10 Hz repetitive transcranial magnetic stimulation (rTMS) may improve cognitive function: An exploratory study of schizophrenia patients with auditory hallucinations

Jiankai Mao; Kaili Fan; Yaoyao Zhang; Na Wen; Xinyu Fang; Xiangming Ye; Yi Chen

doi:10.1016/j.heliyon.2023.e19912

10 Hz repetitive transcranial magnetic stimulation (rTMS) may improve cognitive function: An exploratory study of schizophrenia patients with auditory hallucinations

Heliyon. 2023 Sep 9;9(9):e19912. doi: 10.1016/j.heliyon.2023.e19912. eCollection 2023 Sep.

Authors

Jiankai Mao¹, Kaili Fan², Yaoyao Zhang³, Na Wen³, Xinyu Fang⁴, Xiangming Ye⁵, Yi Chen³

Affiliations

¹ Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, PR China.
² Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, PR China.
³ The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, Zhejiang, PR China.
⁴ The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, PR China.
⁵ Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, PR China.

Abstract

Objectives: Cognitive impairment in schizophrenia patients with auditory hallucinations is more prominent compared to those without. Our study aimed to investigate the cognitive improvement effects of 10 Hz repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) in schizophrenia with auditory hallucinations.

Methods: A total of 60 schizophrenic patients with auditory hallucinations in this study were randomly assigned to sham or active group. Both groups received 10 Hz or sham rTMS targeted in left DLPFC for 20 sessions. The Positive and Negative Syndrome Scale (PANSS), the Auditory Hallucination Rating Scale (AHRS), the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and the Udvalg for Kliniske Under-sogelser (UKU) side effect scale were used to measure psychiatric symptoms, auditory hallucinations, cognition, and side reaction, respectively.

Results: Our results indicated that the active group experienced greater improvements in RBANS-total score (P = 0.043) and immediate memory subscale score (P = 0.001). Additionally, the PANSS-total score, negative and positive subscale score were obviously lower in the active group compared to the sham group (all P < 0.050). Furthermore, our study found that the improvement of RBANS-total score was positively associated with the decline of positive factor score, and the improvement of language score in RBANS was positively associated with the reduction in PANSS-total scale, negative and positive subscale score in the real stimulation group (all P < 0.050).

Conclusion: Our results demonstrated that a four-week intervention of 10 Hz rTMS over the left DLPFC can improve cognition (particularly immediate memory) among schizophrenia patients with auditory hallucinations. Future studies with larger sample size are needful to verify our preliminary findings.

Keywords: Auditory hallucinations; Cognitive function; Immediate memory; Repetitive transcranial magnetic stimulation; Schizophrenia.