Dataset Information

Functional MRI in the effect of transcranial magnetic stimulation therapy for patients with schizophrenia: a meta-analysis protocol.

ABSTRACT: Introduction: Schizophrenia is a psychiatric illness associated with brain function alterations and varying degree of treatment resistance, often leading to severe social malfunctioning. In recent decades, numerous studies have been investigating the therapeutic potential of transcranial magnetic stimulation (TMS) as a non-invasive therapy for schizophrenia. However, its clinical efficacy remains controversial, as a number of clinical trials indicated moderate therapeutic effect while others failed to reproduce the positive result. Moreover, the neurobiological mechanism of action remains unclear, possibly constricting the application of TMS in clinical practice. The present protocol of meta-analysis aims to investigate the TMS-related functional neuroimaging (ie, functional MRI) features and alterations in subjects with schizophrenia, and to discuss the potential of functional MRI in TMS researches.

Methods and analysis: The study selection process will follow the Preferred Reporting Items for Meta-Analyses guideline and quality assessment will be conducted with a customised checklist. We plan to search in the following databases: PubMed, Embase, OVID, China National Knowledge Infrastructure and Wanfang Data, from their respective dates of inception to 1 May 2020, with language restricted to English and Chinese. Studies focusing on the brain functional alterations in patients with schizophrenia treated by TMS will be retrieved.

Ethics and dissemination: This work does not require ethics approval as it will be based on published studies. This systematic review will be publicly disseminated in peer-reviewed journals.

Prospero registration number: CRD42020166288.

SUBMITTER: Zhong S

PROVIDER: S-EPMC7713205 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Functional MRI in the effect of transcranial magnetic stimulation therapy for patients with schizophrenia: a meta-analysis protocol.

Zhong Siqian S Hu Yiru Y Fu Yu Y Cao Liping L Zhang Bin B

BMJ open 20201202 12

<h4>Introduction</h4>Schizophrenia is a psychiatric illness associated with brain function alterations and varying degree of treatment resistance, often leading to severe social malfunctioning. In recent decades, numerous studies have been investigating the therapeutic potential of transcranial magnetic stimulation (TMS) as a non-invasive therapy for schizophrenia. However, its clinical efficacy remains controversial, as a number of clinical trials indicated moderate therapeutic effect while oth ...[more]

PMID: 33268405

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Project description:Schizophrenia is a devastating illness with an indeterminate pathophysiology. Several lines of evidence implicate dysfunction in the thalamus, a key node in the distributed neural networks underlying perception, emotion, and cognition. Existing evidence of aberrant thalamic function is based on indirect measures of thalamic activity, but dysfunction has not yet been demonstrated with a causal method.To test the hypothesis that direct physiological stimulation of the cortex will produce an abnormal thalamic response in individuals with schizophrenia.We stimulated the precentral gyrus with single-pulse transcranial magnetic stimulation (spTMS) and measured the response to this pulse in synaptically connected regions (thalamus, medial superior frontal cortex, insula) using concurrent functional magnetic resonance imaging. The mean hemodynamic response from these regions was fit with the sum of 2 gamma functions, and response parameters were compared across groups.Academic research laboratory.Patients with schizophrenia and sex- and age-matched psychiatrically healthy subjects were recruited from the community.Peak amplitude of the thalamic hemodynamic response to spTMS of the precentral gyrus.The spTMS-evoked responses did not differ between groups at the cortical stimulation site. Compared with healthy subjects, patients with schizophrenia showed a reduced response to spTMS in the thalamus (P=1.86 × 10(-9)) and medial superior frontal cortex (P=.02). Similar results were observed in the insula. Sham TMS indicated that these results could not be attributed to indirect effects of TMS coil discharge. Functional connectivity analyses revealed weaker thalamus-medial superior frontal cortex and thalamus-insula connectivity in patients with schizophrenia compared with control subjects.Individuals with schizophrenia showed reduced thalamic activation in response to direct perturbation delivered to the cortex. These results extend prior work implicating the thalamus in the pathophysiology of schizophrenia and suggest that the thalamus contributes to the patterns of aberrant connectivity characteristic of this disease.

Dataset Information

Functional MRI in the effect of transcranial magnetic stimulation therapy for patients with schizophrenia: a meta-analysis protocol.

Publications

Functional MRI in the effect of transcranial magnetic stimulation therapy for patients with schizophrenia: a meta-analysis protocol.

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