Neuromodulation of Social Cognitive Circuitry in People With Schizophrenia Spectrum Disorders
Condition: Schizophrenia; Schizoaffective Disorder; Schizophreniform Disorders
MeSH terms: Schizophrenia; Psychotic Disorders
Study type: Interventional

Summary: 
      In this study, the investigators will be examining the effects of repetitive transcranial
      magnetic stimulation (rTMS) and intermittent theta burst stimulation (iTBS) on social
      cognitive impairments in individuals with schizophrenia spectrum disorders. Participants will
      be chosen by chance to receive either active rTMS stimulation, active iTBS stimulation, sham
      rTMS, or sham iTBS. The investigators predict that active 10Hz and iTBS stimulation will
      improve social cognitive impairments compared to sham stimulation. We aim to identify which
      type of active stimulation is most effective at inducing changes social cognition brain
      circuitry and secondarily which type of active stimulation is best tolerated and most
      effective at inducing changes in social cognitive performance.
    

Detailed description: 
      This study is a randomized, double blind, sham controlled study which aims to use repetitive
      transcranial magnetic stimulation (rTMS), a form of neuromodulation, to target the neural
      circuitry of social cognitive (SCog) impairments in people with Schizophrenia Spectrum
      Disorders. We will randomize 60 people with SSDs to three groups: 20 to a conventional form
      of rTMS (i.e. 10 Hz rTMS); 20 to intermittent theta burst stimulation (iTBS); and 20 to
      either sham 10Hz rTMS stimulation or sham iTBS. We will determine whether these treatments
      can change the functional connectivity of key SCog brain circuits by targeting a brain region
      known as the dorsomedial prefrontal cortex (DMPFC). Since each person's anatomical and
      functional brain profile is slightly different, we will optimize the orientation and location
      of coil placement in each individual. Overall, our proposal follows a target engagement
      framework, including specifics regarding testing brain stimulation parameters (i.e., rTMS vs.
      iTBS) and individualizing coil placement for optimal targeting. We anticipate that active 10
      Hz rTMS or iTBS will demonstrate target engagement compared to sham, and potentially
      ameliorate SCog deficits in people with SSDs. Our primary goal is to identify which treatment
      best induces change in SCog brain circuitry and secondarily which treatment is best tolerated
      and induces changes in social cognitive performance.
    

Intervention name(s): Repetitive Transcranial Magnetic Stimulation; Repetitive Transcranial Magnetic Stimulation (Intermittent Theta Burst Stimulation); Repetitive Transcranial Magnetic Stimulation (Sham)
Intervention type(s): Device; Device; Device
Intervention description(s): The present study aims to use both repetitive transcranial magnetic stimulation (rTMS) and intermittent theta burst stimulation (iTBS), safe and effective forms of neuromodulation, to target the neural circuitry of social cognitive (SCog) impairments in people with SSDs. Treatment sessions will be administered five days per week for two weeks.
Other Name: MagPro X100 or R30 (Medtronic A/S. Copenhagen, Denmark) equipped with a Cool-B70 A/P coil and Qooler fluid-cooling device (MagVenture, Farum, Denmark), positioned under MRI guidance using the Brainsight neuronavigation system (Rogue Resolutions, Montreal, Canada) or Localite (Localite GmbH, Bonn, Germany); The present study aims to use both repetitive transcranial magnetic stimulation (rTMS) and intermittent theta burst stimulation (iTBS), safe and effective forms of neuromodulation, to target the neural circuitry of social cognitive (SCog) impairments in people with SSDs. Treatment sessions will be administered five days per week for two weeks.
Other Name: MagPro X100 or R30 (Medtronic A/S. Copenhagen, Denmark) equipped with a Cool-B70 A/P coil and Qooler fluid-cooling device (MagVenture, Farum, Denmark), positioned under MRI guidance using the Brainsight neuronavigation system (Rogue Resolutions, Montreal, Canada) or Localite (Localite GmbH, Bonn, Germany); Other Name: MagPro X100 or R30(Medtronic A/S. Copenhagen, Denmark) equipped with a Cool-B70 A/P coil and Qooler fluid-cooling device (MagVenture, Farum, Denmark), positioned under MRI guidance using the Brainsight neuronavigation system (Rogue Resolutions, Montreal, Canada) or Localite (Localite GmbH, Bonn, Germany)
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment