Targeting auditory verbal hallucinations in schizophrenia: effective connectivity changes induced by low-frequency rTMS.

IF 5.8 1区医学 Q1 PSYCHIATRY Translational Psychiatry Pub Date : 2024-09-28 DOI:10.1038/s41398-024-03106-4

Xie Yuanjun, Muzhen Guan, Tian Zhang, Chaozong Ma, Lingling Wang, Xinxin Lin, Chenxi Li, Zhongheng Wang, Ma Zhujing, Huaning Wang, Fang Peng

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Abstract

Low-frequency repetitive transcranial magnetic stimulation (rTMS) has emerged as an effective intervention for alleviating symptoms of psychiatric disorders, particularly schizophrenia characterized by persistent auditory verbal hallucinations (AVH). However, the underlying mechanism of its action remain elusive. This study employed a randomized controlled design to investigate the impact of low-frequency rTMS on the neural connectivity at the stimulate site, specifically left temporoparietal junction (TPJ), in schizophrenia patients with suffering from AVH. Using Dynamic Causal Modeling (DCM), this study assessed changes in directed connectivity patterns and their correlations with clinical symptomatology. The results demonstrated significant improvements in AVH. Notably, significant changes in connectivity were observed, including both abnormal functional connectivity and effective connectivity among multiple brain regions. Particularly, the inhibition effects from the left precentral gyrus and left medial superior frontal gyrus to the left TPJ were closely associated with improvements in AVH. These findings underscore the potential of rTMS to effectively modulate neural pathways implicated in hallucinations in schizophrenia, thereby providing a neurobiological foundation for its therapeutic effects.

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针对精神分裂症患者的听觉言语幻觉：低频经颅磁刺激引起的有效连接变化

低频重复经颅磁刺激（rTMS）已成为一种有效的干预措施，可减轻精神疾病的症状，尤其是以持续性听觉言语幻觉（AVH）为特征的精神分裂症。然而，其潜在的作用机制仍然难以捉摸。本研究采用随机对照设计，研究低频经颅磁刺激对精神分裂症患者刺激部位（尤其是左侧颞顶叶交界处（TPJ））神经连接的影响。本研究采用动态因果模型（DCM）评估了定向连接模式的变化及其与临床症状的相关性。结果表明，AVH 有了明显改善。值得注意的是，研究人员观察到连通性发生了重大变化，包括异常功能连通性和多个脑区之间的有效连通性。特别是，从左侧中央前回和左侧内侧额上回到左侧 TPJ 的抑制作用与 AVH 的改善密切相关。这些发现强调了经颅磁刺激可以有效调节与精神分裂症幻觉有关的神经通路，从而为其治疗效果提供了神经生物学基础。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Translational Psychiatry PSYCHIATRY-

CiteScore

11.50

自引率

2.90%

发文量

484

审稿时长

23 weeks

期刊介绍： Psychiatry has suffered tremendously by the limited translational pipeline. Nobel laureate Julius Axelrod''s discovery in 1961 of monoamine reuptake by pre-synaptic neurons still forms the basis of contemporary antidepressant treatment. There is a grievous gap between the explosion of knowledge in neuroscience and conceptually novel treatments for our patients. Translational Psychiatry bridges this gap by fostering and highlighting the pathway from discovery to clinical applications, healthcare and global health. We view translation broadly as the full spectrum of work that marks the pathway from discovery to global health, inclusive. The steps of translation that are within the scope of Translational Psychiatry include (i) fundamental discovery, (ii) bench to bedside, (iii) bedside to clinical applications (clinical trials), (iv) translation to policy and health care guidelines, (v) assessment of health policy and usage, and (vi) global health. All areas of medical research, including — but not restricted to — molecular biology, genetics, pharmacology, imaging and epidemiology are welcome as they contribute to enhance the field of translational psychiatry.