TY - JOUR
T1 - Effect of Bilateral Prefrontal rTMS on Left Prefrontal NAA and Glx Levels in Schizophrenia Patients with Predominant Negative Symptoms
T2 - An Exploratory Study
AU - Dlabac-de Lange, Jozarni J.
AU - Liemburg, Edith J.
AU - Bais, Leonie
AU - van de Poel-Mustafayeva, Aida T.
AU - de Lange-de Klerk, Elly S. M.
AU - Knegtering, Henderikus
AU - Aleman, Andre
PY - 2017
Y1 - 2017
N2 - 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.
AB - 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.
KW - Schizophrenia
KW - Negative symptoms
KW - Transcranial magnetic stimulation
KW - Randomized controlled trial
KW - Dorsolateral prefrontal cortex
KW - H-1-Magnetic resonance spectroscopy
KW - Glutamate
KW - N-Acetyl aspartate
KW - TRANSCRANIAL MAGNETIC STIMULATION
KW - ANTERIOR CINGULATE CORTEX
KW - RESONANCE-SPECTROSCOPY
KW - N-ACETYLASPARTATE
KW - ORBITOFRONTAL CORTEX
KW - DOPAMINE RELEASE
KW - METAANALYSIS
KW - BRAIN
KW - NEUROCOGNITION
KW - HYPOFRONTALITY
U2 - 10.1016/j.brs.2016.08.002
DO - 10.1016/j.brs.2016.08.002
M3 - Article
SN - 1935-861X
VL - 10
SP - 59
EP - 64
JO - Brain stimulation
JF - Brain stimulation
IS - 1
ER -