Efficacy And Safety Evaluation Of Auxiliary High-frequency Repetitivetranscranial Magnetic Stimulation On Negative Symptoms And Social Functions Of Schizophrenia

Objective:1.To examine the efficacy and feasibility of auxiliary high-frequency repetitivetranscranial magnetic stimulation treatment on schizophrenia patients with negative symptoms and social functions,thus providing a theoretical basis for novel non-drug treatment with less side effects.2.Act as pilot study to provide clinical insight in selecting optimal parameters such as minimum duration of treatment/ course of treatment of repeated transcranial magnetic stimulation to improve the negative symptoms of schizophrenia patients.3.To preliminarily investigate the efficacy of High-frequency Repetitive Transcranial Magnetic Stimulation onpositive Symptoms of Schizophrenia Patients.Method:73 subjects with schizophrenia were selected based on International Classification of Diseases(ICD-10).All the subjects scored more than 30 points onnegative symptom dimension ofthe positive and negative symptom scale.Subjects were randomly divided into experimental group(n = 37)and control group(n = 36).The experimental group was treated with “true stimulus”,and the control group with “pseudo stimulus” while keeping original medication unchanged in both groups.Both true stimulus and pseudo stimulus stimulate the lateral cortex of the left prefrontal cortex with 10 HZ frequency,110% Motor threshold intensity,20 strings each time,50 times in one sequence and 30 s interval.All subjects received treatments 5 days in a week and last for 3 weeks.Pseudo-stimulation treatment flips the coil 90 °(the sound produced is the same as in the true stimulus except for a ~ 80% reduction in stimulus intensity).The positive and negative symptom scales(PANSS),the brief negative symptoms scale(BNSS),the personal and social functional scales(PSP)were evaluated before treatment(baseline),after 3 weeks of treatment and at the 11 weeks respectively.Adverse reactions were assessed using the TESS scale at 3rd and 11 th weeks of treatment.Result:1.There was significant difference in BNSS total score and PANSS negative factor score in experimental group between baseline and the end of observation(P <0.05).However,there was no significant difference in PANSS positive score,PANSS general psychopathology score,total score of individual and social function scale(P> 0.05).In control group,PANSS positive score showed significant difference between baseline and the end of observation(P <0.05).2.At 3rd week in the experimental group,PANSS negative factor score and BNSS total score decreased significantly when compared with the baseline(P<0.05).There is persistent difference in PANSS negative factor score,BNSS total score Points between 3rd week and 11 th week(P <0.001).3.In the control group,after Pseudo Stimulation,PANSS positive scores were statistically significant at the 3rd week(P=0.029)and 11 th week(P =0.020)compared with baseline,respectively.But from the 3rd week to 11 th week(after the cessation of the pseudo-stimulus),the downward trend slowed down significantly.There is no statistical difference in PANSS positive factor scores(P=1.000)between 3rd weeks and 11 th weeks(after stopping the pseudo-stimulation). 4.There was no significant difference in the incidence of adverse reactions between the two groups(P> 0.05).The adverse reactions were mild and relieved spontaneously.Conclusion:1.High-frequencyrepetitive transcranial magnetic stimulation adjuvant therapy for patients with schizophrenia showed improvements in negative symptoms at3 rd weeks of treatment and sustained at 11 th week.2.High-frequency repetitivetranscranial magnetic stimulation adjuvant treatment did not show improvements in social functions on schizophrenia patients with negative symptoms.3.High-frequency repetitivetranscranial magnetic stimulation only cause minor adverse reactions with self-remission,no severe side effects were found in all groups,therefore it is safe and effective treatment.