The clinical efficacy and mechanism of iTBS combined with working memory training on negative symptoms of schizophrenia based on fNIRS: A randomized controlled study.
This study investigates the clinical efficacy and mechanisms of intermittent theta burst stimulation (iTBS) combined with working memory training(WMT) for treating negative symptoms(NS) in schizophrenia.
This was a double-blind randomized controlled clinical trial.Ninety-four patients were assigned to four groups: combination therapy group (CTG, n = 23), iTBS treatment group (iTBSG, n = 24), working memory training group (WMG, n = 23), and control group (CG, n = 24). The four group received 4 weeks of iTBS treatment and WMT,iTBS, WMT and sham stimulation respectively.
All the clinical evaluation results and functional near-infrared spectroscopy(fNIRS) indicators showed no significant statistical difference before treatment.After 20 times treatment, in the Negative Symptom Assessment Scales (SANS), the CTG showed the most pronounced therapeutic effects. The iTBS group displayed significant improvements in SANS-total score, affective flattening, alogia, and anhedonia.The WMT group demonstrated significant enhancements in SANS-total, affective flattening and attentional impairment.In the Positive and Negative Syndrome Scale (PANSS),the CTG exhibited superior efficacy compared to single iTBS or WMT interventions. The CTG and iTBSG demonstrated significant improvements compared to baseline.fNIRS analysis revealed that the CTG exhibited significantly greater activation in the medial prefrontal cortex (mPFC) compared to the CG. The CTG had the highest connectivity strength, showing an increasing trend compared to before treatment.
The combination of iTBS and WMT demonstrated significant potential in ameliorating NS in schizophrenia. Furthermore, the integrated therapy showed promise in enhancing prefrontal activation.
This was a double-blind randomized controlled clinical trial.Ninety-four patients were assigned to four groups: combination therapy group (CTG, n = 23), iTBS treatment group (iTBSG, n = 24), working memory training group (WMG, n = 23), and control group (CG, n = 24). The four group received 4 weeks of iTBS treatment and WMT,iTBS, WMT and sham stimulation respectively.
All the clinical evaluation results and functional near-infrared spectroscopy(fNIRS) indicators showed no significant statistical difference before treatment.After 20 times treatment, in the Negative Symptom Assessment Scales (SANS), the CTG showed the most pronounced therapeutic effects. The iTBS group displayed significant improvements in SANS-total score, affective flattening, alogia, and anhedonia.The WMT group demonstrated significant enhancements in SANS-total, affective flattening and attentional impairment.In the Positive and Negative Syndrome Scale (PANSS),the CTG exhibited superior efficacy compared to single iTBS or WMT interventions. The CTG and iTBSG demonstrated significant improvements compared to baseline.fNIRS analysis revealed that the CTG exhibited significantly greater activation in the medial prefrontal cortex (mPFC) compared to the CG. The CTG had the highest connectivity strength, showing an increasing trend compared to before treatment.
The combination of iTBS and WMT demonstrated significant potential in ameliorating NS in schizophrenia. Furthermore, the integrated therapy showed promise in enhancing prefrontal activation.