title: Repetitive transcranial magnetic stimulation (rTMS) improves facial affect recognition in schizophrenia.
abstract: OBJECTIVE
  Facial affect recognition, a basic building block of social cognition, is often impaired in schizophrenia. Poor facial affect recognition is closely related to poor functional outcome; however, neither social cognitive impairments nor functional outcome are sufficiently improved by antipsychotic drug treatment alone. Adjunctive repetitive transcranial magnetic stimulation (rTMS) has been shown to enhance cognitive functioning in both healthy individuals and in people with neuropsychiatric disorders and to ameliorate clinical symptoms in psychiatric disorders, but its effects on social cognitive impairments in schizophrenia have not yet been studied. Therefore, we evaluated the effects of sham-controlled rTMS on facial affect recognition in patients with chronic schizophrenia.
  
  
  METHODS
  Inpatients (N = 36) on stable antipsychotic treatment were randomly assigned to double-blind high-frequency (10 Hz) rTMS or sham stimulation for a total of ten sessions over two weeks. In the verum group, each session consisted of 10 000 stimuli (20 trains of 5 s) applied over the left dorsolateral prefrontal cortex at 110% of motor threshold. Facial affect recognition was assessed before (T0) and after (T1) the ten sessions.
  
  
  RESULTS
  Facial affect recognition improved significantly more after rTMS (accuracy change: mean = 8.9%, SD = 6.0%) than after sham stimulation (mean = 1.6%, SD = 3.5; Cohen's d = 1.45). There was no correlation with clinical improvement.
  
  
  CONCLUSIONS
  Our results indicate that prefrontal 10 Hz rTMS stimulation may help to ameliorate impaired facial affect recognition in schizophrenia.
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University Düsseldorf, Bergische Landstrasse 2, 40629 Düsseldorf, Germany. Electronic address: woelwer@uni-duesseldorf.de.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Wölwer
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University Düsseldorf, Bergische Landstrasse 2, 40629 Düsseldorf, Germany.
authors.forename: Agnes
authors.initials: A
authors.lastname: Lowe
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University Düsseldorf, Bergische Landstrasse 2, 40629 Düsseldorf, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Brinkmeyer
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University Düsseldorf, Bergische Landstrasse 2, 40629 Düsseldorf, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Streit
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University Düsseldorf, Bergische Landstrasse 2, 40629 Düsseldorf, Germany.
authors.forename: Mareke
authors.initials: M
authors.lastname: Habakuck
authors.affiliation: Department of Psychiatry, Psychotherapy and Preventive Medicine, Ruhr-University Bochum, Alexandrinenstr. 1-3, 44791 Bochum, Germany.
authors.forename: Marcus W
authors.initials: MW
authors.lastname: Agelink
authors.affiliation: Department of Psychiatry and Psychotherapy, Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131 Mainz, Germany.
authors.forename: Arian
authors.initials: A
authors.lastname: Mobascher
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University Düsseldorf, Bergische Landstrasse 2, 40629 Düsseldorf, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Gaebel
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University Düsseldorf, Bergische Landstrasse 2, 40629 Düsseldorf, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Cordes
mesh_terms: D000328:Adult; D000339:Affect; D003071:Cognition; D003072:Cognition Disorders / Q000150:complications / Q000523:psychology / Q000628:therapy*; D004311:Double-Blind Method; D005149:Facial Expression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017397:Prefrontal Cortex / Q000502:physiology; D012559:Schizophrenia / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D012565:Schizophrenic Psychology; D050781:Transcranial Magnetic Stimulation; D055815:Young Adult
keywords: Facial affect recognition; Repetitive transcranial magnetic stimulation (rTMS); Schizophrenia