Theta burst cerebellar stimulation may benefit schizophrenia patients
MedWire News: Results from a proof of principle study suggest that theta burst stimulation (TBS) of the cerebellar vermis is well tolerated and improves symptoms, mood, and cognition in patients with schizophrenia.
"Early invasive electrical stimulation studies suggested that enhancement of cerebellar vermal activity might prove valuable in symptomatic treatment of refractory neuropsychiatric diseases via modulation of emotion and affect," explain Alvaro Pascual-Leone (Harvard Medical School, Boston, Massachusetts, USA) and team.
To test this hypothesis using noninvasive brain stimulation, and examine the safety of this technique, the researchers studied eight treatment-refractory patients with schizophrenia who were aged between 29 and 54 years.
All of the patients underwent 10 sessions of intermittent TBS to the cerebellar vermis using magnetic resonance imaging-guided transcranial magnetic stimulation.
The participants underwent psychiatric evaluations and comprehensive neuropsychological testing before and 1 week after TBS, and completed side-effect questionnaires.
The researchers found that although there was no significant reduction in total scores on the Positive and Negative Symptoms Scale (PANSS), scores on the negative symptom subscale fell by a mean of 19.3% among the patients after TBS compared with baseline.
Neuropsychological testing also revealed significantly fewer omission errors in the working memory and interference conditions of the Seidman Auditory Continuous Performance Test after TBS compared with baseline, at 5.3 versus 10.5, and 22.3 versus 27.0, respectively, as well as better delay organization on the Rey-Osterrieth Complex Figure test.
The researchers also note that patients showed improvement on the Calgary Depression Scale and self-report visual analog scales for Happiness and Sadness after TBS compared with baseline.
No significant worsening in psychiatric or neuropsychological measures was detected.
TBS was also well tolerated with no significant side effects, although patients reported mild neck pain and headache that responded to treatment with acetaminophen.
Pascual-Leone and colleagues conclude in the journal Schizophrenia Research: "TBS of the cerebellar vermis is safe and well-tolerated, while offering the potential to modulate affect, emotion and cognition in schizophrenia."
They add: "Future randomized, sham-stimulation controlled studies are warranted to support the clinical efficacy of this technique."
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By Mark Cowen