Influencing Cognitive Deficit in Schizophrenia by Repetitive Transcranial Magnetic Stimulation
Authors:
R. Přikryl; H. Kučerová; P. Navrátilová; T. Kašpárek; L. Ustohal; S. Venclíková; E. Češková; M. Večeřová
Authors‘ workplace:
Psychiatrická klinika LF MU a FN, Brno
přednostka prof. MUDr. E. Češková, CSc.
Published in:
Čes. a slov. Psychiat., 104, 2008, No. 4, pp. 161-166.
Category:
Original Article
Overview
Schizophrenia is an illness characterized by long-term impairment of cognitive functions such as memory, attention, executive functions or psychomotor performance. High-frequency rTMS has an activating effect on the prefrontal cortex, provoking also release of endogenous dopamine in the ipsilateral caudate nucleus, facilitating thus dopaminergic neurotransmission in the prefrontal cortex. The study included 11 patients with schizophrenia. Previous antipsychotic medication was kept without any change throughout the stimulation treatment period. Stimulation rTMS treatment was administered on all workdays, i.e. 5 times a week, up to the total of 15 sessions. The rTMS treatment was defined by application site (left dorsolateral prefrontal cortex), intensity of magnetic stimulation in 110 % of motor threshold, stimulation frequency (10 Hz), duration of the pulse series (10 sec), intervals between sequences (30 sec) and the overall number of stimuli applied (1,500). Intensity of psychopathology was assessed on the PANSS scale before and after therapy and a neuropsychological examination performed in the same timing. Treatment with rTMS has led to a significant reduction of the intensity of both negative and general symptoms of schizophrenia, an improvement of visuomotor performance, verbal fluency and verbal memory. The improvement of these cognitive domains during rTMS therapy was however not associated with any simultaneous alleviation of negative symptoms. The findings of our study do provide evidence of a statistically significant effect on some domains of the cognitive domains characterized by a cognitive deficit associated with schizophrenia, but the clinical effect of this change does not seem very prominent. The conclusion is consistent with a majority of findings of previous studies dealing with these issues and published to date.
Key words:
cognitive deficit, negative symptoms, rTMS, schizophrenia, stimulation, treatment.
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Addictology Paediatric psychiatry PsychiatryArticle was published in
Czech and Slovak Psychiatry
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