Exploring the Feasibility of Transcranial Ultrasound Stimulation in the Treatment of Schizophrenia

Normal or Abnormal

The Positive and Negative Syndrome Scale (PANSS), developed by Kay et al. in 1987, is a well-established clinical scale utilized to assess symptoms in patients with schizophrenia. The PANSS comprises 30 items categorized into three primary subscales:

Positive Scale (7 items): Evaluates pathologically amplified symptoms, such as delusions and hallucinations.

Negative Scale (7 items): Focuses on deficit symptoms, including blunted affect and social withdrawal.

General Psychopathology Scale (16 items): Covers non-specific psychological states, such as anxiety and tension.

Scoring and Clinical Application: Each item is scored on a 7-point severity scale ranging from 1 (absent) to 7 (extreme), yielding a total score between 30 and 210. Characterized by high reliability and validity, the PANSS serves as a critical tool in both clinical research and practice for measuring symptom severity, tracking therapeutic efficacy, and evaluating disease progression.

The Clinical Global Impressions (CGI) scale is a brief, widely accepted instrument used by clinicians to rapidly evaluate psychiatric patients' symptom severity, therapeutic response, and overall efficacy based on direct observation and clinical experience. It comprises three companion subscales:

CGI-Severity (CGI-S): Rates the clinician's impression of current illness severity on a 7-point scale, ranging from 1 (normal, not at all ill) to 7 (among the most extremely ill patients).

CGI-Improvement (CGI-I): Evaluates overall change relative to the baseline state on a 7-point scale, from 1 (very much improved), 4 (no change), to 7 (very much worse).

CGI-Efficacy (CGI-E): Indexes both therapeutic efficacy and treatment-related side effects to gauge global clinical benefit.

Due to its simplicity and independence from complex instruments, the CGI is frequently employed in clinical trials and routine practice.

The Hamilton Depression Rating Scale (HAMD), designed by Hamilton in 1960, is a clinical scale used to assess symptom severity in patients with depression. The most widely used version contains 17 items (HAMD-17). Each item is scored 0-4 or 0-2 based on severity. The HAMD-17 ranges from 0 to 52.

The HAMD evaluates multiple dimensions, including mood, insomnia, appetite, anxiety, somatic symptoms, and daily functioning. Specific areas assessed include depressed mood, guilt, suicidal ideation, and changes in weight. Total scores indicate illness severity: scores below 7 are generally considered normal, while scores of 20 or higher indicate moderate-to-severe depression. Characterized by high reliability and validity, the HAMD serves as a gold-standard instrument for evaluating the efficacy of antidepressant therapies in clinical trials.

The following specific subtests from the Cambridge Neuropsychological Test Automated Battery (CANTAB) will be administered, and individual scores for each task will be systematically recorded:

Emotion Recognition Task (ERT): Measures social cognition and emotional processing.

Multitasking Test (MTT): Evaluates executive function and cognitive flexibility.

One Touch Stockings of Cambridge (OTS): Assesses spatial planning and problem-solving.

Paired Associates Learning (PAL): Evaluates visual episodic memory and learning.

Reaction Time (RTI): Measures motor and mental response speeds.

Rapid Visual Information Processing (RVP): Assesses sustained attention.

Spatial Working Memory (SWM): Evaluates working memory and strategy.

Verbal Recognition Memory (VRM): Measures immediate and delayed verbal memory.