Cerebral blood flow changes in schizophrenia patients with auditory verbal hallucinations during low-frequency rTMS treatment

被引:5
|
作者
Xie, Yuanjun [1 ,2 ]
Guan, Muzhen [3 ]
Wang, Zhongheng [4 ]
Ma, Zhujing [5 ]
Fang, Peng [1 ]
Wang, Huaning [4 ]
机构
[1] Fourth Mil Med Univ, Sch Psychol, Dept Mil Med Psychol, Xian, Peoples R China
[2] Fourth Mil Med Univ, Xijing Hosp, Dept Radiol, Xian, Peoples R China
[3] Xian Med Univ, Dept Mental Hlth, Xian, Peoples R China
[4] Fourth Mil Med Univ, Xijing Hosp, Dept Psychiat, Xian, Peoples R China
[5] Fourth Mil Med Univ, Sch Psychol, Dept Clin Psychol, Xian, Peoples R China
关键词
Schizophrenia; Auditory verbal hallucinations; Cerebral blood flow; Arterial spin labeling; Transcranial magnetic stimulation; TRANSCRANIAL MAGNETIC STIMULATION; LEFT TEMPOROPARIETAL CORTEX; INFERIOR FRONTAL GYRUS; QUANTITATIVE METAANALYSIS; RESTING-STATE; CINGULATE CORTEX; MAPPING EVIDENCE; LANGUAGE; CONNECTIVITY; ACTIVATION;
D O I
10.1007/s00406-023-01624-8
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Auditory verbal hallucinations (AVH) are a prominent symptom of schizophrenia. Low-frequency repetitive transcranial magnetic stimulation (rTMS) has been evidenced to improve the treatment of AVH in schizophrenia. Although abnormalities in resting-state cerebral blood flow (CBF) have been reported in schizophrenia, the perfusion alterations specific to schizophrenia patients with AVH during rTMS require further investigation. In this study, we used arterial spin labeling (ASL) to investigate changes in brain perfusion in schizophrenia patients with AVH, and their associations with clinical improvement following low-frequency rTMS treatment applied to the left temporoparietal junction area. We observed improvements in clinical symptoms (e.g., positive symptoms and AVH) and certain neurocognitive functions (e.g., verbal learning and visual learning) following treatment. Furthermore, at baseline, the patients showed reductions in CBF in regions associated with language, sensory, and cognition compared to controls, primarily located in the prefrontal cortices (e.g., left inferior frontal gyrus and left middle frontal gyrus), occipital lobe (e.g., left calcarine cortex), and cingulate cortex (e.g., bilateral middle cingulate cortex), compared to controls. Conversely, we observed increased CBF in the left inferior temporal gyrus and bilateral putamen in patients relative to controls, regions known to be involved in AVH. However, the hypoperfusion or hyperperfusion patterns did not persist and instead were normalized, and were related to clinical response (e.g., AVH) in patients during low-frequency rTMS treatment. Importantly, the changes in brain perfusion were related to clinical response (e.g., AVH) in patients. Our findings suggest that low-frequency rTMS can regulate brain perfusion involving critical circuits by its remote effect in schizophrenia, and may play an important mechanistic role in the treatment of AVH.
引用
收藏
页码:1851 / 1861
页数:11
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