The Effect of Cerebellar Vermal rTMS with TBS Paradigm on Negative Symptoms, Cognitive Function and Serum Inflammatory Factors in Elderly Patients with Chronic Schizophrenia: a Randomized Controlled Trial

Background The cerebellar vermis is closely related to emotional regulation and cognitive function. There have been few reports on whether repeated transcranial magnetic stimulation (rTMS) of the cerebellar vermis can improve clinical symptoms in elderly patients with chronic schizophrenia (CSZ) . O...

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Main Author: DONG Xiaomei, ZHAO Hongyan, GENG Zhongli, XU Tianchao, WANG Qi
Format: Article
Language:zho
Published: Chinese General Practice Publishing House Co., Ltd 2025-02-01
Series:Zhongguo quanke yixue
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Online Access:https://www.chinagp.net/fileup/1007-9572/PDF/20240161.pdf
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author DONG Xiaomei, ZHAO Hongyan, GENG Zhongli, XU Tianchao, WANG Qi
author_facet DONG Xiaomei, ZHAO Hongyan, GENG Zhongli, XU Tianchao, WANG Qi
author_sort DONG Xiaomei, ZHAO Hongyan, GENG Zhongli, XU Tianchao, WANG Qi
collection DOAJ
description Background The cerebellar vermis is closely related to emotional regulation and cognitive function. There have been few reports on whether repeated transcranial magnetic stimulation (rTMS) of the cerebellar vermis can improve clinical symptoms in elderly patients with chronic schizophrenia (CSZ) . Objective Observing the effects of cerebellar vermis rTMS with theta burst stimulation (TBS) paradigm on negative symptoms, cognitive function, and serum inflammatory cytokine levels in elderly CSZ patients. Methods This study was a single blind randomized controlled trial. Fifty elderly CSZ patients in stable condition admitted to Shenyang Mental Health Center were selected between October 2022 and August 2023 as the subjects. Using a random number table method, CSZ patients were divided into an observation group and a control group, with 25 cases in each group. The patients in observation group were treated with rTMS with TBS paradigm, the stimulation site was the vermis of the cerebellum. The treatment was conducted 5 days a week, once a day, for 4 consecutive weeks. The patients in control group were intervention with pseudo stimulation, and the treatment time and parameters were the same as those in the observation group. Use the Positive and Negative Symptom Scale (PANSS) to evaluate overall psychiatric symptoms, and use the SANS to evaluate negative symptoms. Evaluate cognitive function using the MATRICS Consensus Cognitive Battery (MCCB) . Detecting serum interleukin-1β (IL-1β) , Interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α) . Results Compared with the control group, the observation group had lower PANSS negative symptom scores [ (17.11±2.00) scores vs (19.21±2.76) scores], general psychopathological symptom scores [ (26.34±2.07) scores vs (29.33±4.27) scores], total scores after treatment [ (53.10±3.61) scores vs (58.99±5.53) scores], and lower SANS scale scores [ (54.00±3.78) scores vs (57.83±4.15) scores] (P<0.05) . Compared with the control group, the observation group had higher post-treatment information processing speed scores [ (39.78±2.45) scores vs (37.24±1.10) scores], attention alertness scores [ (47.07±4.27) scores vs (40.01±2.17) scores], working memory scores [ (45.12±3.20) scores vs (41.89±4.11) scores], and social cognitive scores [ (46.40±4.29) scores vs (41.42±7.45) scores] (P<0.05) . Compared with the control group, the observation group had lower levels of IL-1β [ (41.09±7.34) μg/L vs (47.03±12.45) μg/L], IL-6 [ (41.28±7.32) μg/L vs (47.03±9.45) μg/L], and TNF-α [ (53.28±14.15) μg/L vs (61.35±12.79) μg/L] after treatment (P<0.05) . During the rTMS treatment process, only 4 cases in the observation group experienced dizziness and headache symptoms during the first treatment, which gradually became tolerable with prolonged treatment time. All other patients have no complaints of discomfort. Conclusion The rTMS with TBS paradigm can improve negative symptoms, cognitive function, and serum inflammatory factor levels in elderly patients with CSZ.
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spelling doaj-art-1e7134fdd9014b7b849444bd0441beaf2025-08-20T03:11:46ZzhoChinese General Practice Publishing House Co., LtdZhongguo quanke yixue1007-95722025-02-01280557558010.12114/j.issn.1007-9572.2024.0161The Effect of Cerebellar Vermal rTMS with TBS Paradigm on Negative Symptoms, Cognitive Function and Serum Inflammatory Factors in Elderly Patients with Chronic Schizophrenia: a Randomized Controlled TrialDONG Xiaomei, ZHAO Hongyan, GENG Zhongli, XU Tianchao, WANG Qi01. Department of Psychiatry and Psychology, General Hospital of Northern Theater Command, Shenyang 110015, China;2. Lishi Road Outpatient Department of Jingzhong Medical District, General Hospital of the People's Liberation Army, Beijing 100842, China;3. Shenyang Mental Health Center (Shenyang Mental Disease Prevention and Control Center) , Shenyang 110168, ChinaBackground The cerebellar vermis is closely related to emotional regulation and cognitive function. There have been few reports on whether repeated transcranial magnetic stimulation (rTMS) of the cerebellar vermis can improve clinical symptoms in elderly patients with chronic schizophrenia (CSZ) . Objective Observing the effects of cerebellar vermis rTMS with theta burst stimulation (TBS) paradigm on negative symptoms, cognitive function, and serum inflammatory cytokine levels in elderly CSZ patients. Methods This study was a single blind randomized controlled trial. Fifty elderly CSZ patients in stable condition admitted to Shenyang Mental Health Center were selected between October 2022 and August 2023 as the subjects. Using a random number table method, CSZ patients were divided into an observation group and a control group, with 25 cases in each group. The patients in observation group were treated with rTMS with TBS paradigm, the stimulation site was the vermis of the cerebellum. The treatment was conducted 5 days a week, once a day, for 4 consecutive weeks. The patients in control group were intervention with pseudo stimulation, and the treatment time and parameters were the same as those in the observation group. Use the Positive and Negative Symptom Scale (PANSS) to evaluate overall psychiatric symptoms, and use the SANS to evaluate negative symptoms. Evaluate cognitive function using the MATRICS Consensus Cognitive Battery (MCCB) . Detecting serum interleukin-1β (IL-1β) , Interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α) . Results Compared with the control group, the observation group had lower PANSS negative symptom scores [ (17.11±2.00) scores vs (19.21±2.76) scores], general psychopathological symptom scores [ (26.34±2.07) scores vs (29.33±4.27) scores], total scores after treatment [ (53.10±3.61) scores vs (58.99±5.53) scores], and lower SANS scale scores [ (54.00±3.78) scores vs (57.83±4.15) scores] (P<0.05) . Compared with the control group, the observation group had higher post-treatment information processing speed scores [ (39.78±2.45) scores vs (37.24±1.10) scores], attention alertness scores [ (47.07±4.27) scores vs (40.01±2.17) scores], working memory scores [ (45.12±3.20) scores vs (41.89±4.11) scores], and social cognitive scores [ (46.40±4.29) scores vs (41.42±7.45) scores] (P<0.05) . Compared with the control group, the observation group had lower levels of IL-1β [ (41.09±7.34) μg/L vs (47.03±12.45) μg/L], IL-6 [ (41.28±7.32) μg/L vs (47.03±9.45) μg/L], and TNF-α [ (53.28±14.15) μg/L vs (61.35±12.79) μg/L] after treatment (P<0.05) . During the rTMS treatment process, only 4 cases in the observation group experienced dizziness and headache symptoms during the first treatment, which gradually became tolerable with prolonged treatment time. All other patients have no complaints of discomfort. Conclusion The rTMS with TBS paradigm can improve negative symptoms, cognitive function, and serum inflammatory factor levels in elderly patients with CSZ.https://www.chinagp.net/fileup/1007-9572/PDF/20240161.pdfchronic schizophrenia|repetitive transcranial magnetic stimulation|inflammatory cytokines|negative symptoms|cognitive function|randomized controlled trial
spellingShingle DONG Xiaomei, ZHAO Hongyan, GENG Zhongli, XU Tianchao, WANG Qi
The Effect of Cerebellar Vermal rTMS with TBS Paradigm on Negative Symptoms, Cognitive Function and Serum Inflammatory Factors in Elderly Patients with Chronic Schizophrenia: a Randomized Controlled Trial
Zhongguo quanke yixue
chronic schizophrenia|repetitive transcranial magnetic stimulation|inflammatory cytokines|negative symptoms|cognitive function|randomized controlled trial
title The Effect of Cerebellar Vermal rTMS with TBS Paradigm on Negative Symptoms, Cognitive Function and Serum Inflammatory Factors in Elderly Patients with Chronic Schizophrenia: a Randomized Controlled Trial
title_full The Effect of Cerebellar Vermal rTMS with TBS Paradigm on Negative Symptoms, Cognitive Function and Serum Inflammatory Factors in Elderly Patients with Chronic Schizophrenia: a Randomized Controlled Trial
title_fullStr The Effect of Cerebellar Vermal rTMS with TBS Paradigm on Negative Symptoms, Cognitive Function and Serum Inflammatory Factors in Elderly Patients with Chronic Schizophrenia: a Randomized Controlled Trial
title_full_unstemmed The Effect of Cerebellar Vermal rTMS with TBS Paradigm on Negative Symptoms, Cognitive Function and Serum Inflammatory Factors in Elderly Patients with Chronic Schizophrenia: a Randomized Controlled Trial
title_short The Effect of Cerebellar Vermal rTMS with TBS Paradigm on Negative Symptoms, Cognitive Function and Serum Inflammatory Factors in Elderly Patients with Chronic Schizophrenia: a Randomized Controlled Trial
title_sort effect of cerebellar vermal rtms with tbs paradigm on negative symptoms cognitive function and serum inflammatory factors in elderly patients with chronic schizophrenia a randomized controlled trial
topic chronic schizophrenia|repetitive transcranial magnetic stimulation|inflammatory cytokines|negative symptoms|cognitive function|randomized controlled trial
url https://www.chinagp.net/fileup/1007-9572/PDF/20240161.pdf
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