Safety and proof of principle study of cerebellar vermal theta burst stimulation in refractory schizophrenia.
Safety and proof of principle study of cerebellar vermal theta burst stimulation in refractory schizophrenia.
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DOI：
10.1016/j.schres.2010.08.015
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发表时间：
2010-12
影响因子：
4.5
通讯作者：
Pascual-Leone, Alvaro
中科院分区：
文献类型：
--
作者：
Demirtas-Tatlidede, Ash;Freitas, Catarina;Cromer, Jennifer R.;Safar, Laura;Ongur, Dost;Stone, William S.;Seidman, Larry J.;Schmahmann, Jeremy D.;Pascual-Leone, Alvaro
关键词：
早期侵入性电刺激研究表明，小脑蚓部活动的增强可能被证明是有价值的，通过情绪和情感的调制在对症治疗难治性神经精神疾病。这项原理证明研究旨在使用无创脑刺激来验证这一假设，并探索该方案在精神分裂症中的安全性。8例难治性精神分裂症患者接受了10次间歇性θ波群刺激（TBS）小脑蚓部使用MRI引导的经颅磁刺激（TMS）。评估包括副作用问卷调查，心血管监测，精神评估和全面的神经心理测试之前和之后TBS和一周的随访。总体而言，TBS耐受性良好，副作用轻微，主要包括颈部疼痛和头痛。未发生严重不良事件。TBS后5分钟舒张压（BP）显示轻度降低;收缩压或脉搏未检测到显著变化。PANSS阴性子量表在TBS后和随访期间显示出显著改善。卡尔加里抑郁量表和幸福和悲伤的自我报告视觉模拟量表指出，显着的情绪升高。神经心理学测试显示，在工作记忆和干扰条件下的连续性能测试，更长的空间跨度和更好的延迟组织的Rey-Osterrieth复杂的数字在后续的遗漏显着减少。未检测到精神或神经心理学指标的显著恶化。Theta爆发刺激小脑蚓部是安全和耐受性良好的，同时提供了调节精神分裂症患者的情感，情绪和认知的潜力。未来的随机、假刺激对照研究有必要支持该技术的临床疗效。
Early invasive electrical stimulation studies suggested that enhancement of cerebellar vermal activity might prove valuable in symptomatic treatment of refractory neuropsychiatric diseases via modulation of emotion and affect. This proof of principle study aimed to test this hypothesis using noninvasive brain stimulation, and to explore the safety of this protocol in schizophrenia. Eight treatment-refractory patients with schizophrenia underwent ten sessions of intermittent theta burst stimulation (TBS) to the cerebellar vermis using MRI-guided transcranial magnetic stimulation (TMS). Assessments included side effect questionnaires, cardiovascular monitoring, psychiatric evaluations and comprehensive neuropsychological testing before and after TBS and at one-week follow-up. Overall, TBS was tolerated well with mild side effects primarily comprising neck pain and headache. No serious adverse events occurred. Diastolic blood pressure (BP) showed mild decreases for five minutes post-TBS; no significant changes were detected for systolic BP or pulse. PANSS negative subscale showed significant improvements following TBS and during the follow-up. Calgary Depression Scale and self-report visual analog scales for Happiness and Sadness pointed to significant mood elevation. Neuropsychological testing revealed significantly fewer omissions in working memory and interference conditions of a Continuous Performance Test, a longer spatial span and better delay organization on the Rey-Osterrieth Complex Figure during follow-up. No significant worsening in psychiatric or neuropsychological measures was detected. Theta burst stimulation of the cerebellar vermis is safe and well-tolerated, while offering the potential to modulate affect, emotion and cognition in schizophrenia. Future randomized, sham-stimulation controlled studies are warranted to support the clinical efficacy of this technique.
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作者：
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通讯作者：
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DOI：
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发表时间：
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影响因子：
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DOI：
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发表时间：
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影响因子：
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作者：
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