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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
Repetitive transcranial magnetic stimulation guided by event-related potential P300 application in schizophrenia
Ai-Ming Gu, Chao Liang, Chao Liu, Ru-Ya Guo, Jin Hu, Xing-Shi Chen, Jun-Jie Xu, Jie Huang
Ai-Ming Gu, Jun-Jie Xu, Department of Neurology, The First Hospital of Jiaxing, Jiaxing 314000, Zhejiang Province, China
Chao Liang, Jie Huang, Department of General Practice, The First Hospital of Jiaxing, Jiaxing 314000, Zhejiang Province, China
Chao Liu, Department of Psychiatry, The First Hospital of Jiaxing, Jiaxing 314000, Zhejiang Province, China
Ru-Ya Guo, Department of Endocrinology, The First Hospital of Jiaxing, Jiaxing 314000, Zhejiang Province, China
Jin Hu, Department of Neurology, First Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
Xing-Shi Chen, Department of Electrophysiology, Shanghai Mental Health Center, Shanghai 200030, China
Co-corresponding authors: Chao Liang and Chao Liu.
Author contributions: Gu AM, Hu J, and Chen XS designed the research; Gu AM, Liu C, Xu JJ, Guo RY, and Huang J performed the research; Liang C and Xu JJ contributed analytic tools; Gu AM and Liu C analyzed the data and wrote the manuscript; and all authors have read and approve the final manuscript. Liang C and Liu C contributed equally to this work as co-corresponding authors.
Supported by Key Discipline Construction Project of Neurology of Jiaxing City in Zhejiang Province of China, No. 2023-ZC-006.
Institutional review board statement: The study was reviewed and approved by the Shanghai Institute of Mental Health, No. 201505.
Informed consent statement: All research participants signed informed consent forms before the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Chao Liang, MMed, Department of General Practice, The First Hospital of Jiaxing, No. 1882 Zhonghuan South Road, Jiaxing 314000, Zhejiang Province, China.
liangchao202408@163.com
Received: October 23, 2024
Revised: December 2, 2024
Accepted: January 6, 2025
Published online: March 19, 2025
Processing time: 125 Days and 18.7 Hours
BACKGROUND
Repetitive transcranial magnetic stimulation (rTMS) entered clinical practice in China after 2000, first used in psychiatric surgery, and then in neurology and other disciplines. The First Hospital of Jiaxing introduced TMS in 2015. In practical applications, it has been found that different models of instruments and technical parameters can lead to differences in therapeutic efficacy. Therefore, our hospital selected the Danish TMS instrument, which ranks second in China, to test patients with schizophrenia from March 2021 to July 2021, with a focus on comparing the results at 5 Hz, 10 Hz, and 15 Hz. The testing time is concentrated between 8:30 to 10:30 in the morning. A contingency plan was made for the quality after inspection before testing. Two evaluators independently control the quality of the contingency plan. The data is independently saved and proofread by two evaluators. The purpose of this study is to translate the research results into clinical practice and provide reference basis.
AIM
To investigate the effects of rehabilitation therapy using rTMS on the negative symptoms and event-related potential component of P300 in chronic schizophrenia.
METHODS
One hundred and five patients with chronic schizophrenia were randomly allocated to three groups based on the frequency of rTMS (5, 10, or 15 Hz). The patients underwent five sessions of rTMS per week for 5 weeks. We compared the pre- and post-treatment P300 latency and scores for the Scale for Assessment of Negative Symptoms (SANS).
RESULTS
A significant decrease in SANS score after rTMS was observed in the 10-Hz group (P < 0.05), which was not observed in the 5-Hz and 15-Hz groups. There was a significant increase in P300 amplitude in the 10-Hz group after rTMS treatment (P < 0.05), but there was no significant change in P300 latency (P > 0.05). The improvement of SANS score in the 10-Hz rTMS group was related to patient age and disease course.
CONCLUSION
rTMS at 10 Hz improved negative symptoms and cognitive function in chronic schizophrenia; however, further studies on the mechanism of action are required to validate our observations.
Core Tip: This study investigates the optimal frequency of repetitive transcranial magnetic stimulation (rTMS) in the treatment of schizophrenia and discovers that 10 Hz is superior to 5 Hz and 15 Hz. The innovations of this study consist of designing the experiment in accordance with the Chinese rTMS standard, utilizing the P300 to assess the treatment effect, formulating a detection plan and a quality assurance plan, and adjusting technical parameters. The results demonstrate that the Scale for Assessment of Negative Symptoms score improved in the 10 Hz group, and the P300 wave amplitude presented initial evidence of change. The conclusion is that 10 Hz is appropriate for adult schizophrenia patients, and P300 can serve as an electrophysiological evaluation indicator before and after rTMS treatment.
