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The semantic processing deficit stands as a central feature of cognitive abnormalities in schizophrenia. Both transcranial electrical stimulation (tES) and retrieval practice have been demonstrated as external techniques capable of ameliorating the semantic processing deficit in individuals with schizophrenia. The inquiry examines whether the combined effect of tES and retrieval practice, following tES intervention targeting the left dorsolateral prefrontal cortex (L-DLPFC) in patients with schizophrenia, contributes to the preservation of semantic memory in these individuals.
Investigators plan to recruit 60 patients diagnosed with schizophrenia from hospitals. Treatment is administered by two examiners, each patient receives transcranial electrical stimulation(2mA×20min) with simultaneous learning of word lists. Each participant of each stimulation type was involved in both learning conditions, meaning that all participants completed both retrieval and restudy learning and testing Subsequently, Investigators observed their immediate and delayed memory performance through tests.
Stimulation phase:
In the tDCS group, the anode was placed over the left DLPFC (F3), and the cathode was placed over the contralateral supraorbital area (FP2). A direct current of 2mA was applied for 20 minutes during each stimulation session. In the tACS group, the anode was placed in the F3 region of the left dorsolateral prefrontal cortex (DLPFC), and the cathode was placed in the right supraorbital region (Fp2), and the current used was 2 mA AC at 40 Hz, with a stimulation time of 20 min. In the sham group, the stimulation parameters, including the stimulation site and duration, were identical to those of the anodal group. However, during the 10-second ramp-up and ramp-down periods before and after stimulation, patients were unaware that the current was turned off.
Learning phase:
The experimental procedure followed the classic retrieval practice paradigm, which included a learning phase and a final test phase.
During the experiment, participants were informed that they would learn two lists of words. Subsequently, they might either learn the words again or complete a list recall test, and will be given a final test shortly thereafter. The learning of the retrieval practice list and the restudy list was conducted in a randomly balanced manner. Each word was presented for 5 seconds, with a 500-millisecond interval between words. To avoid providing secondary retrieval cues between examples, all words were shuffled pseudo-randomly within categories. Each list contained 17 words, consisting of 5 examples from each of the 3 experimental categories (15 experimental examples, 2 filler examples). The first and last words presented in each list were filler words, thus controlling for the primacy and recency effects on memory.
For the retrieval practice list, participants underwent two learning sessions and two retrieval sessions (S-T-S-T). During retrieval, participants were instructed to write down all the words they had just remembered within 5 minutes. For the restudy list, participants underwent four study sessions (S-S-S-S). Between each learning cycle, participants completed a 3-minute simple arithmetic task (dispersed attention task).
Testing phase:
Immediate Test: Participants were instructed to recall as many words as possible from the learned lists within 10 minutes after completing all learning tasks.
Delayed Test: Participants were informed to recall as many words as possible from the learned lists within 10 minutes 24 hours later.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| tDCS group | Experimental | In the tDCS group, the anode was placed over the left DLPFC (F3), and the cathode was placed over the contralateral supraorbital area (FP2). A direct current of 2mA was applied for 20 minutes during each stimulation session. |
|
| tACS group | Experimental | In the tACS group, the anode was placed in the F3 region of the left dorsolateral prefrontal cortex (DLPFC), and the cathode was placed in the right supraorbital region (Fp2), and the current used was 2 mA AC at 40 Hz, with a stimulation time of 20 min. |
|
| sham group | Sham Comparator | In the sham group, the stimulation parameters, including the stimulation site and duration, were identical to those of the anodal group. However, during the 10-second ramp-up and ramp-down periods before and after stimulation, patients were unaware that the current was turned off. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| tES-tDCS group | Device | 2mA/20mins/session |
| |
| tES-tACS group |
| Measure | Description | Time Frame |
|---|---|---|
| The correct recall rate of word lists | The correct recall rate of word lists was calculated for each subject by the experimental assistant. | Immediate Test: 5minutes; Delayed Test: 24 hours |
| Adjusted Ratio of Clustering (ARC) | Free recall organization was measured by the Adjusted Ratio of Clustering (ARC) scores. ARC scores range from 1 to 1. A 0 score indicates a level of clustering similar to what would be expected by chance, and a score of 1 implies perfect clustering. Negative values of ARC scores mean atypical and uninterpretable recall patterns. For that reason, negative scores were excluded from analyses. | Immediate Test: 5minutes; Delayed Test: 24 hours |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Xiaofeng Ma, Professor | Northwest Normal University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Northwest Normal University | Lanzhou | Gansu | 730070 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27116682 | Background | Hoy KE, Whitty D, Bailey N, Fitzgerald PB. Preliminary investigation of the effects of gamma-tACS on working memory in schizophrenia. J Neural Transm (Vienna). 2016 Oct;123(10):1205-12. doi: 10.1007/s00702-016-1554-1. Epub 2016 Apr 26. | |
| 30024457 | Background | Sreeraj VS, Shivakumar V, Sowmya S, Bose A, Nawani H, Narayanaswamy JC, Venkatasubramanian G. Online Theta Frequency Transcranial Alternating Current Stimulation for Cognitive Remediation in Schizophrenia: A Case Report and Review of Literature. J ECT. 2019 Jun;35(2):139-143. doi: 10.1097/YCT.0000000000000523. |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Aug 3, 2024 | Aug 7, 2024 | Prot_000.pdf |
| ICF | No | No | Yes | Informed Consent Form | Aug 3, 2024 | Aug 7, 2024 | ICF_001.pdf |
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| Device |
2mA/40Hz/20mins/session |
|
| tES-sham group | Device | 0mA/20mins/session |
|
| 31776375 | Background | Marko M, Cimrova B, Riecansky I. Neural theta oscillations support semantic memory retrieval. Sci Rep. 2019 Nov 27;9(1):17667. doi: 10.1038/s41598-019-53813-y. |
| 23137702 | Background | Javadi AH, Cheng P. Transcranial direct current stimulation (tDCS) enhances reconsolidation of long-term memory. Brain Stimul. 2013 Jul;6(4):668-74. doi: 10.1016/j.brs.2012.10.007. Epub 2012 Oct 31. |
| 31550617 | Background | Crossman M, Bartl G, Soerum R, Sandrini M. Effects of transcranial direct current stimulation over the posterior parietal cortex on episodic memory reconsolidation. Cortex. 2019 Dec;121:78-88. doi: 10.1016/j.cortex.2019.08.009. Epub 2019 Aug 28. |
| 9162204 | Background | McKay AP, McKenna PJ, Bentham P, Mortimer AM, Holbery A, Hodges JR. Semantic memory is impaired in schizophrenia. Biol Psychiatry. 1996 Jun 1;39(11):929-37. doi: 10.1016/0006-3223(95)00250-2. |