PMID- 36841956 OWN - NLM STAT- MEDLINE DCOM- 20230706 LR - 20240227 IS - 1745-1701 (Electronic) IS - 0586-7614 (Print) IS - 0586-7614 (Linking) VI - 49 IP - 4 DP - 2023 Jul 4 TI - Visuospatial Learning Selectively Enhanced by Personalized Transcranial Magnetic Stimulation over Parieto-Hippocampal Network among Patients at Clinical High-Risk for Psychosis. PG - 923-932 LID - 10.1093/schbul/sbad015 [doi] AB - BACKGROUND AND HYPOTHESIS: Cognitive deficits in visuospatial learning (VSL) are highly associated with an increased risk of developing psychosis among populations with clinical high risk (CHR) for psychosis. Early interventions targeting VSL enhancement are warranted in CHR but remain rudimentary. We investigated whether personalized transcranial magnetic stimulation (TMS) over the left parieto-hippocampal network could improve VSL performance in CHR patients and if it could reduce the risk of psychosis conversion within 1 year. STUDY DESIGN: Sixty-five CHR patients were randomized to receive active or sham TMS treatments using an accelerated TMS protocol, consisting of 10 sessions of 20 Hz TMS treatments within 2 days. TMS target was defined by individual parieto-hippocampal functional connectivity and precisely localized by individual structural magnetic resonance imaging. VSL performance was measured using Brief Visuospatial Memory Test-Revised included in measurement and treatment research to improve cognition in schizophrenia consensus cognitive battery (MCCB). Fifty-eight CHR patients completed the TMS treatments and MCCB assessments and were included in the data analysis. STUDY RESULTS: We observed significant VSL improvements in the active TMS subgroup (Cohen's d = 0.71, P < .001) but not in the sham TMS subgroup (Cohen's d = 0.07, P = .70). In addition, active TMS improved the precision of VSL performance. At a 1-year follow-up, CHR patients who received active TMS showed a lower psychosis conversion rate than those who received sham TMS (6.7% vs 28.0%, chi2 = 4.45, P = .03). CONCLUSIONS: Our findings demonstrate that personalized TMS in the left parieto-hippocampal network may be a promising preventive intervention that improves VSL in CHR patients and reduces the risk of psychosis conversion at follow-up. CI - (c) The Author(s) 2023. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com. FAU - Tang, Yingying AU - Tang Y AD - Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Xu, Lihua AU - Xu L AD - Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Zhu, Tianyuan AU - Zhu T AD - Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Cui, Huiru AU - Cui H AD - Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Qian, Zhenying AU - Qian Z AD - Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Kong, Gai AU - Kong G AD - Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Tang, Xiaochen AU - Tang X AD - Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Wei, Yanyan AU - Wei Y AD - Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Zhang, Tianhong AU - Zhang T AUID- ORCID: 0000-0002-5379-7119 AD - Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Hu, Yegang AU - Hu Y AD - Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Sheng, Jianhua AU - Sheng J AD - Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Wang, Jijun AU - Wang J AD - Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. AD - Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China. AD - CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai, China. LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - Schizophr Bull JT - Schizophrenia bulletin JID - 0236760 SB - IM MH - Humans MH - Transcranial Magnetic Stimulation/methods MH - *Psychotic Disorders MH - *Schizophrenia/complications/therapy MH - *Cognition Disorders MH - *Cognitive Dysfunction/etiology/prevention & control PMC - PMC10318868 OTO - NOTNLM OT - Brief Visuospatial Memory Test-Revised OT - MATRICS Consensus Cognitive Battery OT - accelerated TMS protocol OT - clinical high risk for psychosis OT - risk of developing psychosis EDAT- 2023/02/27 06:00 MHDA- 2023/07/06 06:42 PMCR- 2024/02/26 CRDT- 2023/02/26 03:53 PHST- 2023/07/06 06:42 [medline] PHST- 2023/02/27 06:00 [pubmed] PHST- 2023/02/26 03:53 [entrez] PHST- 2024/02/26 00:00 [pmc-release] AID - 7058426 [pii] AID - sbad015 [pii] AID - 10.1093/schbul/sbad015 [doi] PST - ppublish SO - Schizophr Bull. 2023 Jul 4;49(4):923-932. doi: 10.1093/schbul/sbad015.