Grant: Project Grant

Schizophrenia is a severe psychiatric disorder that causes a substantial burden to patients, their families, and society as a whole. Unfortunately, an estimated 40% of patients attain only a partial response and 10% show no response with conventional antipsychotic treatment. Patients that fail to respond to conventional antipsychotic medication are said to have treatment resistant schizophrenia (TRS). Neuromodulation therapies involve the use of technologies that act directly on the nervous system to alter or modulate nerve activity by applying electrical or magnetic stimulation to the brain. Electroconvulsive therapy (ECT) is one of the oldest neuromodulation therapies and continues to serve as a useful management option in resistant mental illnesses. For TRS, ECT is safe and effective in combination with standard antipsychotic therapy. However, ECT is a very limited treatment option due to the feared complication of memory side effects amongst patients. Magnetic seizure therapy (MST) is a newer neuromodulation treatment that induces therapeutic seizures through the use of high frequency repetitive transcranial magnetic stimulation. MST may have a favorable clinical benefit in terms of the risks of cognitive side-effects and is also free of the heavy burden of stigma that accompanies ECT. Thus, MST could potentially offer a cognition-sparing and clinically useful alternative to ECT for treatment-resistant illnesses. The overall aim of this project is to compare the efficacy of MST to ECT with regards to psychotic symptoms and adverse cognitive side-effects in patients with TRS. If our results indicate that MST is as effective as ECT in reducing psychotic symptoms while sparing cognitive function; our proposed work will lead to MST as the new treatment for TRS. This is particularly important as no new treatments have been made available for TRS since the release of clozapine in the late 1960s.