Journal of Psychiatry

Abstract

To Evaluate the Efficacy of Repetitive Transcranial Magnetic Stimulation (rTMS) For Treatment of Negative Symptoms in Patients with Schizophrenia

Nayab Anjum*, Zeba Khan, M. Reyazuddin and Faisal Shaan

Introduction: The therapeutic use of rTMS (Repetitive Transcranial Magnetic Stimulation) across the dorsolateral prefrontal cortex in the management of negative symptoms of schizophrenia has recently emerged. This study was done to determine the effectiveness of high frequency rTMS over the left DLPFC (Dorsolateral Prefrontal Cortex) in reducing negative symptoms of schizophrenia.

Aim: To determine the efficacy of high frequency rTMS (20 Hz, 110 MT, 3000 pulses/day) over left dorsolateral prefrontal cortex as an augmentation treatment in negative symptoms of schizophrenia.

Materials and methods: 50 Patients with Schizophrenia diagnosed as per ICD-10 (International Classification of Diseases) having predominantly negative symptoms that fulfilled the inclusion and exclusion criteria were recruited for study. All patients were assessed on SANS (Scale for Assessment of Negative Symptoms) for negative symptoms, CDSS for depressive symptoms and Clinical Global Impression scale CGI for overall clinical improvement. The patients were then divided into active group and a sham group by chit method.

Results: There was significant improvement in the total SANS score between active and sham group after intervention. Total SANS scores reduced significantly after intervention in both active (78.52 ± 11.58 to 45.68 ± 5.52, p<0.001) and sham (74.64 ± 7.99 to 50.80 ± 4.77, p<0.001) rTMS arms on fractional measure ANOVA test but post interventional scores were significantly lesser in those who receive active rTMS as compared to those who receive sham.

Conclusion: Our study found a significant reduction in negative symptoms and overall clinical global improvement in patients with negative symptoms. This study adds to the existing literature with its robust design and large sample size as compared to previous studies despite few limitations and paves the path for future research regarding administration of high frequency rTMS. This protocol can be used as standard protocol for patients with negative symptoms of schizophrenia as there was significant improvement in all 5 subdomains of SANS scale which was not shown by previous studies.

Published Date: 2023-12-25; Received Date: 2023-11-23