The Application Of Transcranial Magnetic Stimulation (TMS) In Schizophrenia Reasearch And Therapy

Transcranial magnetic stimulation(TMS),a non-invasive means of electrically stimulating neurons in the human cerebral cortex,is able to modify neuronal activity locally and at distant sites when delivered in series or trains of pulses.As a non-invasive method,TMS was increasingly being used in neurophychiatric research and clinical psychiatry in the 20 years.TMS was mainly used in depression therapy in earlier period,while in schizophrenia research and therapy was in the initial stage.As a severity and highly mutilation mind desease,the etiological factors of schizophrenia is not know,and the presently treatment methods were not satisfactorily.In this investigation,we focus on TMS as a neurophysiological tool in schizophrenia research and as a therapeutic resource for the treatment of schizephrenia.一,The research on cortical excitability in schizophrenic patientsObjective:To investigate the difference of motor threshold(MT) between the schizophrenic patients and normal volunteers,and analyze the changement of cortical excitability in patients.Method:48 right-handed patients with schizophrenia and 48 right-handed healthy control subjects were used singnal-pulse Transcranial Magnetic Stimulation(sTMS) to detect the MT.Results:MT in left(47.01±9.14) was higher than right(44.59±10.54) in patients,and reverse in normal controls(t₁=2.11,P₁=0.04; t₂=3.18,P₂=0.00);Compared with the controls,the left MT in schizophrenia was increased significantly(t=2.36,P =0.02),but no difference in right MT(t= 0.10,P =0.92);The different sex had no difference in MT(P>0.05);There was no correlation between the MT in schizophrenia and other agents such as age,the course of disease etc(P＞0.05).Conclusion:The interhemispheric asymmetries of brain motor cortical excitability in patients with schizophrenia disorder was opposite to the controls,and the left cortical excitability in patients had a evident decrease relative to normal subjects.二,The effect of repetitive transcranial magnetic stimulation on serum prolactin levels and event related potential P₃₀₀ in male patients with schizophreniaObjective To explore the effects of repetitive transcranial magnetic stimulation(rTMS) on serum prolactin and the event-related potential P30o in male patients with schizophrenia.Method Forty-three male patients with schizophrenia were randomly assigned to active rapid rTMS group(21 cases) and sham rTMS group(22 cases).All the patients were examined with serum prolactin,P3oo,the Positive and Negative Syndrom Scale(PANSS) and 17-item Hamilton Depression Rating Scale(HAMD₁₇) before and after 5 daily rTMS(20 5-sec trains of 10 Hz stimulation with 35-sec intervals;delivered at 100%motor threshold with the figure-of-eight coil positioned over the left dorsolateral prefrontal cortex) Results The baseline serum prolactin in patients was not significantly different from controls(P＞0.05),but significantly increased after rTMS(P＜0.01).The amplitude of waves P₂,P₃ was heightened after rTMS(P＜0.01),while there was no significant different from controls(P＞0.05).The PANSS scores were not significantly different after rTMS between both groups (P＞0.05),while the HAMD₁₇ scores was only decreased in active rTMS group (P＜0.05).Conclusion The results indicate that rapid rTMS is effective in treatment of cognitive impairment and depression in male patients with schizophrenia,but it also can increase the serum prolactin levels.