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KMID : 0897520170220020047
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Journal of Korean Association of Social Psychiatry
2017 Volume.22 No. 2 p.47 ~ p.56
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Short-Term Response Pattern of Serum Brain-Derived Neurotrophic Factor to Repetitive Transcranial Magnetic Stimulation and Brain Neuroplasticity in Patients with Chronic Schizophrenia
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Oh Ji-Young
Hwang Tae-Young
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Abstract
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Objective : For evidence-based activities for psychiatric rehabilitation in patients with chronic schizophrenia, it is necessary to investigate the capacity and characteristics in the brain neuroplasticity of patients with chronic schizophrenia. This study aimed at examining short-term response pattern of serum Brain-Derived Neurotrophic Factor (sBDNF) to the quantified stimuli applied with repetitive Transcranial Magnetic Stimulation (rTMS).
Methods : Right-handed 20 inpatients with chronic schizophrenia were recruited. The handedness was assessed using Edinburgh Handedness Inventory. Consecutive 10-weekday sessions with 20Hz rTMS (a total of 20,000 stimuli) were applied over the left dorsolateral prefrontal cortex at 100% of motor threshold. There was no change in the medication for at least 2 weeks before enrollment and 4 weeks thereafter. Serum Prolactin level was co-measured for the reference of stable medication. Primary outcome measure was the change in the mean concentration of duplicated sBDNF (pg/ml). Clinical severity or change was measured using the Clinical Global Impression scale (CGI) and the Positive and Negative Symptom Scale (PANSS).
Results : Eighteen participants (male, 10 ; female, 8) completed the study. The chlorpromazine equivalent (CPZE) of antipsychotics were 1,325.69 (761.58) mg. Baseline CGI-severity and total PANSS score were 4.61 (0.50) and 68.44 (6.05), respectively. In the level of sBDNF just after 2-week rTMS sessions, the differences from baseline were statistically significant (p=0.038). At 2 weeks after the completion of rTMS sessions, however, the significance in the level of sBDNF was not manifest (p=0.185).
Conclusion : The findings of this study showed that the neuroplastic capacity is limited in the brain of patients with chronic schizophrenia and persistent therapeutic stimuli over certain level in activities for psychiatric rehabilitation may be necessary due to the absence of cumulative effect, suggesting positive and negative implications to psychiatric rehabilitation in patients with chronic schizophrenia.
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KEYWORD
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Chronic schizophrenia, Neuroplasticity, Serum BDNF, rTMS, Psychiatric rehabilitation
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