended to 11 sessions followed by one booster session in both conditions. In total, N = 462 patients were included in the analysis (N = 117 with schizophrenia spectrum disorders, ICD-10 F2x; N = 345 with depression, ICD-10 F31.3-F31.5, F32-F34, and F43.2). Clinical and stigma-related measures were assessed before and directly after treatment, as well as after 6 weeks, 6 months, and 12 months (M12). Primary outcome was improvement in quality of life (QoL) assessed with the WHO-QOL-BREF between pre-assessment and M12 analyzed by mixed models and adjusted for pre-treatment differences. Overall, QoL and secondary outcome measures (symptoms, functioning, compliance, internalized stigma, self-esteem, empowerment) improved significantly, but there was no significant difference between intervention and control group. The short STEM module has proven its practicability as an add-on in different settings in routine mental health care. The overall increase in empowerment in both, schizophrenia and depression, indicates patients' treatment benefit. However, factors contributing to improvement need to be explored.The study has been registered in the following trial registers. ClinicalTrials.gov: https://register.clinicaltrials.gov/ Registration number: NCT01655368. DRKS: https://www.drks.de/drks_web/ Registration number: DRKS00004217.
MeSH term(s)	Adaptation, Psychological ; Adult ; Depressive Disorder/rehabilitation ; Empowerment ; Female ; Humans ; Male ; Mentally Ill Persons/psychology ; Middle Aged ; Outcome Assessment, Health Care ; Patient Education as Topic ; Psychotherapy, Group ; Quality of Life ; Schizophrenia/rehabilitation ; Self Concept ; Social Stigma
Language	English
Publishing date	2019-09-13
Publishing country	Germany
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	1045583-8
ISSN	1433-8491 ; 0175-758X ; 0940-1334
ISSN (online)	1433-8491
ISSN	0175-758X ; 0940-1334
DOI	10.1007/s00406-019-01064-3
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Article ; Online: The effect of long-term high frequency repetitive transcranial magnetic stimulation on working memory in schizophrenia and healthy controls--a randomized placebo-controlled, double-blind fMRI study.

Guse, Birgit / Falkai, Peter / Gruber, Oliver / Whalley, Heather / Gibson, Lydia / Hasan, Alkomiet / Obst, Katrin / Dechent, Peter / McIntosh, Andrew / Suchan, Boris / Wobrock, Thomas

Behavioural brain research

2013 Volume 237, Page(s) 300–307

Abstract: In schizophrenia patients negative symptoms and cognitive impairment often persist despite treatment with second generation antipsychotics leading to reduced quality of life and psychosocial functioning. One core cognitive deficit is impaired working ... ...

Abstract	In schizophrenia patients negative symptoms and cognitive impairment often persist despite treatment with second generation antipsychotics leading to reduced quality of life and psychosocial functioning. One core cognitive deficit is impaired working memory (WM) suggesting malfunctioning of the dorsolateral prefrontal cortex. High frequency repetitive transcranial magnetic stimulation (rTMS) has been used to transiently facilitate or consolidate neuronal processes. Pilot studies using rTMS have demonstrated improvement of psychopathology in other psychiatric disorders, but a systematic investigation of working memory effects outlasting the stimulation procedure has not been performed so far. The aim of our study was to explore the effect of a 3-week high frequency active or sham 10 Hz rTMS on cognition, specifically on working memory, in schizophrenia patients (n=25) in addition to antipsychotic therapy and in healthy controls (n=22). We used functional magnetic resonance imaging (fMRI) to compare activation patterns during verbal WM (letter 2-back task) before and after 3-weeks treatment with rTMS. Additionally, other cognitive tasks were conducted. 10 Hz rTMS was applied over the left posterior middle frontal gyrus (EEG electrode location F3) with an intensity of 110% of the individual resting motor threshold (RMT) over a total of 15 sessions. Participants recruited the common fronto- parietal and subcortical WM network. Multiple regression analyses revealed no significant activation differences over time in any contrast or sample. According to the ANOVAs for repeated measures performance remained without alterations in all groups. This is the first fMRI study that has systematically investigated this topic within a randomized, placebo-controlled, double-blind design, contrasting the effects in schizophrenia patients and healthy controls.
MeSH term(s)	Adult ; Analysis of Variance ; Brain/blood supply ; Brain Mapping ; Double-Blind Method ; Female ; Humans ; Image Processing, Computer-Assisted ; Magnetic Resonance Imaging ; Male ; Memory Disorders/etiology ; Memory Disorders/therapy ; Memory, Short-Term/physiology ; Middle Aged ; Neuropsychological Tests ; Oxygen/blood ; Psychiatric Status Rating Scales ; Schizophrenia/complications ; Transcranial Magnetic Stimulation/methods ; Treatment Outcome ; Young Adult
Chemical Substances	Oxygen (S88TT14065)
Language	English
Publishing date	2013-01-15
Publishing country	Netherlands
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	449927-x
ISSN	1872-7549 ; 0166-4328
ISSN (online)	1872-7549
ISSN	0166-4328
DOI	10.1016/j.bbr.2012.09.034
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Article ; Online: Cognitive Effects of High-Frequency rTMS in Schizophrenia Patients With Predominant Negative Symptoms: Results From a Multicenter Randomized Sham-Controlled Trial.

Schizophrenia bulletin

2016 Volume 42, Issue 3, Page(s) 608–618

Abstract: Cognitive impairments are one of the main contributors to disability and poor long-term outcome in schizophrenia. Proof-of-concept trials indicate that repetitive transcranial magnetic stimulation (rTMS) applied to the left dorsolateral prefrontal cortex ...

Abstract	Cognitive impairments are one of the main contributors to disability and poor long-term outcome in schizophrenia. Proof-of-concept trials indicate that repetitive transcranial magnetic stimulation (rTMS) applied to the left dorsolateral prefrontal cortex (DLPFC) has the potential to improve cognitive functioning. We analyzed the effects of 10-Hz rTMS to the left DLPFC on cognitive deficits in schizophrenia in a large-scale and multicenter, sham-controlled study. A total of 156 schizophrenia patients with predominant negative symptoms were randomly assigned to a 3-week intervention (10-Hz rTMS, 15 sessions, 1000 stimuli per session) with either active or sham rTMS. The Rey Auditory Verbal Learning Test, Trail Making Test A and B, Wisconsin Card Sorting Test, Digit Span Test, and the Regensburg Word Fluency Test were administered before intervention and at day 21, 45, and 105 follow-up. From the test results, a neuropsychological composite score was computed. Both groups showed no differences in any of the outcome variables before and after intervention. Both groups improved markedly over time, but effect sizes indicate a numeric, but nonsignificant superiority of active rTMS in certain cognitive tests. Active 10-Hz rTMS applied to the left DLPFC for 3 weeks was not superior to sham rTMS in the improvement of various cognitive domains in schizophrenia patients with predominant negative symptoms. This is in contrast to previous preliminary proof-of-concept trials, but highlights the need for more multicenter randomized controlled trials in the field of noninvasive brain stimulation.
MeSH term(s)	Adult ; Cognitive Dysfunction/etiology ; Cognitive Dysfunction/therapy ; Female ; Humans ; Male ; Middle Aged ; Outcome Assessment (Health Care) ; Placebos ; Schizophrenia/complications ; Schizophrenia/therapy ; Transcranial Magnetic Stimulation/methods ; Treatment Outcome
Chemical Substances	Placebos
Language	English
Publishing date	2016-05
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	439173-1
ISSN	1745-1701 ; 0586-7614
ISSN (online)	1745-1701
ISSN	0586-7614
DOI	10.1093/schbul/sbv142
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Article ; Online: Left prefrontal high-frequency repetitive transcranial magnetic stimulation for the treatment of schizophrenia with predominant negative symptoms: a sham-controlled, randomized multicenter trial.

Biological psychiatry

2015 Volume 77, Issue 11, Page(s) 979–988

Abstract: Background: Investigators are urgently searching for options to treat negative symptoms in schizophrenia because these symptoms are disabling and do not respond adequately to antipsychotic or psychosocial treatment. Meta-analyses based on small proof-of- ...

Abstract	Background: Investigators are urgently searching for options to treat negative symptoms in schizophrenia because these symptoms are disabling and do not respond adequately to antipsychotic or psychosocial treatment. Meta-analyses based on small proof-of-principle trials suggest efficacy of repetitive transcranial magnetic stimulation (rTMS) for the treatment of negative symptoms and call for adequately powered multicenter trials. This study evaluated the efficacy of 10-Hz rTMS applied to the left dorsolateral prefrontal cortex for the treatment of predominant negative symptoms in schizophrenia. Methods: A multicenter randomized, sham-controlled, rater-blinded and patient-blinded trial was conducted from 2007-2011. Investigators randomly assigned 175 patients with schizophrenia with predominant negative symptoms and a high-degree of illness severity into two treatment groups. After a 2-week pretreatment phase, 76 patients were treated with 10-Hz rTMS applied 5 days per week for 3 weeks to the left dorsolateral prefrontal cortex (added to the ongoing treatment), and 81 patients were subjected to sham rTMS applied similarly. Results: There was no statistically significant difference in improvement in negative symptoms between the two groups at day 21 (p = .53, effect size = .09) or subsequently through day 105. Also, symptoms of depression and cognitive function showed no differences in change between groups. There was a small, but statistically significant, improvement in positive symptoms in the active rTMS group (p = .047, effect size = .30), limited to day 21. Conclusions: Application of active 10-Hz rTMS to the left dorsolateral prefrontal cortex was well tolerated but was not superior compared with sham rTMS in improving negative symptoms; this is in contrast to findings from three meta-analyses.
MeSH term(s)	Adolescent ; Adult ; Double-Blind Method ; Electroencephalography ; Female ; Functional Laterality/physiology ; Humans ; Longitudinal Studies ; Male ; Middle Aged ; Prefrontal Cortex/physiology ; Psychiatric Status Rating Scales ; Schizophrenia/physiopathology ; Schizophrenia/therapy ; Transcranial Magnetic Stimulation/methods ; Treatment Outcome ; Young Adult
Language	English
Publishing date	2015-06-01
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	209434-4
ISSN	1873-2402 ; 0006-3223
ISSN (online)	1873-2402
ISSN	0006-3223
DOI	10.1016/j.biopsych.2014.10.009
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