Intermittent Theta Burst Stimulation (iTBS) as an Optimal Treatment for Schizophrenia Risk Decision: an ERSP Study

Objective: People with schizophrenia have serious impairments in social function, especially in decision-making ability. Transcranial magnetic stimulation modified intermittent theta burst transcranial magnetic stimulation (iTBS) has been shown to regulate the functional connection of brain networks. Our study explored the therapeutic effect of iTBS on decision-making disorders in schizophrenia. Methods: Participants were pseudorandomized and assigned to iTBS (n = 16) or sham (n = 16) group. iTBS group was administered 1,800 pulses on the target of the left dorsol lateral prefrontal cortex (L-DLPFC) per day for 14 consecutive days. We compared Iowa gambling task performance and associated event-related spectral perturbation results (ERSP) among two groups. Results: The results show that participants' performance in the high-lose in the iTBS group had stronger stimulation of theta spectral power than those in the sham group. Specifically, we found that under high-risk conditions, compared with the control group, the iTBS group showed significant activation of the theta spectrum power in the FPZ, FZ, FCZ, and CZ regions after treatment. Conclusions: Our results provide evidence that long-term iTBS stimulation effectively improves the decision-making ability of schizophrenia. After receiving negative feedback, patients can turn to safety options. These findings support that iTBS may be a potential treatment for clinical decision-making disorders.