Intermittent Theta Burst Stimulation (iTBS) as an Optimal Treatment for Schizophrenia Risk Decision: an ERSP Study.

Chen Xingui,Lu Wang,Fengqiong Yu,Kai Wang,Gong-Jun Ji,Yang Wu,Zhu Chunyan,Xu Feifei,Guixian Xiao

doi:10.3389/fpsyt.2021.594102

Abstract

Objective: People with schizophrenia have serious impairments in social function, especially in decision-making ability. Transcranial magnetic stimulation modified intermittent theta burst transcranial magnetic stimulation (iTBS) has been shown to regulate the functional connection of brain networks. Our study explored the therapeutic effect of iTBS on decision-making disorders in schizophrenia.Methods: Participants were pseudorandomized and assigned to iTBS (n = 16) or sham (n = 16) group. iTBS group was administered 1,800 pulses on the target of the left dorsol lateral prefrontal cortex (L-DLPFC) per day for 14 consecutive days. We compared Iowa gambling task performance and associated event-related spectral perturbation results (ERSP) among two groups.Results: The results show that participants' performance in the high-lose in the iTBS group had stronger stimulation of theta spectral power than those in the sham group. Specifically, we found that under high-risk conditions, compared with the control group, the iTBS group showed significant activation of the theta spectrum power in the FPZ, FZ, FCZ, and CZ regions after treatment.Conclusions: Our results provide evidence that long-term iTBS stimulation effectively improves the decision-making ability of schizophrenia. After receiving negative feedback, patients can turn to safety options. These findings support that iTBS may be a potential treatment for clinical decision-making disorders.

Highlights

Patients with schizophrenia exhibit positive and negative symptoms and, generally, varying degrees of social cognitive impairment [1]
- intermittent theta burst transcranial magnetic stimulation (iTBS) can induce the left dorsolateral prefrontal lobe to show stronger theta-band activity. - iTBS has a special advantage in improving the risk decision-making of patients with schizophrenia
There was no significant difference in Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD), PANSS, Scale for the Assessment of Positive Symptoms (SAPS), or Scale for the Assessment of Negative Symptoms (SANS) scores at baseline between the iTBS and sham groups

Summary

Introduction

Patients with schizophrenia exhibit positive and negative symptoms and, generally, varying degrees of social cognitive impairment [1]. The decision-making ability of patients with schizophrenia is severely impaired [3, 4]. During a task, they cannot adjust the subsequent choices according to the results of previous choices and either cannot choose or need to spend a long time choosing the favorable options. Compared with low-risk and long-term favorable options, patients with schizophrenia are more inclined to choose high-risk and longterm unfavorable options [5,6,7]. Clinical antipsychotic drugs are not effective in improving social cognitive deficits, and new treatment methods are urgently needed to solve the decision-making obstacles of patients with schizophrenia [8]

Methods

Results

Discussion

Conclusion