1. Effect of Bilateral Prefrontal rTMS on Left Prefrontal NAA and Glx Levels in Schizophrenia Patients with Predominant Negative Symptoms: An Exploratory Study
- Author
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André Aleman, Jozarni J. Dlabac-de Lange, Aida T. van de Poel-Mustafayeva, Elly S.M. de Lange-de Klerk, Leonie Bais, Henderikus Knegtering, Edith J. Liemburg, Clinical Neuropsychology, Interdisciplinary Centre Psychopathology and Emotion regulation (ICPE), Perceptual and Cognitive Neuroscience (PCN), and Clinical Cognitive Neuropsychiatry Research Program (CCNP)
- Subjects
Male ,TRANSCRANIAL MAGNETIC STIMULATION ,RESONANCE-SPECTROSCOPY ,medicine.medical_treatment ,Hypofrontality ,1H-Magnetic resonance spectroscopy ,0302 clinical medicine ,DOPAMINE RELEASE ,BRAIN ,Prefrontal cortex ,Positive and Negative Syndrome Scale ,General Neuroscience ,Middle Aged ,Magnetic Resonance Imaging ,Pessimism ,ORBITOFRONTAL CORTEX ,Treatment Outcome ,medicine.anatomical_structure ,Randomized controlled trial ,Schizophrenia ,Female ,Negative symptoms ,Dorsolateral prefrontal cortex ,Glutamate ,HYPOFRONTALITY ,Psychology ,Adult ,medicine.medical_specialty ,Biophysics ,Glutamic Acid ,Prefrontal Cortex ,N-ACETYLASPARTATE ,behavioral disciplines and activities ,lcsh:RC321-571 ,Young Adult ,03 medical and health sciences ,Double-Blind Method ,Internal medicine ,mental disorders ,medicine ,Humans ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,METAANALYSIS ,Anterior cingulate cortex ,Aspartic Acid ,N-Acetyl aspartate ,medicine.disease ,H-1-Magnetic resonance spectroscopy ,030227 psychiatry ,Transcranial magnetic stimulation ,Endocrinology ,nervous system ,ANTERIOR CINGULATE CORTEX ,Orbitofrontal cortex ,Neurology (clinical) ,NEUROCOGNITION ,Neuroscience ,030217 neurology & neurosurgery - Abstract
Background: Prefrontal repetitive Transcranial Magnetic Stimulation (rTMS) may improve negative symptoms in patients with schizophrenia, but few studies have investigated the underlying neural mechanism.Objective: This study aims to investigate changes in the levels of glutamate and glutamine (Glx, neurotransmitter and precursor) and N-Acetyl Aspartate (NAA) in the left dorsolateral prefrontal cortex of patients with schizophrenia treated with active bilateral prefrontal rTMS as compared to sham-rTMS, as measured with H-1-Magnetic Resonance Spectroscopy (H-1-MRS).Methods: Patients were randomized to a 3-week course of active or sham high-frequency rTMS. Pretreatment and post-treatment 1H-MRS data were available for 24 patients with schizophrenia with moderate to severe negative symptoms (Positive and Negative Syndrome Scale (PANSS) negative subscale >= 15). Absolute metabolite concentrations were calculated using LCModel with the water peak as reference. To explore the association between treatment condition and changes in concentration of Glx and NAA, we applied a linear regression model.Results: We observed an increase of Glx concentration in the active treatment group and a decrease of Glx concentration in the group receiving sham treatment. The association between changes in Glx concentration and treatment condition was significant. No significant associations between changes in NAA and treatment condition were found.Conclusions: Noninvasive neurostimulation with high-frequency bilateral prefrontal rTMS may influence Glx concentration in the prefrontal cortex of patients with schizophrenia. Larger studies are needed to confirm these findings and further elucidate the underlying neural working mechanism of rTMS. (C) 2016 Elsevier Inc. All rights reserved.
- Published
- 2017