Efficacy and Mechanisms of Low-intensity Focused Ultrasound on Negative Symptoms in Patients With Schizophrenia

Study Overview
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Brief Summary
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Based on our research background, we hypothesize that LIFUS has neuromodulation effects on brain cortex and the active LIFUS on left-DLPFC would improve negative symptoms in schizophrenia patients. It would firstly verify the safety of LIFUS on human as well. The multimodal MRI will be contributed to investigate the possible mechanism of negative symptoms.

Detailed Description
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Firstly, we plan to explore the short-term effects of LIFUS on cortical excitability by detecting the MEP amplitude. 40 patients and relatively well matched healthy-control would be enrolled. After MEP detection and baseline evaluations, the two groups will be treated with one-single intervention on the primary motor cortex. The cognitive function and MEP amplitude will be assessed respectively at the moment, after 15 minutes and 30 minutes. Then, it is a randomized double-blind sham-controlled LIFUS intervention trial in schizophrenia patients. After screening and baseline evaluations, the 40 patients with schizophrenia will be treated with active LIFUS or sham stimulation for 3 weeks on the left DLPFC. The multimodal MRI will be acquired. Clinical symptoms and cognitive function will be assessed respectively at baseline, at the end of fifth treatments and after the end of the treatment.

Official Title
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Efficacy and Mechanisms of Low-intensity Focused Ultrasound on Negative Symptoms in Patients With Schizophrenia

Conditions
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Negative Symptoms of Schizophrenia

Intervention / Treatment
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* Device: Low-intensity Focused Ultrasound(LIFUS)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria (patients): Meet the DSM-5 diagnostic criteria for schizophrenia or schizoaffective disorder; Age18-50, right-handed, Han nationality; the score of at least 1 item from N1 to N7 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 (patients): 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.; A history of MECT or other physical therapy within 6 months; A 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 LIFUS and MRI are present.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 50 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: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: LIFUS-left DLPFC<br>20 patients will be treated with active LIFUS for 3 weeks on the left DLPFC. | Device: Low-intensity Focused Ultrasound(LIFUS)<br>* Patients with schizophrenia will be treated with active LIFUS or sham stimulation for 3 weeks on the left DLPFC.<br>|
| Sham Comparator: LIFUS-SHAM<br>20 patients will be treated with sham LIFUS for 3 weeks on the left DLPFC. | Device: Low-intensity Focused Ultrasound(LIFUS)<br>* Patients with schizophrenia will be treated with active LIFUS or sham stimulation for 3 weeks on the left DLPFC.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Clinical Symptoms-PANSS | Change from baseline in Positive and Negative Syndrome Scale(PANSS) | baseline and 15 days | 
| Clinical Symptoms-SANS | Change from baseline in the Scale for the Assessment of Negative Symptoms(SANS) | baseline and 15 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cognitive Function | Change from baseline in the Brief Cognition Test (C-BCT) | baseline, after the fifth treatment and 15 days | 
| Change of brain neuroimaging | Brain structure, Resting-state fMRI data, Arterial Spin Labeling(ASL), 1H-MRS in DLPFC are acquired. | baseline, fifth treatment and 15th treatment | 
| Cortex Excitability | MEP amplitude | baseline，the moment after the intervention, after 15 minutes and 30 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Low-intensity Focused Ultrasound, Negative Symptoms of Schizophrenia Patients