Effects of Accelerated Intermittent Theta Burst Stimulation Targeting the Superior Frontal Gyrus on Cognitive...

Cognitive impairment is a core symptom of schizophrenia, which contributes significantly to poor prognosis. However, effective treatments for cognitive deficits remain limited. Accelerated intermittent theta burst stimulation (aiTBS) targeting the superior frontal gyrus (SFG) is a promising intervention for cognitive impairment in schizophrenia, although evidence remains scarce.

This double-blind, randomized, sham-controlled study involved 66 individuals with schizophrenia who were randomly assigned to receive either active (n = 33) or sham (n = 33) aiTBS for 30 sessions (3 times daily for 10 consecutive days). Cognitive improvement was assessed using the MATRICS Consensus Cognitive Battery (MCCB) and additional neuropsychological tests. Voxelwise whole-brain functional connectivity (FC) and spectral dynamic connectivity modeling were also evaluated.

Compared with the sham group, the active aiTBS group exhibited significantly greater improvements in the MCCB composite score, speed of processing, verbal learning, and reasoning/problem solving. After 40 days, the active aiTBS group showed a significantly increased FC between the left SFG and the bilateral middle occipital gyrus and cuneus compared to the sham group, and this increase was positively correlated with improvement in MCCB performance. Additionally, directed FC from the left SFG to the left and right middle occipital gyrus was observed.

Collectively, these findings suggest that aiTBS may improve cognitive function in schizophrenia, potentially through alterations in functional connectivity.