Structural brain changes are associated with response of negative symptoms to prefrontal repetitive transcranial magnetic stimulation in patients with schizophrenia

Item Type:	Article
Title:	Structural brain changes are associated with response of negative symptoms to prefrontal repetitive transcranial magnetic stimulation in patients with schizophrenia
Creators Name:	Hasan, A. and Wobrock, T. and Guse, B. and Langguth, B. and Landgrebe, M. and Eichhammer, P. and Frank, E. and Cordes, J. and Woelwer, W. and Musso, F. and Winterer, G. and Gaebel, W. and Hajak, G. and Ohmann, C. and Verde, P.E. and Rietschel, M. and Ahmed, R. and Honer, W.G. and Dechent, P. and Malchow, B. and Castro, M.F.U. and Dwyer, D. and Cabral, C. and Kreuzer, P.M. and Poeppl, T.B. and Schneider-Axmann, T. and Falkai, P. and Koutsouleris, N.
Abstract:	Impaired neural plasticity may be a core pathophysiological process underlying the symptomatology of schizophrenia. Plasticity-enhancing interventions, including repetitive transcranial magnetic stimulation (rTMS), may improve difficult-to-treat symptoms; however, efficacy in large clinical trials appears limited. The high variability of rTMS-related treatment response may be related to a comparably large variation in the ability to generate plastic neural changes. The aim of the present study was to determine whether negative symptom improvement in schizophrenia patients receiving rTMS to the left dorsolateral prefrontal cortex (DLPFC) was related to rTMS-related brain volume changes. A total of 73 schizophrenia patients with predominant negative symptoms were randomized to an active (n=34) or sham (n=39) 10-Hz rTMS intervention applied 5 days per week for 3 weeks to the left DLPFC. Local brain volume changes measured by deformation-based morphometry were correlated with changes in negative symptom severity using a repeated-measures analysis of covariance design. Volume gains in the left hippocampal, parahippocampal and precuneal cortices predicted negative symptom improvement in the active rTMS group (all r-0.441, all P0.009), but not the sham rTMS group (all r0.211, all P0.198). Further analyses comparing negative symptom responders (20% improvement) and non-responders supported the primary analysis, again only in the active rTMS group (F(9, 207)=2.72, P=0.005, partial eta 2=0.106). Heterogeneity in clinical response of negative symptoms in schizophrenia to prefrontal high-frequency rTMS may be related to variability in capacity for structural plasticity, particularly in the left hippocampal region and the precuneus.
Keywords:	Brain, Double-Blind Method, Neuronal Plasticity, Prefrontal Cortex, Psychiatric Status Rating Scales, Schizophrenia, Transcranial Magnetic Stimulation, Treatment Outcome
Source:	Molecular Psychiatry
ISSN:	1359-4184
Publisher:	Nature Publishing Group
Volume:	22
Number:	6
Page Range:	857-864
Date:	June 2017
Official Publication:	https://doi.org/10.1038/mp.2016.161
PubMed:	View item in PubMed

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