Repetitive transcranial magnetic stimulation guided by event-related potential P300 application in schizophrenia

BACKGROUND Repetitive transcranial magnetic stimulation (rTMS) entered clinical practice in China after 2000, first used in psychiatric surgery, and then in neurology and other disciplines. The First Hospital of Jiaxing introduced TMS in 2015. In practical applications, it has been found that different models of instruments and technical parameters can lead to differences in therapeutic efficacy. Therefore, our hospital selected the Danish TMS instrument, which ranks second in China, to test patients with schizophrenia from March 2021 to July 2021, with a focus on comparing the results at 5 Hz, 10 Hz, and 15 Hz. The testing time is concentrated between 8:30 to 10:30 in the morning. A contingency plan was made for the quality after inspection before testing. Two evaluators independently control the quality of the contingency plan. The data is independently saved and proofread by two evaluators. The purpose of this study is to translate the research results into clinical practice and provide reference basis. AIM To investigate the effects of rehabilitation therapy using rTMS on the negative symptoms and event-related potential component of P300 in chronic schizophrenia. METHODS One hundred and five patients with chronic schizophrenia were randomly allocated to three groups based on the frequency of rTMS (5, 10, or 15 Hz). The patients underwent five sessions of rTMS per week for 5 weeks. We compared the pre- and post-treatment P300 latency and scores for the Scale for Assessment of Negative Symptoms (SANS). RESULTS A significant decrease in SANS score after rTMS was observed in the 10-Hz group (P < 0.05), which was not observed in the 5-Hz and 15-Hz groups. There was a significant increase in P300 amplitude in the 10-Hz group after rTMS treatment (P < 0.05), but there was no significant change in P300 latency (P > 0.05). The improvement of SANS score in the 10-Hz rTMS group was related to patient age and disease course. CONCLUSION rTMS at 10 Hz improved negative symptoms and cognitive function in chronic schizophrenia; however, further studies on the mechanism of action are required to validate our observations.