precise intervention technology and application of low intensity tus on negative symptoms of schizophrenia

Conditions: Negative Symptoms of Schizophrenia

Summary: based on the current background and our previous studies, tus has been proved that rtus intervention could induce long-term potentiation like (ltp-like) plasticity and neuromodulate the brain cortex in schizophrenia patients. rtus over the left dorsolateral prefrontal cortex (dlpfc) can alleviate the negative symptoms in schizophrenia. in this double-blind, randomized, sham-controlled study, the efficacy of different treatment options and mechanisms of low-intensity rtus on negative symptoms will be investigated.

negative symptoms is a core symptom of schizophrenia related to poor functional outcome which remains largely treatment refractory. prior studies indicated that abnormalities in the prefrontal-temporal circuit and glutamate/gaba imbalances may be the root causes of negative symptoms. transcranial ultrasound stimulation (tus), an emerging non-invasive neuromodulation technique, can modulate neuroplasticity in the prefrontal and temporal cortex. in this double-blind, randomized, sham-controlled study, the efficacy of different treatment options and mechanisms of low-intensity rtus on negative symptoms will be investigated. schizophrenia inpatients with predominant negative symptoms will be recruited and randomly allocated into single-target group (left dlpfc), both-target group (both left dlpfc and right stg) or sham group in ratio of 1:1:1. this study aims to determine the efficacy of tus and to reveal its underlying neural mechanism. meps, teps ,multi-modal mri and rs-eeg will be detected. neuropsychological assessments will also be conducted to develop the optimized treatment strategy. the study points to a novel and promising therapeutic neuromodulation approach that may improve the functional outcome of schizophrenia, which has been the main cause of mental disability.

Eligibility criteria:
inclusion criteria: * meet the dsm-5 diagnostic criteria for schizophrenia or schizoaffective disorder; * age18-50, right-handed, han nationality; * score of at least 1 item from n1 to n7 in panss is ≥4 (moderate or above); * be in a stable condition, received second-generation antipsychotics for at least 4 weeks or more; * written informed consent; exclusion criteria: * current or past neurological illness, severe physical diseases, substance abuse or alcohol dependence, mental retardation, pregnant or lactation; * uncooperative or risky patients with high excitement, stupor, disorder of words and deeds, negative suicide, etc.; * history of mect or other physical therapy within 6 months; * history of epilepsy, or epileptic waves on the baseline eeg; * ruled out share antiepileptic drugs, carbamazepine, valproic acid salt) or larger doses of benzodiazepines drugs (\> 10 mg/day, diazepam clonazepam 2 mg/day, 1 mg/day, alprazolam lorazepam 2 mg/day, midazolam 10 mg/day, 20 mg/day, mr shah diazepam triazolam 0.5 mg/day), avoid the use of chlorine drug, (in principle, to avoid the use of antiepileptic drugs and clonazepam;other antipsychotic drugs, if necessary, remain unchanged during the course of treatment; * contraindications to tus and mri are present.

Keywords: schizophrenia negative symptoms transcranial ultrasound stimulation