AUTHOR=Jiang Jiangling , Li Jin , Xu Yuanhong , Zhang Bin , Sheng Jianhua , Liu Dengtang , Wang Wenzheng , Yang Fuzhong , Guo Xiaoyun , Li Qingwei , Zhang Tianhong , Tang Yingying , Jia Yuping , Daskalakis Zafiris J. , Wang Jijun , Li Chunbo 

TITLE=Magnetic Seizure Therapy Compared to Electroconvulsive Therapy for Schizophrenia: A Randomized Controlled Trial

JOURNAL=Frontiers in Psychiatry

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.770647

DOI=10.3389/fpsyt.2021.770647

ISSN=1664-0640

ABSTRACT=<p><bold>Background:</bold> Magnetic seizure therapy (MST) is a potential alternative to electroconvulsive therapy (ECT). However, reports on the use of MST for patients with schizophrenia, particularly in developing countries, which is a main indication for ECT, are limited.</p><p><bold>Methods:</bold> From February 2017 to July 2018, 79 inpatients who met the DSM-5 criteria for schizophrenia were randomized to receive 10 sessions of MST (43 inpatients) or ECT (36 inpatients) over the course of 4 weeks. At baseline and 4-week follow-up, the Positive and Negative Syndrome Scale (PANSS) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) were used to assess symptom severity and cognitive functions, respectively.</p><p><bold>Results:</bold> Seventy-one patients who completed at least half of the treatment protocol were included in the per-protocol analysis. MST generated a non-significant larger antipsychotic effect in terms of a reduction in PANSS total score [<italic>g</italic> = 0.17, 95% confidence interval (CI) = −0.30, 0.63] and response rate [relative risk (RR) = 1.41, 95% CI = 0.83–2.39]. Twenty-four participants failed to complete the cognitive assessment as a result of severe psychotic symptoms. MST showed significant less cognitive impairment over ECT in terms of immediate memory (<italic>g</italic> = 1.26, 95% CI = 0.63–1.89), language function (<italic>g</italic> =1.14, 95% CI = 0.52–1.76), delayed memory (<italic>g</italic> = 0.75, 95% CI = 0.16–1.35), and global cognitive function (<italic>g</italic> = 1.07, 95% CI = 0.45–1.68). The intention-to-treat analysis generated similar results except for the differences in delayed memory became statistically insignificant. Better baseline cognitive performance predicted MST and ECT response.</p><p><bold>Conclusions:</bold> Compared to bitemporal ECT with brief pulses and age-dose method, MST had similar antipsychotic efficacy with fewer cognitive impairments, indicating that MST is a promising alternative to ECT as an add-on treatment for schizophrenia.</p><p><bold>Clinical Trial Registration:</bold> ClinicalTrials.gov, identifier: NCT02746965.</p>