Efficacy of rTMS on SCZ symptoms: Insights from connectome mapping.

Journal: Psychiatry research
Published Date: May 31, 2025

Abstract

Repetitive transcranial magnetic stimulation (rTMS) is a potential treatment for schizophrenia (SCZ), yet its efficacy and underlying mechanisms remain uncertain. This study evaluates the impact of rTMS targeting the right orbitofrontal cortex (OFC) in SCZ patients and constructs a connectome atlas based on symptomatology and treatment responses. Ninety-eight SCZ patients were randomly assigned to rTMS (n = 53) or sham stimulation (n = 45) groups. rTMS was delivered at 1 Hz, 110 % of the resting motor threshold, targeting the AF8 site over the right OFC, with 720 pulses per session, administered twice daily for a total of 20 sessions. Symptom assessments were conducted using the Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale (HAMD), and Hamilton Anxiety Rating Scale (HAMA) at baseline, 2 weeks, and 4 weeks post-treatment. Resting-state functional magnetic resonance imaging (rsfMRI) and diffusion-weighted imaging (DWI) scans were acquired pre-treatment. Machine learning analysis of resting-state functional connectivity (rsFC) patterns revealed significant improvements in PANSS scores in the rTMS group at 4 weeks compared to the sham group. Specific rsFC patterns associated with depression, anxiety, and SCZ symptoms were identified, emphasizing the impact of the Default Mode Network (DMN) and Central Executive Network (CEN). Overall, rTMS targeting the right OFC effectively reduced SCZ symptoms, showcasing new therapeutic targets and an enhanced approach to rTMS treatment.

Authors

  • Tianyuan Zhu
    Neuromodulation Center, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, 200030, Shanghai, PR China.
  • Xiong Jiao
    College of Biomedical Engineering, Taiyuan University of Technology, Jinzhong, Shanxi, China. Electronic address: jiaoxiong@tyut.edu.cn.
  • Jie Zhou
    Departments of Ultrasound, Jiading District Central Hospital Affiliated Shanghai University of Medicine &Health Sciences, Shanghai, China.
  • Peter J Nicholas
    Omniscient Neurotechnology, Sydney 2000, Australia.
  • Karol Osipowicz
    Omniscient Neurotechnology, Sydney 2000, Australia.
  • Stephane Doyen
    Omniscient Neurotechnology, Sydney, Australia.
  • Michael E Sughrue
    Omniscient Neurotechnology, Sydney, Australia.
  • Yin Wang
    State Key Laboratory of ASIC and System, School of Microelectronics, Fudan University, Shanghai 200433, China.
  • Yanli Zhang
    School of Information Science and Engineering, Shandong University, Jinan 250100, P. R. China.
  • Jun Zhu
    Sinopharm Dongfeng General Hospital, Hubei University of Medicine, Shiyan, Hubei, 442008, China.
  • Danwei Zhang
    Department of Psychiatry, Zhenjiang Mental Health Center 212000 Jiangsu, PR China.
  • Ziliang Wang
    4School of Psychology, Beijing Normal University, Beijing, PR China.
  • Qiang Hu
    School of Information Science and Technology, Qingdao University of Science and Technology, Qicngdao 266061, China.
  • Jijun Wang
    Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.

Keywords

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