Memory changes following adjuvant temporo-parietal repetitive transcranial magnetic stimulation in schizophrenia

Abstract

Objective: The use of repetitive transcranial magnetic stimulation (rTMS) in schizophrenia has shown improvement as well as deficits in memory. Though most studies had focused on dorsolateral prefrontal cortex only, but impact of rTMS on cognitive functions remain inconclusive. The need of the study is to assess the impact of rTMS on memory in schizophrenia. Materials and Methods: Forty right-handed male patients with schizophrenia were included by purposive sampling and rated on Positive and Negative Syndrome Scale (PANSS) before starting the rTMS treatment with the experimental group. Low frequency 1 Hz rTMS including 1200 stimulations were given over temporo-parietal cortex for 20 min as add on to medications. At the end of 10 session treatment (5 days a week for 2 weeks), the patients were re-evaluated. Results: A total of 39 patients (20 for experimental group and 19 for control group) with mean age of 29.70 ± 9.05 and 31.26 ± 7.78 years, respectively, shows significant difference to pre- and post-treatment mean PANSS score in positive, negative and general psychopathology domains. The pre- and post-treatment mean Postgraduate Institute Memory Scale Scores with multivariate repeated measures analysis of variance revealed significant improvements in all memory domains ( P < 0.01) except remote memory in both experimental and control groups. Conclusion: RTMS in combination with antipsychotics has shown improvement in psychopathology in patients of schizophrenia without any deterioration of memory.

rTMS Shows Efficacy in Improving Negative Symptoms in Early Psychosis: A Systematic Review

“…In that review, twelve studies found evidence for a positive treatment effect of TMS on positive symptoms, whereas eighteen studies were inconclusive (Marzouk et al, 2020). We observed similar findings in our review, with half of relevant studies reporting reduced positive outcomes after rTMS (Gupta et al, 2021) (Ray et al, 2015) (Xie et al, 2021), and the remaining half reporting no improvement in positive symptoms (X. Li et al, 2020), (Lin et al, 2018), and (Tikka et al, 2015).…”

“…Twelve studies used clinical outcome measures to assess the effect of rTMS in early psychosis patients (Francis et al, 2019) (Gupta et al, 2021) (Huang et al, 2022) (X. Li et al, 2020) (Lin et al, 2018) (Prikryl et al, 2014) (Ray et al, 2015) (Sverak et al, 2018) (Tikka et al, 2015) (Tikka et al, 2017) (Wang et al, 2022) (Xie et al, 2021).…”

“…Of the controlled trials, seven of the studies used sham rTMS in a schizophrenia group as a control, one used patients taking risperidone only (vs. risperidone and rTMS) as a control (X. Li et al, 2020), one study used healthy controls that did not receive rTMS, (Xie et al, 2021), and one used an unblinded schizophrenia group that did not receive rTMS or sham rTMS as a control (Gupta et al, 2021).…”

“…Five of the studies rated as high risk ( (Sverak et al, 2018); (Xie, Cai, et al, 2022;Xie et al, 2021;Xie, He, Guan, Wang, et al, 2022;Xie, He, Guan, Zhou, et al, 2022)) lacked an appropriate control group, either with no control or healthy controls also given rTMS, making it difficult to draw conclusions about the effect of rTMS on early psychosis symptoms. Another four studies included an appropriate control group ( (Gupta et al, 2021;Huang et al, 2022;Lin et al, 2018) (Tikka et al, 2015)), but were not randomized or blinded, making the risk of observer bias significant enough to warrant a classification of high risk. Finally, one paper (Tikka et al, 2017) included appropriate controls and randomization, but suffered from a high enough drop out rate to warrant a high risk rating.…”

10 Hz repetitive transcranial magnetic stimulation (rTMS) may improve cognitive function: An exploratory study of schizophrenia patients with auditory hallucinations

“…Therefore, the different protocol used in our study may be the explanation that no significant effect on auditory hallucinations was observed. In addition, the lack of effect may be attributed to the relatively long causes of disease of the patients in this study; most of the patients here had been repeatedly hospitalized [ 65 , 66 ]. Furthermore, the short observation period of the current study may not have allowed us to observe an effect.…”