High-frequency repetitive transcranial magnetic stimulation in schizophrenia: a combined treatment and neuroimaging study.
BACKGROUND
Repetitive transcranial magnetic stimulation (rTMS) of frontal brain regions is under study as a non-invasive method in the treatment of affective disorders. Recent publications provide increasing evidence that rTMS may be useful in treating schizophrenia. Results are most intriguing, demonstrating a reduction of negative symptoms following high-frequency rTMS. In this context, disentangling of negative and depressive symptoms is of the utmost importance when understanding specific rTMS effects on schizophrenic symptoms.


METHODS
Using a sham-controlled parallel design, 20 patients with schizophrenia were included in the study. Patients were treated with high-frequency 10 Hz rTMS over 10 days. Besides clinical ratings, ECD-SPECT (technetium-99 bicisate single photon emission computed tomography) imaging was performed before and after termination of rTMS treatment.


RESULTS
High-frequency rTMS leads to a significant reduction of negative symptoms combined with a trend for non-significant improvement of depressive symptoms in the active stimulated group as compared with the sham stimulated group. Additionally, a trend for worsening of positive symptoms was observed in the actively treated schizophrenic patients. In both groups no changes in regional cerebral blood flow could be detected by ECD-SPECT.


CONCLUSIONS
Beneficial effects of high-frequency rTMS on negative and depressive symptoms were found, together with a trend for worsening positive symptoms in schizophrenic patients.
Hajak
G
G
Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany. goeran.hajak@medbo.de
Marienhagen
J
J
Langguth
B
B
Werner
S
S
Binder
H
H
Eichhammer
P
P
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D010054:Brief Psychiatric Rating Scale; D003131:Combined Modality Therapy; D003863:Depression / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D005260:Female; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D012039:Regional Blood Flow / Q000502:physiology; D012559:Schizophrenia / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D012565:Schizophrenic Psychology; D015899:Tomography, Emission-Computed, Single-Photon; D050781:Transcranial Magnetic Stimulation / Q000627:therapeutic use*; D016896:Treatment Outcome
D014150:Antipsychotic Agents