顶叶 iTBS 对精神分裂症患者额叶网络内静息态有效连接的影响：一项 fMRI 研究

IF 3.4 2区医学 Q2 NEUROIMAGING

Neuroimage-Clinical Pub Date : 2024-11-26 DOI:10.1016/j.nicl.2024.103715

Li Li , Lina Wang , Han Wu , Bing Li , Weigang Pan , Wenqing Jin , Wen Wang , Yanping Ren , Chaomeng Liu , Xin Ma

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引用次数: 0

摘要

背景虽然间歇θ脉冲刺激（iTBS）在解决精神分裂症（SZ）患者的工作记忆（WM）缺陷方面显示出了有效性，但目前的证据有限，其中涉及的具体机制仍不清楚。因此，这项试验性fMRI研究旨在检验顶叶iTBS在改善SZ患者WM障碍方面的疗效，并探讨其对前顶叶网络内静息态有效连接的影响。方法：将48名确诊为SZ的患者随机分配到主动或假性iTBS组，并在4周内接受20次主动或假性iTBS治疗。随后，所有患者都接受了认知测试、临床症状评估和静息态功能磁共振成像（rs-fMRI）扫描。采用频谱动态因果建模方法分析了rs-fMRI扫描期间额叶和顶叶脑区之间的有效连接。结果iTBS治疗改善了患者的阳性症状、阴性症状、一般精神病理学和WM缺陷。接受 iTBS 干预后，与治疗前水平相比，积极组从右侧 MFG 到右侧 SPL（p = 0.031）和从左侧 SPL 到左侧 MFG（p = 0.010）的连接强度显著增加。结论所有这些研究结果表明，以顶叶区为靶点的iTBS可能会影响额顶网络内的静息态有效连接，从而为缓解SZ的认知缺陷提供有前景的治疗意义。

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Effects of parietal iTBS on resting-state effective connectivity within the frontoparietal network in patients with schizophrenia: An fMRI study

Background

Although intermittent theta burst stimulation (iTBS) has shown effectiveness in addressing working memory (WM) deficits in individuals with schizophrenia (SZ), the current body of evidence is limited and the specific mechanisms involved remain unclear. Therefore, this pilot fMRI study aimed to examine the efficacy of parietal iTBS in ameliorating WM impairments and explore its influence on the resting-state effective connectivity within the frontoparietal network in patients with SZ.

Method

A total of 48 patients diagnosed with SZ were randomly assigned to an active or sham iTBS group and underwent 20 sessions of active or sham iTBS over 4 weeks. Subsequently, all patients underwent cognitive tests, clinical symptom assessments, and resting-state functional MRI (rs-fMRI) scans. The effective connectivity between the frontal and parietal brain regions during the rs-fMRI scans was analyzed using a spectral dynamic causal modeling approach. Additionally, this trial was registered at the Chinese Clinical Trial Registry in November 2022 (registry number: ChiCTR2200057286).

Results

iTBS treatment improved the positive symptoms, negative symptoms, general psychopathology, and WM deficits. Following the iTBS intervention, the active group demonstrated a significant increase in connectivity strengths from the right MFG to the right SPL (p = 0.031) and from the left SPL to the left MFG (p = 0.010) compared to the pre-treatment levels. Additionally, compared to the sham group, the active group displayed a significantly higher connectivity strength from the right MFG to the right SPL (p = 0.042) after iTBS treatment.

Conclusion

All these findings suggest that iTBS targeting the parietal region may influence the resting-state effective connectivity within the frontoparietal network, thereby offering promising therapeutic implications for alleviating the cognitive deficits in SZ.

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来源期刊

Neuroimage-Clinical NEUROIMAGING-

CiteScore

7.50

自引率

4.80%

发文量

368

审稿时长

52 days

期刊介绍： NeuroImage: Clinical, a journal of diseases, disorders and syndromes involving the Nervous System, provides a vehicle for communicating important advances in the study of abnormal structure-function relationships of the human nervous system based on imaging. The focus of NeuroImage: Clinical is on defining changes to the brain associated with primary neurologic and psychiatric diseases and disorders of the nervous system as well as behavioral syndromes and developmental conditions. The main criterion for judging papers is the extent of scientific advancement in the understanding of the pathophysiologic mechanisms of diseases and disorders, in identification of functional models that link clinical signs and symptoms with brain function and in the creation of image based tools applicable to a broad range of clinical needs including diagnosis, monitoring and tracking of illness, predicting therapeutic response and development of new treatments. Papers dealing with structure and function in animal models will also be considered if they reveal mechanisms that can be readily translated to human conditions.