This study sought to determine the moderators in the treatment effect of repetitive transcranial magnetic stimulation (rTMS) on negative symptoms in schizophrenia. weeks Mouse monoclonal to CD41.TBP8 reacts with a calcium-dependent complex of CD41/CD61 ( GPIIb/IIIa), 135/120 kDa, expressed on normal platelets and megakaryocytes. CD41 antigen acts as a receptor for fibrinogen, von Willebrand factor (vWf), fibrinectin and vitronectin and mediates platelet adhesion and aggregation. GM1CD41 completely inhibits ADP, epinephrine and collagen-induced platelet activation and partially inhibits restocetin and thrombin-induced platelet activation. It is useful in the morphological and physiological studies of platelets and megakaryocytes.
of treatment treatment site at the left dorsolateral prefrontal cortex (DLPFC) and a 110% motor threshold (MT) were found to be the best rTMS parameters for the treatment of negative symptoms. The results of our meta-analysis suggest that rTMS is an effective treatment option for negative symptoms in schizophrenia. The moderators of rTMS on negative symptoms included duration of illness stimulus frequency duration of illness position and intensity of treatment as well as the type of outcome measures used. HDAC-42 or test values that could be used HDAC-42 to calculate effect size. For studies that met inclusion criteria but did not report these statistics the authors were contacted for this information. 2.3 Data extraction For each study we recorded the following variables with a semi-structured form: (1) name of the first author and year of publication; (2) study design; (3) demographic and clinical characteristics (sample size sex mean age mean DOI and percentage of use of FGA); (4) means and S.D.s of the selected outcome measure at baseline and after treatment for the active (uncontrolled studies) and sham groups (controlled studies); if means and S.D.s were not available or test values were collected; (5) means and S.D.s of the baseline clinical status; and (6) TMS protocol [number of patients submitted to active/sham stimulation frequency intensity (% of motor threshold) number of sessions total stimulus strength sham coil position]. 2.4 Effect size calculation All our analyses were performed using the Comprehensive Meta-Analysis software package (Borenstein et al. 2005 Effect sizes were calculated as Cohen’s (Cohen 1988 HDAC-42 which is the difference in group means divided by the pooled standard HDAC-42 deviation based either upon pre- and post-treatment values of one group (active group) within each study or comparison of the mean changes in HDAC-42 pre- to post-treatment ratings of two independent groups (sham and active rTMS) in controlled trials using the means and S.D.s. An individual effect size for each study was calculated and a combined (pool weighted) effect size was obtained using both random and fixed effect models. When means and S.D.s were not reported in a study or statistics. statistics tests the null hypothesis that there is no dispersion across effect sizes and a significant = 0.085]. We then used the active arms of the controlled studies for further analysis. In this part 10 studies were included. The random effects model showed a pooled effect size of 0.625 [95% confidence interval (CI): 0.228 1.021 = 0.002] (see Fig. 2). The test for heterogeneity showed significant heterogeneity between studies (Q9 χ2 = 30.115 < 0.001). The fail-safe number of studies was 41. These results indicated that rTMS induced a significant and moderate reduction in negative symptoms in patients receiving active treatment. To explore the placebo effect we also analyzed the mean weighted effect size of pre-post sham rTMS using the sham arm in controlled studies. The random effects model showed a pooled effect size of 0.396 (95% CI: 0.158 0.677 = 0.002). The test for heterogeneity did not show significant heterogeneity between studies (Q7 χ2 = 10.336 = 0.170). The fail-safe number of studies was 16. These results indicated that there was a small placebo effect of rTMS treatment on negative symptoms. Fig. 2 Pooled effect size (before versus after treatment) for studies of rTMS effects on negative symptoms (random effect model). 3.2 Pooled effect size of placebo versus active treatment The mean weighted effect size was 0.532 (95% CI: 0.191 0.874 = 0.002) when we compared mean changes between active rTMS and sham treatment using the random effects model (see Fig. 3). The test for heterogeneity showed significant heterogeneity between studies (Q12 χ2 = 24.600 = 0.017). The fail-safe number was 41. These results indicated that active rTMS compared with sham rTMS induced a significant and moderate improvement in negative symptoms. Fig. 3 Pooled effect size (placebo versus active treatment) for studies of rTMS effects on negative symptoms (random effect model). HDAC-42 3.3 Moderators of the treatment effect of rTMS Due to the small number of studies we were unable to run meta-regressions to examine the effects of possible moderators such as assessment tools baseline PANSS score baseline severity of negative symptoms DOI.