四川精神卫生2026，Vol.39Issue(4)：295-302,8.DOI:10.11886/scjsws20260422002
间歇性θ爆发刺激治疗精神分裂症持续性阴性症状的效果及其与外周血炎症指标变化的关系
Efficacy of intermittent theta burst stimulation therapy in treating persistent negative symptoms of schizophrenia and its relationship with changes in peripheral blood inflammatory markers
摘要
Abstract
Background Negative symptoms of schizophrenia impose a substantial burden on society,and the current antipsychotic drugs have limited efficacy in treating these symptoms.Intermittent theta burst stimulation(iTBS),as a novel neuromodulation technique,shows potential therapeutic promise.However,the evidence for its efficacy in treating negative symptoms of schizophrenia and its relationship with associated immuno-inflammatory changes remain to be further elucidated.Objective To investigate the efficacy of iTBS targeting the left dorsolateral prefrontal cortex(L-DLPFC)on persistent negative symptoms of schizophrenia,and to analyze its relationship with changes in peripheral blood inflammatory markers,so as to provide references for the clinical application of iTBS in treating persistent negative symptoms and to offer clues for further research into its potential biological mechanisms.Methods A randomized,double-blind,sham-controlled clinical trial was conducted.A total of 60 patients with schizophrenia who were hospitalized at Xuzhou Oriental Peopple's Hospital from February 20,2024 to May 10,2025 were consecutively enrolled.All patients met the diagnostic criteria for schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders,fifth edition(DSM-5)and fulfilled the criteria for persistent negative symptoms.Participants were randomly assigned into the study group and the control group,with 30 patients in each group.The two groups respectively received 20 sessions of either active iTBS or sham stimulation over a 4-week period.Clinical symptoms were assessed using the Positive and Negative Syndrome Scale(PANSS)at the baseline,the end of treatment,and 3 months after treatment.Peripheral blood inflammatory markers were measured at the baseline and at the end of treatment,including white blood cell count,platelet count,neutrophil count,lymphocyte count,and monocyte count,the neutrophil-to-lymphocyte ratio(NLR),monocyte-to-lymphocyte ratio(MLR),and platelet-to-lymphocyte ratio(PLR)were also calculated.A linear mixed model was used to compare PANSS scores between the two groups.Spearman correlation analysis was performed to examine the association between reductions in inflammatory markers at the end of treatment and reductions in PANSS negative symptom subscale scores,with body mass index(BMI)and chlorpromazine-equivalent dose as covariates.Results ①The time-group interaction effect for the PANSS negative symptom subscale score was statistically significant(F=5.410,P<0.01).At the end of treatment and 3 months after treatment,the study group had significantly lower scores on the PANSS negative symptom subscale than the control group(P<0.01).② At the end of treatment,group differences in reduction scores for neutrophil count,NLR,and PLR were significant(Z=-2.262,-2.048,-2.070,P<0.05).However,after FDR correction,the between-group differences in reductions in peripheral blood inflammatory markers were no longer statistically significant(P>0.05).③ After adjusting for BMI and chlorpromazine equivalents,the reduction in PANSS negative symptom subscale scores was positively correlated with the reduction in neutrophil count in the study group(rs=0.382,P=0.045).Conclusion iTBS targeting the L-DLPFC may be beneficial in improving persistent negative symptoms of schizophrenia,and its clinical efficacy may be associated with changes in neutrophil count.关键词
精神分裂症/持续性阴性症状/间歇性θ爆发刺激/炎症Key words
Schizophrenia/Persistent negative symptoms/Intermittent theta burst stimulation/Inflammation分类
医药卫生引用本文复制引用
陈思思,仝书严,童柱,李皖陇,史汉青,姚蕾,周超,张向荣..间歇性θ爆发刺激治疗精神分裂症持续性阴性症状的效果及其与外周血炎症指标变化的关系[J].四川精神卫生,2026,39(4):295-302,8.基金项目
国家自然科学基金项目(项目名称:精神分裂症阴性症状经颅磁刺激治疗效应遗传影像学机制学习预测模型研究,项目编号:82371510) （项目名称:精神分裂症阴性症状经颅磁刺激治疗效应遗传影像学机制学习预测模型研究,项目编号:82371510）
江苏省社会发展基金项目(项目名称:基于机器学习的精神分裂症阴性症状转归预测关键技术研究及应用,项目编号:BE2023668)www.chictr.org.cn注册号:ChiCTR2500101060 [Funded by National Natural Science Foundation of China(number,82371510) （项目名称:基于机器学习的精神分裂症阴性症状转归预测关键技术研究及应用,项目编号:BE2023668）
Social Development Project of Jiangsu Province(number,BE2023668).www.chictr.org.cn number,ChiCTR2500101060] （number,BE2023668）
