TMS Enhancement of Visual Plasticity in Schizophrenia

Study Overview
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Brief Summary
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The major goal is to determine if Transcranial magnetic stimulation (TMS) enhances visual plasticity in schizophrenia. TMS sessions (sham/placebo and real TMS) will be conducted before two MRI scans with two weeks in-between to assess whether TMS stimulation to the visual cortex will enhance visual plasticity in patients with schizophrenia-spectrum disorders. This project may provide a better understanding of the underlying neurobiological mechanisms responsible for learning and memory deficits in schizophrenia.

Detailed Description
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Learning and memory impairments are commonly observed in schizophrenia spectrum disorders. Alterations in long-term potentiation (LTP), a basic mechanism underlying learning and memory, may explain this impairment. This project will assess fMRI visual plasticity, thought to reflect LTP, in participants with and without schizophrenia spectrum disorders. Previous studies have shown that visual plasticity is impaired in schizophrenia. The major goal is to determine if Transcranial magnetic stimulation (TMS) enhances visual plasticity in schizophrenia. Transcranial magnetic stimulation (TMS) provides a non-invasive means for altering brain electrical neural activity. TMS sessions (sham/placebo and real TMS) will be conducted before two MRI scans with two weeks in-between to assess whether TMS stimulation to the visual cortex will enhance visual plasticity in patients with schizophrenia-spectrum disorders. This project may provide a better understanding of the underlying neurobiological mechanisms responsible for learning and memory deficits in schizophrenia.

Official Title
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Testing TMS Enhancement of Visual Plasticity in Schizophrenia

Conditions
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Schizophrenia

Intervention / Treatment
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* Device: Transcranial Magnetic Stimulation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age: 18-65, no neurological illness, head trauma, or major medical illness, not pregnant or nursing, no contraindication for TMS or MRI scanning, no current substance abuse/dependence. Healthy controls will have no DSM-5 diagnosis and no first-degree relatives with a psychotic disorder. Inclusion criteria for patients includes: DSM-5 diagnosis of schizophreniform, schizophrenia or schizoaffective and competent to sign an informed consent, not currently taking other medications that affects brain structure (e.g. steroids), less than 12 months antipsychotic exposure and on the same psychotropic medications for 4 weeks prior to study, not be taking clozapine (due to its effects on NMDA receptors and increase of seizure threshold), clinically stable (i.e. no change in psychotic symptoms for at least 4 weeks). Exclusion Criteria: age outside of 18-65, neurological illness, head trauma, or major medical illness, pregnant or nursing, contraindication for TMS or MRI scanning, current substance abuse/dependence, currently taking medications that affects brain structure (e.g. steroids). Healthy controls with a DSM-5 diagnosis and/or a first-degree relative with a psychotic disorder. Participants with schizophrenia that are not competent to sign an informed consent, have more than 12 months antipsychotic exposure, not on the same psychotropic medications for 4 weeks prior to study, taking clozapine, and not clinically stable (i.e.a change in psychotic symptoms for at least 4 weeks).

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: TMS<br>rTMS | Device: Transcranial Magnetic Stimulation<br>* Transcranial Magnetic Stimulation<br>|
| Sham Comparator: Sham TMS<br>A sham coil will be used. This condition controls for the auditory artifacts induced by rTMS. | Device: Transcranial Magnetic Stimulation<br>* Transcranial Magnetic Stimulation<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| fMRI BOLD response of visual plasticity | fMRI BOLD response of visual plasticity | 4 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| MRS assessment of glutamate | occipital cortical glutamate levels | 4 hours |