| Objective:Assess the efficacy and safety of the repeated transcranial magnetic stimulation(rTMS)with theta burst stimulation(TBS)paradigm in the treatment of negative symptoms and social function of chronic schizophrenia.Methods: This is a randomized,sham-controlled,double-blinded trial.Sixty patients with chronic schizophrenia on stable antipsychotic treatment were randomly assigned to a active rTMS treatment group(n=30)or a sham rTMS treatment group(n=30).Each patient in a active rTMS treatment group received 20 rTMS sessions over 4 weeks(5 days per week)that delivered theta burst stimulation(TBS)to the left dorsolateral prefrontal cortex(DLPFC).30 patients were subjected to sham rTMS treatment.During the study period,the two groups maintained the original antipsychotic type and dose unchanged.Efficacy of negative symptom was evaluated blindly with the Positive and Negative Syndrome Scale(PANSS)at baseline,the end of 2 weeks and 4 weeks.The social functioning was assessed with ADL,Personal and Social Performance Scale and the Schizophrenia Quality of Life Scale at baseline,the end of 2 weeks and 4 weeks.The side effects were evaluated with TESS at baseline and the end of 2 weeks and 4 weeks.Results: A total of 60 chronic schizophrenia patients were collected and six patients were dropped out in this study.The demographic data,course of the disease,the roportion of men and women,antipsychotic drug olanzapine dose equivalent,PANSS,ADL,PSP and SQLS score did not differ between the active and sham rTMS groups at baseline(P>0.05).1.At the end of the 2 weeks: There were statistically significant differences between the active and sham rTMS groups in the PANSS-total score and PANSS-negative score(P < 0.05).However,There was no statistically significant difference between the two groups in the PANSS-positive score,ADL testing score,PSP scale score and SQLS score(P<0.05).2.At the end of the 4 weeks: There were statistically significant differences between the two groups in the PANSS-total score,PANSS-negative score,ADL testing score,PSP scale score and SQLS score(P<0.05).There was no statistically significant difference between the active and sham rTMS groups in the PANSS-positive score(P >0.05).3.Repeated measures ANOVA revealed that there were no statistically significant difference in the PANSS-positive score at baseline,the end of 2 weeks and At the end of the 4 weeks in two way pairwise comparison(P > 0.05).There is no interaction between time and group(P > 0.05).There was no statistically significant difference between the two groups(P>0.05).There were statistically significant difference in PANSS-total score,PANSS-negative score,ADL testing score,PSP scale score and SQLS score two way pairwise comparison at each vist point(P < 0.05),a significant interaction between measuring time and group(P < 0.05).There was notable difference between the two groups(P<0.05).4.PANSS-negative reduction was positively correlated with ADL subtraction and SQLS reduction,and was negatively correlated with the PSP scale score subtraction.Conclusion: The TBS protocol for rTMS can reduce the severity of negative symptoms of schizophrenic patients significantly with high safety.The rTMS with TBS paradigm can improve the social function of schizophrenia and is related to the improvement of negative symptoms. |
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