Enhancing visual working memory in schizophrenia: effects of frontoparietal theta tACS in low-performing patients.

IF 3 Q2 PSYCHIATRY Schizophrenia (Heidelberg, Germany) Pub Date : 2024-10-26 DOI:10.1038/s41537-024-00518-5
Jiunn-Kae Wang, Prangya Parimita Sahu, Hsiao-Lun Ku, Yu-Hui Lo, Ying-Ru Chen, Che-Yin Lin, Philip Tseng
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Abstract

Schizophrenia is a complex neuro-psychiatric disorder including positive symptoms, negative symptoms, and cognitive deficits. A key cognitive dysfunction in schizophrenia is a deficit in visual working memory (VWM). VWM involves three distinct stages: encoding, maintenance, and retrieval. The deficit in any one stage would produce the same symptom (i.e., poor VWM), although their causes are not the same. In this study, we used a retro-cue VWM task that provides helpful cues at different stages: early in maintenance (early cue), late in maintenance (late cue), or during retrieval (retrieval cue). This modification would help "tag" or identify the cognitive stage(s) most responsible for impaired VWM performance in schizophrenia. Additionally, we took advantage of this tagging feature and applied 6 Hz transcranial alternating current stimulation (tACS) over the right dorsolateral prefrontal cortex (DLPFC) and right posterior parietal cortex (PPC)-which has previously been shown to enhance VWM in low-performing healthy individuals-to examine whether tACS would improve a specific stage or all stages of VWM processing in schizophrenia. We observed that cues significantly enhanced performance in low-performing patients, who benefited equally from early and late maintenance cues, but not from retrieval cues. These low-performers also responded well to theta tACS in their overall VWM performance as opposed to a specific VWM stage. No improvement effect was observed in high-performing patients for both retro cue and tACS. Together, our data suggest that 1) low-performing patients' VWM deficits likely stem from poor memory consolidation rather than retrieval, 2) right frontoparietal theta tACS can improve low-performing patients' VWM performance, and 3) such facilitatory tACS effect is not selective of a specific VWM stage and thus is likely driven by an improvement in overall visual attention.

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增强精神分裂症患者的视觉工作记忆:前顶叶θ tACS 对低效患者的影响。
精神分裂症是一种复杂的神经精神疾病,包括阳性症状、阴性症状和认知障碍。精神分裂症的一个主要认知功能障碍是视觉工作记忆(VWM)缺陷。视觉工作记忆包括三个不同的阶段:编码、维持和检索。任何一个阶段的缺陷都会产生相同的症状(即视觉工作记忆差),尽管它们的原因并不相同。在本研究中,我们使用了一种逆向线索 VWM 任务,在不同阶段提供有用的线索:维持早期(早期线索)、维持晚期(晚期线索)或检索期间(检索线索)。这种修改将有助于 "标记 "或识别精神分裂症患者在哪个(些)认知阶段最容易出现 VWM 能力受损。此外,我们还利用这一标记功能,在右侧背外侧前额叶皮层(DLPFC)和右侧后顶叶皮层(PPC)上施加 6 Hz 经颅交变电流刺激(tACS)--这在以前的研究中已被证明能提高成绩较差的健康人的 VWM--来研究 tACS 是否会改善精神分裂症患者 VWM 处理的特定阶段或所有阶段。我们观察到,线索能显著提高低表现患者的表现,他们从早期和晚期维持线索中同样受益,但从检索线索中却没有受益。与特定的 VWM 阶段相比,这些表现较差的患者在整体 VWM 表现上对 theta tACS 也有很好的反应。在成绩优秀的患者中,没有观察到逆向线索和 tACS 的改善效果。总之,我们的数据表明:1)低表现患者的VWM缺陷可能源于记忆巩固能力差,而非检索能力差;2)右额顶叶θ tACS可改善低表现患者的VWM表现;3)这种促进性tACS效应对特定的VWM阶段没有选择性,因此可能是由整体视觉注意力的改善所驱动的。
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