Low-frequency repetitive transcranial magnetic stimulation over the right orbitofrontal cortex for patients with first-episode schizophrenia: A randomized, double-blind, sham-controlled trial

Qiang Hu; Xiong Jiao; Jie Zhou; Yingying Tang; Tianhong Zhang; Chuanfu Song; Junjie Wang; Qiang Xiao; Junying Ye; Junfeng Sun; Xijin Wang; Chunbo Li; Jijun Wang

doi:10.1016/j.psychres.2023.115600

Low-frequency repetitive transcranial magnetic stimulation over the right orbitofrontal cortex for patients with first-episode schizophrenia: A randomized, double-blind, sham-controlled trial

Psychiatry Res. 2023 Dec:330:115600. doi: 10.1016/j.psychres.2023.115600. Epub 2023 Nov 10.

Authors

Qiang Hu¹, Xiong Jiao², Jie Zhou², Yingying Tang³, Tianhong Zhang³, Chuanfu Song⁴, Junjie Wang⁵, Qiang Xiao⁶, Junying Ye⁶, Junfeng Sun⁷, Xijin Wang⁸, Chunbo Li⁹, Jijun Wang¹⁰

Affiliations

¹ Department of Psychiatry, Zhenjiang Mental Health Center, Jiangsu 212000, China.
² Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; Shanghai Med-X Engineering Research Center, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China.
³ Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
⁴ Department of Psychiatry, The Fourth People's Hospital of Wuhu, Anhui 231200, China.
⁵ Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou 215131, China.
⁶ The First Psychiatric Hospital of Harbin, Harbin 150000, China.
⁷ Shanghai Med-X Engineering Research Center, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China.
⁸ The First Psychiatric Hospital of Harbin, Harbin 150000, China. Electronic address: higginsw@163.com.
⁹ Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai 200031, China; Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China; Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China. Electronic address: licb@smhc.org.cn.
¹⁰ Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai 200031, China; Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China. Electronic address: jijunwang27@163.com.

PMID: 37992513
DOI: 10.1016/j.psychres.2023.115600

Abstract

Repetitive transcranial magnetic stimulation (rTMS) has been used in the treatment of patients with schizophrenia. The conventional targets of rTMS treatment are the dorsolateral prefrontal cortex (DLPFC) and temporoparietal cortex (TPC). However, the efficacy of these two treatment strategies was quite heterogeneous. Structural and functional abnormalities of the orbitofrontal cortex (OFC) in schizophrenia are closely related to negative symptoms. We sought to determine whether 1 Hz rTMS over the right OFC is effective in treating patients with first-episode schizophrenia. In this study, eighty-nine patients with drug-naïve, first-episode schizophrenia were randomly divided into the rTMS (n = 47) or sham stimulation (n = 42) groups, with both groups receiving twenty sessions of 1 Hz rTMS treatment. The PANSS was assessed at baseline, day 10, and day 20, and MATRICS Consensus Cognitive Battery (MCCB) was implemented to assess the cognitive impairment at baseline and day 20. Results showed that patients in the active rTMS group had more improvement in clinical symptoms and cognitive deficits than patients in sham group at day 20. In conclusion, 1 Hz rTMS over OFC can improve psychotic symptoms and cognitive functions in schizophrenic patients. Our study provides a new alternative for the treatment of negative symptoms and cognitive deficits in schizophrenia.

Keywords: First-episode schizophrenia; Low-frequency; Orbitofrontal cortex; Randomized controlled trial; Repetitive transcranial magnetic stimulation.

Publication types

Randomized Controlled Trial

MeSH terms

Cognitive Dysfunction*
Double-Blind Method
Humans
Prefrontal Cortex
Schizophrenia* / diagnosis
Transcranial Magnetic Stimulation / methods
Treatment Outcome