Influencing Cognitive Deficit in Schizophrenia by Repetitive Transcranial Magnetic Stimulation
Authors:
R. Přikryl; H. Kučerová; P. Navrátilová; T. Kašpárek; L. Ustohal; S. Venclíková; E. Češková; M. Večeřová
Authors place of work:
Psychiatrická klinika LF MU a FN, Brno
přednostka prof. MUDr. E. Češková, CSc.
Published in the journal:
Čes. a slov. Psychiat., 104, 2008, No. 4, pp. 161-166.
Category:
Original Article
Summary
Schizophrenia is an illness characterized by long-term impairment of cognitive functions such as memory, attention, executive functions or psychomotor performance. High-frequency rTMS has an activating effect on the prefrontal cortex, provoking also release of endogenous dopamine in the ipsilateral caudate nucleus, facilitating thus dopaminergic neurotransmission in the prefrontal cortex. The study included 11 patients with schizophrenia. Previous antipsychotic medication was kept without any change throughout the stimulation treatment period. Stimulation rTMS treatment was administered on all workdays, i.e. 5 times a week, up to the total of 15 sessions. The rTMS treatment was defined by application site (left dorsolateral prefrontal cortex), intensity of magnetic stimulation in 110 % of motor threshold, stimulation frequency (10 Hz), duration of the pulse series (10 sec), intervals between sequences (30 sec) and the overall number of stimuli applied (1,500). Intensity of psychopathology was assessed on the PANSS scale before and after therapy and a neuropsychological examination performed in the same timing. Treatment with rTMS has led to a significant reduction of the intensity of both negative and general symptoms of schizophrenia, an improvement of visuomotor performance, verbal fluency and verbal memory. The improvement of these cognitive domains during rTMS therapy was however not associated with any simultaneous alleviation of negative symptoms. The findings of our study do provide evidence of a statistically significant effect on some domains of the cognitive domains characterized by a cognitive deficit associated with schizophrenia, but the clinical effect of this change does not seem very prominent. The conclusion is consistent with a majority of findings of previous studies dealing with these issues and published to date.
Key words:
cognitive deficit, negative symptoms, rTMS, schizophrenia, stimulation, treatment.
Zdroje
1. Abi-Dargham, A., Malawi, O., Lombardo, I. et al.: Prefrontal dopamine D1 receptors and working memory in schizophrenia. J. Neurosci, 2002, 22, pp. 3708-3719.
2. Andreasen, N. C.: The evolving koncept of schizophrenia: from Kraepelin to the prezent and future. Schizophr. Res., 28, 1997, pp. 105-109.
3. Ben-Sachar, D., Gazawi, H., Riboyad-Levin, J., Klein, E. Chronic repetitive transcranial magnetic stimulation alters beta-adrenergic and 5-HT2 receptor characteristics in rat brain. Brain Res., 816, 1999, pp. 78-83.
4. Callicott, J. H., Bertolino, A., Matysy, V. S. et al. Physiological dysfunction of the dorsolateral prefrontal cortex in schizophrenia revisited. Cereb Cortex, 10, 2000, pp. 1078-1092.
5. Carpenter, W. T., Heinrichs, D. W., Wagman, A. M. I.: Deficit and nondeficit forms of schizophrenia: the concept. Am. J. Psychiatry, 145, 1988, pp. 578-583.
6. Coakley, G., Youssef, H. A., Waddington, J. L., Scully, P.: Executive dysfunction in schizophrenia intimately related to negative symptoms. Schizophrenia Research, 18, 1996, pp. 229-230.
7. Cohen, E., Bernardo, M., Misana, J., Arrufat, F. J., Navarro, V., Valls, S.: Repetitive transcranial magnetic stimulation in the treatment of chronic negative schizophrenia: a pilot study. J. Neurol. Neurosurg. Psychiatry, 67, 1999, pp. 129-130.
8. Delamillieure, P., Fernandez, J., Constans, J. M. et al.: Proton magnetic resonance spectroscopy of the media prefrontal cortex in patiens with deficit schizophrenia: preliminary report. Am. J. Psychiatry, 157, 2000, pp. 641-643.
9. Fitzgerald, P. B., Brown, T. L., Daskalakis, Z. J.: The application of transcranial magnetic stimulation in psychiatry and neuroscience research. Acta Psychiatr. Scand, 105, 2002, pp. 324-340.
10. Gold, S., Arndt, S., Nopoulos, P., O´Leary, D. S., Andreasen, N. C.: Longitudinal study of cognitive function in first-episode and recent-onset schizophrenia. American Journal of Psychiatry, 156, 1999, pp. 1342-1348.
11. Green, M. F., Kern, R. S., Heaton, R.: Longitudinal studies of cognition and functional outcome in schizophrenia: Implications for MATRICS. Schizophrenia Research, 72, 2004, pp. 41-51.
12. Hajak, G., Marienhagen, J., Langguth, B., Werner, S., Binder, H., Eichhammer, P.: High-frequency repetitive transcranial magnetic stimulation. in schizophrenia: a combined treatment and neuroimaging study. Psychol. Med., 34, 2004, pp. 1157–1163.
13. Haraldson, H. M., Ferrarelli, F., Kalin, N. H., Tononi, G:. Transcranial magnetic stimulation in the investigation and treatment of schizophrenia: a review. Schizophr. Res., 71, 2004, pp. 1-16.
14. Harvey, P.: Cognitive function in patients with schizophrenia. Report from a roundtable meeting of experts in cognitive dysfunction in schizophrenia, Budapest, Hungary, September, 1997.
15. Heinrichs, R. W., Zaksatis, K. K.: Neurocognitive deficit in schizophrenia: a quantitative review of the evidence. Neuropsychology, 12, 1998, pp. 426-445.
16. Holi, M. M., Eronen, M., Toivonem, K., Toivonen, P., Marttunen, M., Naukkarinen, H.: Left prefrontal repetitive transcranial magnetic stimulation in schizophrenia. Schizophr. Bull, 30, 2004, pp. 429-434.
17. Jin, Y., Potkin, S. G., Kemp, A. S., Huerta, S. T., Alva, G., Thai, T. M., Carreon, D., Bunney, W. E.: Therapeutic effects of individualized alpha frequency transcranial magnetic stimulation (TMS) on the negative symptoms of schizophrenia. Schizophrenia Bulletin Advance Access Published on October, 27, 2005.
18. Joyce, E.: Origins of cognitive dysfunction in schizophrenia: clues from age at onset. The British Journal of Psychiatry, 186, 2005, pp. 93-95.
19. Karsson, P., Farde, L., Halldin, C., Sedvall, G.: PET study of D (1) dopamine receptor binding in neuroleptic-naive patients with schizophrenia. Am. J. Psychiatry, 159, 2002, 159, pp. 761-767.
20. Keefe, R. S.: Working memory dysfunction and its relevance to schizophrenia. In: Sharma, T., Harvey, P. (Eds). Cognition in schizophrenia. New York,Oxford University Press, 2000, pp. 16–50.
21. Kok, A.: Event-related-potential (ERP) reflections of mental resources: a review and synthesis. Biol. Psychol., 45, 1997, pp. 19-56.
22. Kučerová, H.: Profil a srovnání kognitivních funkcí u pacientů se schizofrenním a onemocněním a depresivní poruchou. Dizertační práce, Olomouc, 2006, s. 41-68.
23. Mohr, P., Rodriguez, M., Novák, T., Kopeček, M., Horáček, J., Hedrychová, Y., Záleský, R., Kawaciuková, R., Preiss, M., Seifertová, D.: Repetitivní transkraniální magnetická stimulace a rehabilitace kognitivních funkcí u schizofrenie. Psychiatrie, 10, 2006, s. 7-15.
24. Novak, T., Horacek, J., Mohr, P., Kopecek, M., Klirova, M., Rodriguez, M., Spaniel, F., Dockery, C., Hoschl, C.: The double-blind sham-controlled study of high-frequency rTMS (20Hz) for negative symptoms in schizophrenia. Negative results. Neuro Endocrinol. Lett., 25, 2006, pp. 209-213.
25. Post, R. M., Kimbrell, T. A., Frye, M.: Implications of kindling and quenching for the possible frequency dependence of rTMS. CNS Spectrums, 2, 1997, pp. 54-60.
26. Přikryl, R., Češková, E., Kučerová, H., Kašpárek, T., Ustohal, L., Palčíková, I.: Stimulace prefrontálního kortexu a léčba negativních příznaků schizofrenie. Čes. a slov. Psychiat., 102, 2006, s. 416-422.
27. Prikryl, R., Kasparek, T., Skotakova, S., Ustohal, L., Kucerova, H., Ceskova, E.: Treatment of negative symptoms of schizophrenia using repetitive transcranial magnetic stimulation in a double-blind, randomized controlled study. Schizophrenia Research, 95, 2007, pp. 151-157.
28. Rollnik, J. D., Huber, T. J., Mogk, H., Siggelkow, S., Kropp, S., Dengler, R.: High frequency repetitive transcranial magnetic stimulation (rTMS) of the dorsolateral prefrontal cortex in schizophrenic patients. Neuroreport., 11, 2000, pp. 4013-4015.
29. Sachdev, P., Loo, C., Mitchell, P., Malhi, G.: Transcranial magnetic stimulation for the deficit syndrome of schizophrenia: a pilot investigation. Psychiatry Clin Neurosci., 59, 2005, pp. 354-357.
30. Sharma, T., Harvey, P. (Eds.): Cognition in schizophrenia. New York, Oxford University Press, 2000.
31. StatSoft, Inc. (2007). STATISTICA Cz [Softwarový systém na analýzu dat], verze 7.1. www.StatSoft.cz
32. Strafella, A. P., Paus, T., Barrett, J., Dagher, A.: Repetitive transcranial magnetic stimulation of the human prefrontal cortex induces dopamine release in the caudate nucleus. J. Neurosci, 21, 2001, pp. 1-4.
33. Strafella, A. P., Paus, T., Fraraccio, M., Dagher, A.: Striatal dopamine release induced by repetitive transcranial magnetic stimulation of the human motor cortex. Brain, 126, 2003, pp. 2609-2615.
34. Triggs, W. J., McCoy, K. J., Greer, R. et al.: Effects of left frontal transcranial magnetic stimulation on depressed mood, cognition, and corticomotor threshold. Biol. Psychiatry, 45, 1999, pp. 1440-1446.
35. Weinberger, D. R., Berman, K. F., Illowsky, B. P.: Physiological dysfunction of dorsolateral prefrontal cortex in schizophrenia. III. A new cohort and evidence for a monoaminergic mechanism. Arch. Gen. Psychiatry, 45, 1988, pp. 609-615.
36. Yu, H. CH., Liao, K. K., Chang, T. J., Tsai, S. J.: Transcranial magnetic stimulation in schizophrenia. Am. J. Psychiatry, 159, 2002, pp. 494-495.
Štítky
Addictology Paediatric psychiatry PsychiatryČlánok vyšiel v časopise
Czech and Slovak Psychiatry
2008 Číslo 4
- Memantine Eases Daily Life for Patients and Caregivers
- Memantine in Dementia Therapy – Current Findings and Possible Future Applications
- Hope Awakens with Early Diagnosis of Parkinson's Disease Based on Skin Odor
- Deep stimulation of the globus pallidus improved clinical symptoms in a patient with refractory parkinsonism and genetic mutation
Najčítanejšie v tomto čísle
- ADHD – Symptoms and Gender
- Clinical and Biological Markers of Persistent Form of Hyperkinetic Disorder (ADHD)
- Influencing Cognitive Deficit in Schizophrenia by Repetitive Transcranial Magnetic Stimulation
- ArginMax in the Treatment of Female Sexual Dysfunction