Therapeutic effects of different frequencies of repetitive transcranial magnetic stimulation on first-episode schizophrenia with negative symptoms / 中国基层医药

ABSTRACT

Objective:To investigate the therapeutic effects of different frequencies of repetitive transcranial magnetic stimulation (rTMS) on first-episode schizophrenia with negative symptoms, providing evidence for diagnosis and treatment of this disease.Methods:The clinical data of 84 patients with first-episode schizophrenia with negative symptoms who received treatment in the Second People's Hospital of Lishui from October 2017 to October 2019 were retrospectively analyzed. These patients were divided into 5 Hz, 10 Hz, and 15 Hz groups according to different rTMS frequencies ( n = 28/group). Patients in the three groups received 5, 10, and 15 Hz of rTMS. All patients received eight courses of the 1-week treatment. The therapeutic effect was compared between groups at the end of treatment. The scores of the Positive and Negative Syndrome Scale (PANSS), Scale for Assessment of Negative Symptoms (SANS), Personal and Social Performance Scale (PSP), and The Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) pre- and post-treatment, as well as adverse reactions, were determined in each group. Results:Total response rate in the 10 Hz group was 92.86% (26/28), which was significantly higher than that in the 5 Hz group [71.43% (20/28)] and 15 Hz group [67.86% (19/28), χ2 = 5.54, P = 0.019]. The scores of PANSS and SANS post-treatment in the 10 Hz group were (61.28 ± 4.16) points and (34.17 ± 5.02) points, respectively, which were significantly higher than those in the 5 Hz group [(67.19 ± 3.89) points, (42.98 ± 4.17) points] and 15 Hz group [(67.10 ± 3.94) points and (43.21 ± 3.56) points, F = 20.09, 40.38, all P < 0.001]. The score of PSP post-treatment in the 10 Hz group was (60.13 ± 3.78) points, which was significantly higher than that in the 5 Hz group [(54.13 ± 4.12) points] and 15 Hz group [(53.20 ± 3.79) points, F = 26.05, P < 0.05]. The score of LOTCA in the 10 Hz group was (40.13 ± 4.12) points, which was significantly lower than that in the 5 Hz group [(46.28 ± 4.20) points] and 15 Hz group [(47.13 ± 3.89) points, F = 24.64, P < 0.001). The incidence of adverse reactions in the 5 Hz, 10 Hz, and 15 Hz groups was 17.86% (5/28), 7.14% (2/28), and 14.28% (4/28), respectively. There was no significant difference in the incidence of adverse reactions among the three groups ( χ2 = 1.46, P = 0.481). Conclusion:10 Hz rTMS can effectively improve the negative symptoms, cognitive function, and social function of schizophrenic patients. The therapy is of high clinical value.