Left prefrontal high-frequency repetitive transcranial magnetic stimulation for the treatment of schizophrenia with predominant negative symptoms : a sham-controlled, randomized multicenter trial
Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved..
BACKGROUND: Investigators are urgently searching for options to treat negative symptoms in schizophrenia because these symptoms are disabling and do not respond adequately to antipsychotic or psychosocial treatment. Meta-analyses based on small proof-of-principle trials suggest efficacy of repetitive transcranial magnetic stimulation (rTMS) for the treatment of negative symptoms and call for adequately powered multicenter trials. This study evaluated the efficacy of 10-Hz rTMS applied to the left dorsolateral prefrontal cortex for the treatment of predominant negative symptoms in schizophrenia.
METHODS: A multicenter randomized, sham-controlled, rater-blinded and patient-blinded trial was conducted from 2007-2011. Investigators randomly assigned 175 patients with schizophrenia with predominant negative symptoms and a high-degree of illness severity into two treatment groups. After a 2-week pretreatment phase, 76 patients were treated with 10-Hz rTMS applied 5 days per week for 3 weeks to the left dorsolateral prefrontal cortex (added to the ongoing treatment), and 81 patients were subjected to sham rTMS applied similarly.
RESULTS: There was no statistically significant difference in improvement in negative symptoms between the two groups at day 21 (p = .53, effect size = .09) or subsequently through day 105. Also, symptoms of depression and cognitive function showed no differences in change between groups. There was a small, but statistically significant, improvement in positive symptoms in the active rTMS group (p = .047, effect size = .30), limited to day 21.
CONCLUSIONS: Application of active 10-Hz rTMS to the left dorsolateral prefrontal cortex was well tolerated but was not superior compared with sham rTMS in improving negative symptoms; this is in contrast to findings from three meta-analyses.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2015 |
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| Erschienen: |
2015 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:77 |
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| Enthalten in: |
Biological psychiatry - 77(2015), 11 vom: 01. Juni, Seite 979-88 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Wobrock, Thomas [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 26.01.2016 Date Revised 11.05.2015 published: Print-Electronic ClinicalTrials.gov: NCT00783120 Citation Status MEDLINE |
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| doi: |
10.1016/j.biopsych.2014.10.009 |
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| Förderinstitution / Projekttitel: |
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| 500 | |a Date Revised 11.05.2015 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT00783120 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Investigators are urgently searching for options to treat negative symptoms in schizophrenia because these symptoms are disabling and do not respond adequately to antipsychotic or psychosocial treatment. Meta-analyses based on small proof-of-principle trials suggest efficacy of repetitive transcranial magnetic stimulation (rTMS) for the treatment of negative symptoms and call for adequately powered multicenter trials. This study evaluated the efficacy of 10-Hz rTMS applied to the left dorsolateral prefrontal cortex for the treatment of predominant negative symptoms in schizophrenia | ||
| 520 | |a METHODS: A multicenter randomized, sham-controlled, rater-blinded and patient-blinded trial was conducted from 2007-2011. Investigators randomly assigned 175 patients with schizophrenia with predominant negative symptoms and a high-degree of illness severity into two treatment groups. After a 2-week pretreatment phase, 76 patients were treated with 10-Hz rTMS applied 5 days per week for 3 weeks to the left dorsolateral prefrontal cortex (added to the ongoing treatment), and 81 patients were subjected to sham rTMS applied similarly | ||
| 520 | |a RESULTS: There was no statistically significant difference in improvement in negative symptoms between the two groups at day 21 (p = .53, effect size = .09) or subsequently through day 105. Also, symptoms of depression and cognitive function showed no differences in change between groups. There was a small, but statistically significant, improvement in positive symptoms in the active rTMS group (p = .047, effect size = .30), limited to day 21 | ||
| 520 | |a CONCLUSIONS: Application of active 10-Hz rTMS to the left dorsolateral prefrontal cortex was well tolerated but was not superior compared with sham rTMS in improving negative symptoms; this is in contrast to findings from three meta-analyses | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Brain stimulation | |
| 650 | 4 | |a Evidence-based psychiatry | |
| 650 | 4 | |a Negative symptoms | |
| 650 | 4 | |a Randomized controlled trial | |
| 650 | 4 | |a Repetitive transcranial magnetic stimulation | |
| 650 | 4 | |a Schizophrenia | |
| 700 | 1 | |a Guse, Birgit |e verfasserin |4 aut | |
| 700 | 1 | |a Cordes, Joachim |e verfasserin |4 aut | |
| 700 | 1 | |a Wölwer, Wolfgang |e verfasserin |4 aut | |
| 700 | 1 | |a Winterer, Georg |e verfasserin |4 aut | |
| 700 | 1 | |a Gaebel, Wolfgang |e verfasserin |4 aut | |
| 700 | 1 | |a Langguth, Berthold |e verfasserin |4 aut | |
| 700 | 1 | |a Landgrebe, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Eichhammer, Peter |e verfasserin |4 aut | |
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| 700 | 1 | |a Hajak, Göran |e verfasserin |4 aut | |
| 700 | 1 | |a Ohmann, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Verde, Pablo E |e verfasserin |4 aut | |
| 700 | 1 | |a Rietschel, Marcella |e verfasserin |4 aut | |
| 700 | 1 | |a Ahmed, Raees |e verfasserin |4 aut | |
| 700 | 1 | |a Honer, William G |e verfasserin |4 aut | |
| 700 | 1 | |a Malchow, Berend |e verfasserin |4 aut | |
| 700 | 1 | |a Schneider-Axmann, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Falkai, Peter |e verfasserin |4 aut | |
| 700 | 1 | |a Hasan, Alkomiet |e verfasserin |4 aut | |
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