The goal of this clinical trial is to assess the efficacy and safety of hippocampus-targeted deep brain stimulation (DBS) in treatment-resistant schizophrenia. The main question it aims to answer are: * whether patients with treatment-resistant schizophrenia can benefit from hippocampus-targeted DBS; * what is the neural and electrophysiological mechanism underlying the treatment effect of hippocampus-targeted DBS.
The first phase of the study will consist of DBS surgery. Participants will receive electrodes implantation in bilateral ventral hippocampus. Continuous stimulation will be applied to optimize and individualize the stimulus parameters. This period is anticipated between 3 and 6 months. The next phase will consist of the crossover study. Patients who respond to DBS will be randomly assigned to two groups, for a period of 3 months: on stimulation group and off stimulation group. Patients will then be crossed over to the other group for a further 3 months. Participants will receive PET-CT, clinical assessment and cognitive tests at the main study points to evaluate treatment efficacy and patient tolerance, and to reveal the underlying mechanism of the treatment effect of DBS.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
6
The surgical electrode implanted in hippocampus by a pulse generating device is "on".
The surgical electrode implanted in hippocampus by a pulse generating device is "off".
Shanghai Mental Health Center
Shanghai, Shanghai Municipality, China
RECRUITINGPositive and Negative Syndrome Scale for Schizophrenia (PANSS)
Scale to assess changes in clinical symptoms; response to DBS is defined as a 20% reduction from baseline in PANSS score
Time frame: Baseline, 12 weeks, 24 weeks, 36 weeks, 48 weeks
Clinical Global Impression-Schizophrenia (CGI-SCH) Scale
Scale to assess changes in symptoms' severity, global improvement or change
Time frame: Baseline, 12 weeks, 24 weeks, 36 weeks, 48 weeks
Clinician-Rated Dimensions of Psychosis Symptom severity (CRDPS) Scale
Scale to assess different dimensions and severity of symptoms
Time frame: Baseline, 12 weeks, 24 weeks, 36 weeks, 48 weeks
The Chinese version of Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery
Battery of neuropsychological tests to assess changes in cognition
Time frame: Baseline, 12 weeks, 24 weeks, 36 weeks, 48 weeks
Cerebral metabolism(PET-CT scans)
Assessment of changes in metabolic levels of glutamate, GABA and dopamine in the whole brain using PET-CT
Time frame: Baseline, 24 weeks, 48 weeks
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