Augmentation of Antipsychotics by Repetitive Transcranial Magnetic Stimulation Leads to a Remission of Negative Symptoms of Schizophrenia

Overview

The objective of the study was to verify whether augmentation of antipsychotics by high-frequency stimulation of the left prefrontal cortex involving the total of 15 stimulation sessions would prove efficient in reducing the seriousness of negative symptoms of schizophrenia in an open-trial design. The study included 12 patients with schizophrenia characterized by marked negative symptomatology who had been stabilized on antipsychotic medication for a long time. rTMS stimulation was applied every working day, i.e. 5 times a week, up to the total of 15 treatment sessions. rTMS application was defined by application site (left dorsolateral prefrontal cortex), intensity of magnetic stimulation in % of MT (110% of MT), stimulation frequency (10 Hz), pulse series duration (10 sec), intervals between sequences (30 sec) and the total of stimuli applied (1500). The rTMS stimulation therapy succeeded in reducing the seriousness of negative symptoms of schizophrenia, which was reflected in a significant reduction of the median scores of the subscales for negative symptoms of PANSS (by 32%) and SANS (by 59%). The combination of a high frequency (10 Hz), maximum stimulation intensity (i.e. 110% of MT) and a sufficient number of stimulation sessions (at least 15) is what makes rTMS efficient in this indication. Augmentation of antipsychotics by high-frequency stimulation of the left prefrontal cortex consisting in 15 stimulation sessions reduced the seriousness of negative symptoms in schizophrenic patients.

Key words:
treatment, negative symptoms, rTMS, schizophrenia.