Intermittent Theta Burst Stimulation (iTBS) as an Optimal Treatment for Schizophrenia Risk Decision: an ERSP Study

Abstract

Objective: People with schizophrenia have serious impairments in social function, especially in decision-making ability. Transcranial magnetic stimulation modified intermittent theta burst transcranial magnetic stimulation (iTBS) has been shown to regulate the functional connection of brain networks. Our study explored the therapeutic effect of iTBS on decision-making disorders in schizophrenia.Methods: Participants were pseudorandomized and assigned to iTBS (n = 16) or sham (n = 16) group. iTBS group was administered 1,800 pulses on the target of the left dorsol lateral prefrontal cortex (L-DLPFC) per day for 14 consecutive days. We compared Iowa gambling task performance and associated event-related spectral perturbation results (ERSP) among two groups.Results: The results show that participants' performance in the high-lose in the iTBS group had stronger stimulation of theta spectral power than those in the sham group. Specifically, we found that under high-risk conditions, compared with the control group, the iTBS group showed significant activation of the theta spectrum power in the FPZ, FZ, FCZ, and CZ regions after treatment.Conclusions: Our results provide evidence that long-term iTBS stimulation effectively improves the decision-making ability of schizophrenia. After receiving negative feedback, patients can turn to safety options. These findings support that iTBS may be a potential treatment for clinical decision-making disorders.

Efficacy and safety of intermittent theta-burst stimulation in patients with schizophrenia: A meta-analysis of randomized sham-controlled trials

“…This meta-analysis included 13 studies in which iTBS was used to treat patients with schizophrenia ( Chen et al, 2011 ; Kazemi et al, 2012 ; Zheng et al, 2012 ; Zhao et al, 2014 ; Zhen et al, 2015 ; Zhu et al, 2019 ; Walther et al, 2020 ; Wang et al, 2020 ; Basavaraju et al, 2021 ; Bation et al, 2021 ; Chauhan et al, 2021 ; Wu et al, 2021 ; Zhu et al, 2021 ). The included studies were published between 2011 and 2021.…”

A Systematic Review of Intermittent Theta Burst Stimulation for Neurocognitive Dysfunction in Older Adults with Schizophrenia

“…In this systematic review, only one RCT examined the effects of iTBS on total psychopathology as measured by the PANSS and BPRS in older adults with schizophrenia, and there were mixed findings [ 23 ]. Accumulating evidence has demonstrated the positive effects of iTBS on total psychopathology in younger adults with schizophrenia [ 25 , 42 , 43 ]. For example, a recent RCT found that iTBS had a particularly prominent effect as an adjunct treatment in improving the total symptoms in younger adults with schizophrenia [ 43 ].…”

“…Thus, the aim of the current study was to focus on investigating the neurocognitive effects of adjunctive iTBS in older adults with schizophrenia. Based on the findings of a recent study [ 25 ], we hypothesized that adjunctive active iTBS has significant superiority in improving neurocognitive dysfunction for older adults with schizophrenia when compared to sham iTBS.…”

High-Definition Transcranial Direct Current Stimulation Improves Decision-Making Ability: A Study Based on EEG

“…Previous studies suggested that the processing of feedback information involves several distinct processes, which are subserved by oscillations of different frequencies [ 41 ]. Theta oscillation was a prominent time-frequency component implicated during decision task which was widely used in nervous and psychiatric disorders, such as autism spectrum disorder, Parkinson’s disease, schizophrenia [ 35 , 67 , 68 ]. Numerous electrophysiologic literature suggested this reward-related theta activity may be generated by frontal cortex, while anterior cingulate cortex and orbitofrontal cortex were possible contributions of brain regions [ 46 , 69 , 70 ].…”

“…Iowa Gambling Task (IGT) is a common experimental paradigm for observing ambiguous decisions and has been proved to be useful in the detection of decision-making impairments in several neurological and psychiatric conditions [ 34 , 35 ]. Event-related functional magnetic resonance imaging studies showed that a neural circuitry involving the left DLPFC was activated during the IGT and that the changed activity of left DLPFC was associated with the IGT netscores [ 36 ].…”