加速iTBS与个性化靶向方法治疗精神分裂症阴性症状：一项随机对照试验

IF 7.6 1区医学 Q1 CLINICAL NEUROLOGY

Brain Stimulation Pub Date : 2025-03-19 DOI:10.1016/j.brs.2025.03.014

Yunyi Han , Fang Jin , Jimmy Lee , Wenpeng Hou , Xue Yang , Yiming Zhang , Yueying Zhang , Xuefeng Lu , Zhimin Wang , Qijing Bo , Zhengyi Yang , Fuchun Zhou , Tianzi Jiang , Chuanyue Wang

{"title":"加速iTBS与个性化靶向方法治疗精神分裂症阴性症状：一项随机对照试验","authors":"Yunyi Han , Fang Jin , Jimmy Lee , Wenpeng Hou , Xue Yang , Yiming Zhang , Yueying Zhang , Xuefeng Lu , Zhimin Wang , Qijing Bo , Zhengyi Yang , Fuchun Zhou , Tianzi Jiang , Chuanyue Wang","doi":"10.1016/j.brs.2025.03.014","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>The efficacy of non-invasive brain stimulation in ameliorating schizophrenia's negative symptoms remains to be validated. The mesocortical pathway, mostly comprising the ventral tegmental area (VTA) and prefrontal cortex, is the core neural circuit underlying negative symptoms. This study aimed to assess the clinical and biological effects of accelerated intermittent theta burst stimulation (iTBS) targeted to the dorsolateral prefrontal cortex (dlPFC), guided by personalised dlPFC-VTA functional connectivity (FC).</div></div><div><h3>Methods</h3><div>Eighty schizophrenia patients with predominant negative symptoms received 40 sessions of either active (n = 40) or sham (n = 40) accelerated iTBS (1800 pulses) in two weeks, targeting the region of the left dlPFC most functionally correlated with the VTA. Clinical and cognitive follow-ups occurred at week 4, 8, and 12. The primary outcome was the alteration in PANSS negative symptom (PANSS-NS) scores at week 4, while secondary outcomes included additional clinical, cognitive assessments and neuroimaging alterations.</div></div><div><h3>Results</h3><div>At week 4, the active group showed a significant reduction in PANSS-NS compared to the sham group, with a significant group × time interaction effect (P < 0.001, mean difference = 4.10, Cohen's d = 0.83). At week 2, compared to the sham group, the active group exhibited reduced left temporal middle gyrus (TMG) (r = −0.29, p = 0.01) activation and FC between the VTA and left TMG (r = −0.34, p = 0.003), and both were negatively correlated with PANSS-NS changes in both groups.</div></div><div><h3>Conclusion</h3><div>Accelerated iTBS targeting the personalised region determined by dlPFC-VTA FC is an effective intervention to alleviate negative symptoms of schizophrenia.</div></div>","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":"18 3","pages":"Pages 710-719"},"PeriodicalIF":7.6000,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Accelerated iTBS with a personalised targeting method to treat negative symptoms of schizophrenia: A randomized controlled trial\",\"authors\":\"Yunyi Han , Fang Jin , Jimmy Lee , Wenpeng Hou , Xue Yang , Yiming Zhang , Yueying Zhang , Xuefeng Lu , Zhimin Wang , Qijing Bo , Zhengyi Yang , Fuchun Zhou , Tianzi Jiang , Chuanyue Wang\",\"doi\":\"10.1016/j.brs.2025.03.014\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>The efficacy of non-invasive brain stimulation in ameliorating schizophrenia's negative symptoms remains to be validated. The mesocortical pathway, mostly comprising the ventral tegmental area (VTA) and prefrontal cortex, is the core neural circuit underlying negative symptoms. This study aimed to assess the clinical and biological effects of accelerated intermittent theta burst stimulation (iTBS) targeted to the dorsolateral prefrontal cortex (dlPFC), guided by personalised dlPFC-VTA functional connectivity (FC).</div></div><div><h3>Methods</h3><div>Eighty schizophrenia patients with predominant negative symptoms received 40 sessions of either active (n = 40) or sham (n = 40) accelerated iTBS (1800 pulses) in two weeks, targeting the region of the left dlPFC most functionally correlated with the VTA. Clinical and cognitive follow-ups occurred at week 4, 8, and 12. The primary outcome was the alteration in PANSS negative symptom (PANSS-NS) scores at week 4, while secondary outcomes included additional clinical, cognitive assessments and neuroimaging alterations.</div></div><div><h3>Results</h3><div>At week 4, the active group showed a significant reduction in PANSS-NS compared to the sham group, with a significant group × time interaction effect (P < 0.001, mean difference = 4.10, Cohen's d = 0.83). At week 2, compared to the sham group, the active group exhibited reduced left temporal middle gyrus (TMG) (r = −0.29, p = 0.01) activation and FC between the VTA and left TMG (r = −0.34, p = 0.003), and both were negatively correlated with PANSS-NS changes in both groups.</div></div><div><h3>Conclusion</h3><div>Accelerated iTBS targeting the personalised region determined by dlPFC-VTA FC is an effective intervention to alleviate negative symptoms of schizophrenia.</div></div>\",\"PeriodicalId\":9206,\"journal\":{\"name\":\"Brain Stimulation\",\"volume\":\"18 3\",\"pages\":\"Pages 710-719\"},\"PeriodicalIF\":7.6000,\"publicationDate\":\"2025-03-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Brain Stimulation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1935861X25000671\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Brain Stimulation","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1935861X25000671","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

摘要

背景：非侵入性脑刺激在改善精神分裂症阴性症状方面的疗效有待验证。中皮层通路主要由腹侧被盖区（VTA）和前额叶皮层组成，是阴性症状背后的核心神经回路。本研究旨在评估在个性化dlPFC- vta功能连接（FC）指导下，针对背外侧前额叶皮质（dlPFC）的加速间歇性θ波爆发刺激（iTBS）的临床和生物学效应。方法：80例主要阴性症状的精神分裂症患者在两周内接受了40次主动（n = 40）或假（n = 40）加速iTBS（1800脉冲），目标是与VTA功能最相关的左侧dlPFC区域。在第4、8和12周进行临床和认知随访。主要结局是第4周时PANSS阴性症状（PANSS- ns）评分的改变，而次要结局包括额外的临床、认知评估和神经影像学改变。结果：第4周，与假手术组相比，治疗组PANSS-NS明显降低，组间存在显著的组×时间交互效应（P < 0.001，平均差值= 4.10,Cohen’s d = 0.83）。第2周，与假手术组相比，活动组左颞中回（TMG）激活减少（r = -0.29, p = 0.01）， VTA与左颞中回之间的FC减少（r = -0.34, p = 0.003），两者均与PANSS-NS变化呈负相关。结论：针对dlPFC-VTA FC确定的个体化区域的加速iTBS是缓解精神分裂症阴性症状的有效干预措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Accelerated iTBS with a personalised targeting method to treat negative symptoms of schizophrenia: A randomized controlled trial

Background

The efficacy of non-invasive brain stimulation in ameliorating schizophrenia's negative symptoms remains to be validated. The mesocortical pathway, mostly comprising the ventral tegmental area (VTA) and prefrontal cortex, is the core neural circuit underlying negative symptoms. This study aimed to assess the clinical and biological effects of accelerated intermittent theta burst stimulation (iTBS) targeted to the dorsolateral prefrontal cortex (dlPFC), guided by personalised dlPFC-VTA functional connectivity (FC).

Methods

Eighty schizophrenia patients with predominant negative symptoms received 40 sessions of either active (n = 40) or sham (n = 40) accelerated iTBS (1800 pulses) in two weeks, targeting the region of the left dlPFC most functionally correlated with the VTA. Clinical and cognitive follow-ups occurred at week 4, 8, and 12. The primary outcome was the alteration in PANSS negative symptom (PANSS-NS) scores at week 4, while secondary outcomes included additional clinical, cognitive assessments and neuroimaging alterations.

Results

At week 4, the active group showed a significant reduction in PANSS-NS compared to the sham group, with a significant group × time interaction effect (P < 0.001, mean difference = 4.10, Cohen's d = 0.83). At week 2, compared to the sham group, the active group exhibited reduced left temporal middle gyrus (TMG) (r = −0.29, p = 0.01) activation and FC between the VTA and left TMG (r = −0.34, p = 0.003), and both were negatively correlated with PANSS-NS changes in both groups.

Conclusion

Accelerated iTBS targeting the personalised region determined by dlPFC-VTA FC is an effective intervention to alleviate negative symptoms of schizophrenia.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Brain Stimulation 医学-临床神经学

CiteScore

13.10

自引率

9.10%

发文量

256

审稿时长

72 days

期刊介绍： Brain Stimulation publishes on the entire field of brain stimulation, including noninvasive and invasive techniques and technologies that alter brain function through the use of electrical, magnetic, radiowave, or focally targeted pharmacologic stimulation. Brain Stimulation aims to be the premier journal for publication of original research in the field of neuromodulation. The journal includes: a) Original articles; b) Short Communications; c) Invited and original reviews; d) Technology and methodological perspectives (reviews of new devices, description of new methods, etc.); and e) Letters to the Editor. Special issues of the journal will be considered based on scientific merit.