Predicting rTMS Outcomes for Different Targets in Schizophrenia: A Brain Standard Deviation Analysis

Poster No:

34 

Submission Type:

Abstract Submission 

Authors:

Hui-Yun Hsu1, Chih-Chieh Yang1

Institutions:

1Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan

First Author:

Hui-Yun Hsu  
Institute of Brain Science, National Yang Ming Chiao Tung University
Taipei, Taiwan

Co-Author:

Chih-Chieh Yang  
Institute of Brain Science, National Yang Ming Chiao Tung University
Taipei, Taiwan

Introduction:

Repetitive transcranial magnetic stimulation (rTMS) has been widely used to treat psychiatric disorders. However, targeting the dorsolateral prefrontal cortex (DLPFC) has yielded inconsistent results for overall symptom improvement due to the complexity of schizophrenia. Therefore, the aim of our study is to explore the effects of different target sites. Additionally, we investigate the relationships between symptom changes and brain function changes using fMRI.

Methods:

We recruited 15 individuals with schizophrenia from Taipei Veterans General Hospital. Participants were randomized into two groups: the P3 group received 1Hz rTMS on the left inferior parietal lobule (n = 8; age: 29.38 ± 7.01), and the F3 group received 10Hz rTMS on the left DLPFC (n = 7; age: 35.00 ± 9.13). Treatment consisted of 10 sessions, each lasting 30 minutes per day. Symptom severity was evaluated using the Positive and Negative Syndrome Scale (PANSS). For brain function analysis, we calculated the standard deviation (SD) of the BOLD signal for each brain voxel and derived the mean SD for each brain region. We then explored the relationship between symptom changes and SD changes following rTMS.

Results:

After 10 days of rTMS, all participants showed symptom improvement. For positive symptoms, the P3 group showed greater improvement than the F3 group. The P3 group exhibited reduced SD after treatment, and lower baseline SD was associated with greater positive symptom reduction. In contrast, the F3 group showed increased SD after stimulation, and higher baseline SD correlated with greater negative symptom improvement.

Conclusions:

We explored the efficacy of rTMS at different target sites and their associated brain function changes in individuals with schizophrenia. Stimulating the left inferior parietal lobule alleviated positive symptoms, while targeting the left DLPFC led to greater improvement in negative symptoms. The SD of brain function could serve not only as an indicator of treatment outcomes but also as a predictor of treatment effectiveness.

Brain Stimulation:

Non-invasive Magnetic/TMS 1

Disorders of the Nervous System:

Psychiatric (eg. Depression, Anxiety, Schizophrenia) 2

Modeling and Analysis Methods:

fMRI Connectivity and Network Modeling

Keywords:

FUNCTIONAL MRI
Schizophrenia
Transcranial Magnetic Stimulation (TMS)

1|2Indicates the priority used for review

Abstract Information

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Please indicate below if your study was a "resting state" or "task-activation” study.

Resting state

Healthy subjects only or patients (note that patient studies may also involve healthy subjects):

Patients

Was this research conducted in the United States?

No

Were any human subjects research approved by the relevant Institutional Review Board or ethics panel? NOTE: Any human subjects studies without IRB approval will be automatically rejected.

Yes

Were any animal research approved by the relevant IACUC or other animal research panel? NOTE: Any animal studies without IACUC approval will be automatically rejected.

Not applicable

Please indicate which methods were used in your research:

Functional MRI
TMS

For human MRI, what field strength scanner do you use?

3.0T

Which processing packages did you use for your study?

SPM

Provide references using APA citation style.

Cash, R. F. H., Cocchi, L., Lv, J., Fitzgerald, P. B., & Zalesky, A. (2021). Functional Magnetic Resonance Imaging-Guided Personalization of Transcranial Magnetic Stimulation Treatment for Depression. JAMA psychiatry, 78(3), 337–339.

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