Associated organisationsFeinstein Institute for Medical Research · The Centre for Addiction and Mental HealthEurope PMC affiliations are not treated as award recipients or mapped locations.
Funding£3.0M
PeriodApr 2023 — Mar 2027
In plain English
AI plain-English summary
A 4-week course of magnetic brain stimulation aims to improve the ability of people with early psychosis to read others’ emotions and intentions. In people with psychosis, difficulties with social cognition—the mental processes behind understanding other people—cause much of the long-term disability associated with the illness. The researchers previously identified that a specific set of higher-level social skills, called mentalizing, is the main driver of how well people function in daily life. Standard treatments do not target this deficit. This trial tests whether 20 sessions of repetitive transcranial magnetic stimulation (rTMS) to the dorsomedial prefrontal cortex, a brain region central to mentalizing, can improve social cognitive performance in 100 participants. If the treatment works, it could offer a non-invasive, targeted way to improve social functioning in people with psychosis—something no current medication reliably does. Better social cognition could help patients maintain relationships, hold jobs, and navigate everyday interactions, directly reducing the disability that often accompanies the illness. The study also tracks brain connectivity changes, which could reveal how the therapy works and guide future refinements.
View original technical description
In people with psychosis, deficits in social cognition are responsible for a large proportion of the functional disability associated with illness. In a previous study, we found that social cognitive performance is comprised of two subcomponents: 1) a ‘lower-level’ factor reflecting basic emotion detection skills and 2) a ‘higher- level’ factor reflecting higher social cognitive functions referred to as the ‘mentalizing’ factor. The mentalizing factor predicted functional outcome and fully mediated the relationship between neurocognition and social function. Therefore, the mentalizing factor appears to play a major role in determining functioning in people with psychosis. We propose a 4-week (20 session), double-blind, randomized clinical trial in 100 people with early phase psychosis to examine if repetitive transcranial magnetic stimulation, a non-invasive neuromodulatory technique, improves social cognitive performance. We hypothesize that stimulation of the dorsomedial prefrontal cortex - a key node of the mentalizing network - will alter network functional connectivity in people with psychosis and improve social cognitive performance. Neuroimaging will occur at baseline, at 4 weeks and 6 months after treatment. The primary outcome measure will be social cognitive performance, and the secondary outcome measures will include changes in within-mentalizing network functional connectivity and in long-term social functioning.
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