MedWire News: Repetitive transcranial magnetic stimulation (rTMS) does not alleviate negative symptoms in patients with schizophrenia, but it does improve cognitive function, research shows.
Andrew Mogg and colleagues from the Institute of Psychiatry in London, UK, randomly assigned 17 right-handed schizophrenia patients with prominent negative symptoms to receive a 10-day course of real or sham rTMS applied to the left dorsolateral prefrontal cortex (DLPFC).
The participants had Positive and Negative Syndrome Scale (PANSS) negative subscores of at least 20, and were taking antipsychotic medication.
rTMS was administered at 110% of motor threshold, at a frequency of 10 Hz in 10 s trains, with a 50 s inter-train interval. Twenty trains of treatment were given each day.
The primary outcome was a change in PANSS negative symptom score. Secondary outcomes included mood, cognitive function, and side-effects.
The two groups were similar with regard to the primary outcome at the end of treatment and 2 weeks afterward.
None of the participants met the criterion for treatment response, defined as a 20% reduction in baseline PANSS negative symptom score.
Nevertheless, 2 weeks after the end of treatment, patients who received real rTMS performed better on tests for delayed recall, scoring 2.6 points higher than the sham group on a test of verbal learning.
The real rTMS group also performed slightly better on the Stroop test than patients receiving sham rTMS, indicating that rTMS had benefited their executive function.
rTMS was well tolerated and no adverse effects were reported.
Mogg et al conclude in the journal Schizophrenia Research: “The present study found no significant difference between 2 weeks of real or sham rTMS to activate the left DLPFC in treating negative symptoms of schizophrenia either after the treatment course or 2 weeks later.”
They add: “Interestingly, the neuropsychological test results suggest that rTMS had a beneficial effect on cognitive function, notably delayed recall and possibly also executive function as shown by a trend for improvement as measured by the Stroop test.”
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