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在SCZ症状上rTMS的有效性:从连接组映射的洞察力

Tianyuan Zhu¹, Xiong Jiao¹, Jie Zhou²

¹Neuromodulation Center, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, 200030, Shanghai, PR China.

Psychiatry research

|June 14, 2025

概括

通过准右轨道前皮层,重复性横磁刺激 (rTMS) 有效地减少了精神分裂症的症状. 这种脑刺激方法改善了患者的治疗结果,并确定了与治疗反应相关的关键网络变化.

科学领域:

神经科学是一个神经科学.
精神病学是一个精神病学.
医疗成像医学成像

背景情况:

精神分裂症 (SCZ) 治疗仍然具有挑战性,重复性跨磁刺激 (rTMS) 显示出潜在但不确定的疗效.
了解SCZ中rTMS的神经机制对于优化治疗策略至关重要.

研究的目的:

评估针对SCZ患者右轨道前皮层 (OFC) 的rTMS的疗效.
构建一个连接体地图,将症状与治疗反应相关联.
研究rTMS对静止状态功能连接 (rsFC) 的影响.

主要方法:

98名SCZ患者被随机分配到rTMS (n=53) 或假的 (n=45) 组.
rTMS涉及20个会话 (每天两次),以1Hz的正确OFC为目标,110%的电机值.
症状严重程度 (PANSS,HAMD,HAMA) 和rsfMRI/DWI数据是在治疗前后收集的.

主要成果:

与假装组相比,rTMS组在4周后显示了PANSS得分的显著改善.
机器学习分析确定了与SCZ,抑郁和焦虑症状相关的特定rsFC模式.
突出了默认模式网络 (DMN) 和中央执行网络 (CEN) 的连接性变化.

结论:

针对正确的OFC的RTMS是减少SCZ症状的有效治疗方法.
这项研究提供了对SCZ中rTMS的神经生物学机制的见解.
这些发现表明了新的治疗目标和在SCZ应用rTMS的改进框架.

关键词:

扩散加权成像,机器学习.轨道前皮层轨道前皮层重复性跨脑磁性刺激 (TMS) 是一种重复性跨脑磁性刺激.休息状态功能磁共振成像静止状态功能磁共振成像精神分裂症是一种精神分裂症.

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