title: The efficacy of cerebellar vermal deep high frequency (theta range) repetitive transcranial magnetic stimulation (rTMS) in schizophrenia: A randomized rater blind-sham controlled study.
abstract: Repetitive transcranial magnetic stimulation (rTMS) is a promising therapeutic for schizophrenia. Treatment effects of rTMS have been variable across different symptom clusters, with negative symptoms showing better response, followed by auditory hallucinations. Cerebellum, especially vermis and its abnormalities (both structural and functional) have been implicated in cognitive, affective and positive symptoms of schizophrenia. rTMS to this alternate site has been suggested as a novel target for treating patients with this disorder. Hypothesizing cerebellar vermal magnetic stimulation as an adjunct to treat schizophrenia psychopathology, we conducted a double blind randomized sham controlled rTMS study. In this study, forty patients were randomly allocated (using block randomization method) to active high frequency (theta patterned) rTMS (n=20) and sham (n=20) groups. They received 10 sessions over 2 weeks. The Positive and Negative Syndrome Scale (PANSS) and Calgary Depression Scale for Schizophrenia (CDSS) scores were assessed at baseline, after last session and at 4 weeks (2 weeks post-rTMS). We found a significantly greater improvement in the group receiving active rTMS sessions, compared to the sham group on negative symptoms, and depressive symptoms. We conclude that cerebellar stimulation can be used as an effective adjunct to treat negative and affective symptoms.
authors.affiliation: Department of Psychiatry, Shri Guru Ram Rai Institute of Medical & Health Sciences, Dehradun, Uttarakhand, India.
authors.forename: Shobit
authors.initials: S
authors.lastname: Garg
authors.affiliation: KS Mani Center for Cognitive Neurosciences and Department of Psychiatry, Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand 834006, India.
authors.forename: Vinod Kumar
authors.initials: VK
authors.lastname: Sinha
authors.affiliation: KS Mani Center for Cognitive Neurosciences and Department of Psychiatry, Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand 834006, India. Electronic address: cricsai@gmail.com.
authors.forename: Sai Krishna
authors.initials: SK
authors.lastname: Tikka
authors.affiliation: Department of Psychiatry, Shri Guru Ram Rai Institute of Medical & Health Sciences, Dehradun, Uttarakhand, India.
authors.forename: Preeti
authors.initials: P
authors.lastname: Mishra
authors.affiliation: KS Mani Center for Cognitive Neurosciences and Department of Psychiatry, Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand 834006, India.
authors.forename: Nishant
authors.initials: N
authors.lastname: Goyal
mesh_terms: D000328:Adult; D065814:Cerebellar Vermis / Q000503:physiopathology; D046690:Deep Brain Stimulation / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D006212:Hallucinations / Q000523:psychology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000503:physiopathology / Q000628:therapy*; D012565:Schizophrenic Psychology; D013826:Theta Rhythm / Q000502:physiology; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome
keywords: Cerebellum; Schizophrenia; Transcranial magnetic stimulation