E-ISSN 2475-0581
 

Original Article 


Maintenance Repetitive Transcranial Magnetic Stimulation (rTMS) Weakly Improved Treatment Effect in Patients with Treatment-Resistant Schizophrenia Who Responded to maintenance ECT and Adjunct Olanzapine Treatment – A Pilot Study

Dali Xu, Gongying Li, Yonghui Zhang, Deguo Jiang, Hongjun Tian, Wenqiang Wang, Xiaodong Lin, Chunjun Zhuo, Jinliang Zhang.

Abstract
Objectives: Maintenance treatment with electroconvulsive therapy (ECT) and adjunct antipsychotics can alleviate symptoms of treatment-resistant schizophrenia (TRS), although cognitive impairment is a side effect. Transcranial magnetic stimulation (TMS) has alleviated symptoms and improved cognitive impairment caused by maintenance ECT treatment. This study aimed to investigate long-term treatment effects of maintenance repetitive TMS combined with maintenance ECT and adjunct antipsychotics (MTEO) on TRS patients.
Methods: Eighty TRS patients underwent MTEO or sham-MTEO treatments for 24 months. Severity of illness and patient cognition were evaluated with Positive and Negative Syndrome Scale (PANSS) and MATRICS Consensus Cognitive Battery (MCCB), respectively. Global functional connectivity density (gFCD) was used to assess alterations in brain activity.
Results: Compared to the sham-MTEO group, the MTEO group exhibited an increase in mean MCCB total score [140.8 ± 17.5 vs. 165.5 ± 10.2, respectively; P < 0.05]. Compared to baseline, reductions in PANSS scores were significant in both groups. Also compared to baseline, a marked increase in gFCD was only observed in the left prefontal lobe, parietal lobe, and insular lobe in the MTEO group (FWE correct, P < 0.01). The sham-MTEO group exhibited an increase in gFCD in the temporal lobe and anterior cingulated cortex at baseline. In the striatum, gFCD decreased in both groups.
Conclusions: This novel MTEO treatment for TRS patients improved cognitive ability based on PANSS and MCCB scores, and this improvement may be related to increased brain activity in the prefontal, parietal, and insular lobes. Thus, further study of this treatment approach is warranted.

Key words: TRS, rTMS, gFCD, Antipsychotics, PANSS, MCCB


 
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How to Cite this Article
Pubmed Style

Xu D, Li G, Zhang Y, Jiang D, Tian H, Wang W, Lin X, Zhuo C, Zhang J. Maintenance Repetitive Transcranial Magnetic Stimulation (rTMS) Weakly Improved Treatment Effect in Patients with Treatment-Resistant Schizophrenia Who Responded to maintenance ECT and Adjunct Olanzapine Treatment – A Pilot Study. Psychiatry and Clinical Psychopharmacology - PCP. 2020; 30(3): 254-263. doi:10.5455/PCP.20200229104954


Web Style

Xu D, Li G, Zhang Y, Jiang D, Tian H, Wang W, Lin X, Zhuo C, Zhang J. Maintenance Repetitive Transcranial Magnetic Stimulation (rTMS) Weakly Improved Treatment Effect in Patients with Treatment-Resistant Schizophrenia Who Responded to maintenance ECT and Adjunct Olanzapine Treatment – A Pilot Study. http://www.psychiatryandclinicalpsychopharmacology.org/?mno=89793 [Access: October 03, 2020]. doi:10.5455/PCP.20200229104954


AMA (American Medical Association) Style

Xu D, Li G, Zhang Y, Jiang D, Tian H, Wang W, Lin X, Zhuo C, Zhang J. Maintenance Repetitive Transcranial Magnetic Stimulation (rTMS) Weakly Improved Treatment Effect in Patients with Treatment-Resistant Schizophrenia Who Responded to maintenance ECT and Adjunct Olanzapine Treatment – A Pilot Study. Psychiatry and Clinical Psychopharmacology - PCP. 2020; 30(3): 254-263. doi:10.5455/PCP.20200229104954



Vancouver/ICMJE Style

Xu D, Li G, Zhang Y, Jiang D, Tian H, Wang W, Lin X, Zhuo C, Zhang J. Maintenance Repetitive Transcranial Magnetic Stimulation (rTMS) Weakly Improved Treatment Effect in Patients with Treatment-Resistant Schizophrenia Who Responded to maintenance ECT and Adjunct Olanzapine Treatment – A Pilot Study. Psychiatry and Clinical Psychopharmacology - PCP. (2020), [cited October 03, 2020]; 30(3): 254-263. doi:10.5455/PCP.20200229104954



Harvard Style

Xu, D., Li, . G., Zhang, . Y., Jiang, . D., Tian, . H., Wang, . W., Lin, . X., Zhuo, . C. & Zhang, . J. (2020) Maintenance Repetitive Transcranial Magnetic Stimulation (rTMS) Weakly Improved Treatment Effect in Patients with Treatment-Resistant Schizophrenia Who Responded to maintenance ECT and Adjunct Olanzapine Treatment – A Pilot Study. Psychiatry and Clinical Psychopharmacology - PCP, 30 (3), 254-263. doi:10.5455/PCP.20200229104954



Turabian Style

Xu, Dali, Gongying Li, Yonghui Zhang, Deguo Jiang, Hongjun Tian, Wenqiang Wang, Xiaodong Lin, Chunjun Zhuo, and Jinliang Zhang. 2020. Maintenance Repetitive Transcranial Magnetic Stimulation (rTMS) Weakly Improved Treatment Effect in Patients with Treatment-Resistant Schizophrenia Who Responded to maintenance ECT and Adjunct Olanzapine Treatment – A Pilot Study. Psychiatry and Clinical Psychopharmacology, 30 (3), 254-263. doi:10.5455/PCP.20200229104954



Chicago Style

Xu, Dali, Gongying Li, Yonghui Zhang, Deguo Jiang, Hongjun Tian, Wenqiang Wang, Xiaodong Lin, Chunjun Zhuo, and Jinliang Zhang. "Maintenance Repetitive Transcranial Magnetic Stimulation (rTMS) Weakly Improved Treatment Effect in Patients with Treatment-Resistant Schizophrenia Who Responded to maintenance ECT and Adjunct Olanzapine Treatment – A Pilot Study." Psychiatry and Clinical Psychopharmacology 30 (2020), 254-263. doi:10.5455/PCP.20200229104954



MLA (The Modern Language Association) Style

Xu, Dali, Gongying Li, Yonghui Zhang, Deguo Jiang, Hongjun Tian, Wenqiang Wang, Xiaodong Lin, Chunjun Zhuo, and Jinliang Zhang. "Maintenance Repetitive Transcranial Magnetic Stimulation (rTMS) Weakly Improved Treatment Effect in Patients with Treatment-Resistant Schizophrenia Who Responded to maintenance ECT and Adjunct Olanzapine Treatment – A Pilot Study." Psychiatry and Clinical Psychopharmacology 30.3 (2020), 254-263. Print. doi:10.5455/PCP.20200229104954



APA (American Psychological Association) Style

Xu, D., Li, . G., Zhang, . Y., Jiang, . D., Tian, . H., Wang, . W., Lin, . X., Zhuo, . C. & Zhang, . J. (2020) Maintenance Repetitive Transcranial Magnetic Stimulation (rTMS) Weakly Improved Treatment Effect in Patients with Treatment-Resistant Schizophrenia Who Responded to maintenance ECT and Adjunct Olanzapine Treatment – A Pilot Study. Psychiatry and Clinical Psychopharmacology, 30 (3), 254-263. doi:10.5455/PCP.20200229104954