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A Study of rTMS for Cognitive Deficits in Chronic Patients With Schizophrenia

NCT03273439 — Not applicable, Completed, 47 participants, Suzhou Psychiatric Hospital

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A Randomized, Double-blind Study of Repetitive Transcranial Magnetic Stimulation for Cognitive Deficits in Chronic Patients With Schizophrenia in a Chinese Han Population

RegistryNCT03273439
StatusCompleted
PhaseNot applicable
Study typeInterventional; randomized, parallel, masking: single, treatment
Enrollment47 (Actual)
SponsorSuzhou Psychiatric Hospital (Other)
ConditionsSchizophrenia
Interventionsrepetitive TMS, Sham rTMS (Device)
Datesstart 2012-07-01, primary completion 2014-02-01, completion 2015-06-30, first posted 2017-09-06, last updated 2017-09-06

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-Summary

In this study, we assessed the therapeutic effects and safety of left dorsolateral prefrontal cortex (DLPFC) high-frequency repetitive transcranial magnetic stimulation (rTMS) on negative symptoms of schizophrenia. We evaluated the efficacy of rTMS on cognition in patients with chronic schizophrenia.

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+Detailed description

This is a randomized, sham-controlled, double-blinded trial. 47 patients diagnosed with schizophrenia on stable antipsychotic treatment were randomly assigned to active rTMS treatment group (n=25) or a sham rTMS treatment group (n=22). 25 patients in the active rTMS group received 10 Hz 110% rTMS, while 22 patients were subjected to sham rTMS, both being given 4-week treatment (5 days per week). Efficacy of negative symptom was assessed with the Scale for the Assessment of Negative Symptoms (SANS), the Positive and Negative symptom scale (PANSS) at baseline, the end of 4 weeks and 8 weeks. The cognitive function was assessed with CANTAB at baseline, the end of 4 weeks and 8 weeks .The side effects were assessed with Treatment Emergent Symptoms Scale at baseline and the end of 4 weeks.

+Arms and interventions

ArmTypeInterventionsDescription
repetitive TMSExperimentalDevice: repetitive TMSPrior to each TMS administration, motor threshold was determined by stimulating the left motor strip with the lowest possible energy to produce, within 10 stimuli, at least 5 evoked potentials Z0.05 . In active rTMS, 10 Hz stimulations over left DLPFC occurred at a power of 110% of MT for 5-s intervals with 30-s intertrain interval. 30 trains were administered each day (MondayFriday) for 4 consecutive weeks (total stimuli=30,000).
Sham rTMSSham comparatorDevice: Sham rTMSall procedures were identical except they were the unmagnetized steel cylinders, instead of cylindrical magnets, that were rotated. Participants were, therefore, unable to distinguish between active and sham rTMS.
  • repetitive TMS (Device), also known as rTMS: Prior to each TMS administration, motor threshold was determined by stimulating the left motor strip with the lowest possible energy to produce, within 10 stimuli, at least 5 evoked potentials Z0.05 . In active rTMS, 10 Hz stimulations over left DLPFC occurred at a power of 110% of motor threshold (MT) for 5-s intervals with 30-s intertrain interval. 30 trains were administered each day (MondayFriday) for 4 consecutive weeks (total stimuli=30,000).
  • Sham rTMS (Device): Sham rTMS, without stimulation

+Outcome measures

Primary outcomes

  • Scale for the Assessment of Negative Symptoms (SANS) [4 weeks]: clinical negative symptoms

Secondary outcomes

  • Positive and Negative symptom scale (PANSS) [4 weeks]: Clinical symptoms
  • CANTAB [4 weeks]: cognition

+Eligibility

Sex: All, ages: 18 Years to 60 Years

Inclusion Criteria:

1. Right-handed;
2. meeting the diagnosis of schizophrenia for at least 2 years;
3. had been on anti-psychotic medications for more than 12 weeks;
4. with unresolved negative symptoms (SANS>20).

Exclusion Criteria:

1. with substance use disorders ;
2. with cerebral pathologies (e.g. seizure, aneurysm, stroke), intra-cranial metals, pacemakers, severe cardiovascular diseases;
3. receiving electroconvulsive therapy in the past 3 months.

+Publications

  • Results publication: Li J, Lu X, Du S, Hu W, Xiao D, He B, Su C, Lin S, Zhan Q, Wu H, Li Z. Effects of varied rTMS frequencies on cognitive function in individuals with chronic schizophrenia: A double-blind randomized controlled trial. J Psychiatr Res. 2025 Sep;189:33-41. doi: 10.1016/j.jpsychires.2025.05.052. Epub 2025 May 23. PMID 40479952

+Investigators

My Notes