Abnormalities in cortical excitability and plasticity have been considered to underlie the pathophysiology of schizophrenia. Transcranial magnetic stimulation combined with electroencephalography (TMS-EEG) can provide a direct evaluation of cortical responses to TMS. Here, we employed TMS-EEG to investigate cortical responses to orbitofrontal cortex (OFC) stimulation in schizophrenia. In total, we recruited 92 drug-naïve patients with first-episode schizophrenia and 51 age- and sex-matched healthy individuals. For each participant, one session of 1-Hz repetitive TMS (rTMS) was delivered to the right OFC, and TMS-EEG data were obtained to explore the change in cortical-evoked activities before and immediately after rTMS during the eyes-closed state. The MATRICS Consensus Cognitive Battery was used to assess neurocognitive performance. The cortical responses indexed by global mean field amplitudes (i.e., P30, N45, and P60) were larger in patients with schizophrenia than in healthy control participants at baseline. Furthermore, after one session of 1-Hz rTMS over the right OFC, the N100 amplitude was significantly reduced in the healthy control group but not in the schizophrenia group. In the healthy control participants, there was a significant correlation between modulation of P60 amplitude by rTMS and working memory; however, this correlation was absent in patients with schizophrenia. Aberrant global cortical responses following right OFC stimulation were found in patients with drug-naïve first-episode schizophrenia, supporting its significance in the primary pathophysiology of schizophrenia.

中文翻译：

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未经药物治疗的精神分裂症患者在眶额皮质刺激后异常的整体皮质反应：同步经颅磁刺激-脑电图研究


皮质兴奋性和可塑性的异常被认为是精神分裂症病理生理学的基础。经颅磁刺激与脑电图 (TMS-EEG) 相结合可以直接评估皮质对 TMS 的反应。在这里，我们采用 TMS-EEG 来研究精神分裂症患者对眶额皮质 (OFC) 刺激的皮质反应。我们总共招募了 92 名未曾用药的首发精神分裂症患者和 51 名年龄和性别匹配的健康个体。对于每位参与者，将一次 1 Hz 重复 TMS (rTMS) 传输到右侧 OFC，并获取 TMS-EEG 数据，以探索闭眼状态下 rTMS 之前和之后皮质诱发活动的变化。 MATRICS 共识认知电池用于评估神经认知表现。基线时，精神分裂症患者的以全局平均场振幅（即 P30、N45 和 P60）为索引的皮质反应比健康对照参与者更大。此外，在右侧 OFC 上进行一次 1 Hz rTMS 治疗后，健康对照组的 N100 振幅显着降低，但精神分裂症组则没有显着降低。在健康对照参与者中，rTMS 对 P60 振幅的调节与工作记忆之间存在显着相关性；然而，精神分裂症患者不存在这种相关性。在未接受药物治疗的首发精神分裂症患者中发现了右侧 OFC 刺激后异常的整体皮质反应，这支持了其在精神分裂症的主要病理生理学中的重要性。