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High-definition transcranial direct current stimulation (HD-tDCS) targeting the dorsolateral prefrontal cortex (DLPFC) has shown promise for improving WM, yet biomarkers indicating its efficacy remain limited. We hypothesized that HD-tDCS would enhance WM in SCZ and that changes in transcranial magnetic stimulation combined with electroencephalography (TMS-EEG) metrics can serve as potential biomarkers of treatment response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Sixty-three SCZ patients were randomized to receive either active (n\u2009=\u200932) or sham (n\u2009=\u200931) HD-tDCS. WM was assessed using the accuracy (ACC) and reaction time (RT) of the 2-back task before and after the 20-day intervention. TMS-EEG was conducted before and after the first HD-tDCS session to measure cortical responses. Changes in global mean field amplitude (GMFA) components were analyzed for their association with WM improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Results<\/jats:title>\n                    <jats:p>Active HD-tDCS significantly improved ACC (P&amp;lt;.001) and reduced RT (P&amp;lt;.001), whereas performance remained unchanged in the sham (all P&amp;gt;.05). A single session of active HD-tDCS reduced the N45 amplitude (P=.038), with no significant differences observed in the sham (all P&amp;gt;.05). The N45 reduction correlated with the ACC improvement (r\u2009=\u2009\u20130.452, P=.009). Stepwise regression confirmed the N45 reduction as a significant contributor of ACC improvement (\u03b2\u2009=\u2009\u20130.03, t\u2009=\u2009\u20132.15, P=.040).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>HD-tDCS effectively improved WM in SCZ patients. Reduction in N45 amplitude may serve as a neurophysiological marker of HD-tDCS treatment response.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/schbul\/sbaf241","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T13:04:00Z","timestamp":1765458240000},"source":"Crossref","is-referenced-by-count":0,"title":["Acute Cortical Excitability Change is Associated with Long-Term Working Memory Improvement by HD-tDCS Treatment in Schizophrenia: a TMS-EEG Study"],"prefix":"10.1093","volume":"52","author":[{"given":"Kai","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Affiliated Kangning Hospital of Ningbo University (Ningbo Kangning Hospital), Ningbo Key Laboratory for Physical Diagnosis and Treatment of Mental and Psychological Disorders , No.1 Zhuangyu Road, Zhenhai District, Ningbo, Zhejiang 315201 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,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongming","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Affiliated Kangning Hospital of Ningbo University (Ningbo Kangning Hospital), Ningbo Key Laboratory for Physical Diagnosis and Treatment of Mental and Psychological Disorders , No.1 Zhuangyu Road, Zhenhai District, Ningbo, Zhejiang 315201 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenhao","family":"Zhuang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Affiliated Kangning Hospital of Ningbo University (Ningbo Kangning Hospital), Ningbo Key Laboratory for Physical Diagnosis and Treatment of Mental and Psychological Disorders , No.1 Zhuangyu Road, Zhenhai District, Ningbo, Zhejiang 315201 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,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Affiliated Kangning Hospital of Ningbo University (Ningbo Kangning Hospital), Ningbo Key Laboratory for Physical Diagnosis and Treatment of Mental and Psychological Disorders , No.1 Zhuangyu Road, Zhenhai District, Ningbo, Zhejiang 315201 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lian","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Affiliated Kangning Hospital of Ningbo University (Ningbo Kangning Hospital), Ningbo Key Laboratory for Physical Diagnosis and Treatment of Mental and Psychological Disorders , No.1 Zhuangyu Road, Zhenhai District, Ningbo, Zhejiang 315201 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Tianjin Medical University , No.13 Liulin Road, Hexi District, Tianjin 300222 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9326-4242","authenticated-orcid":false,"given":"Dongsheng","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Affiliated Kangning Hospital of Ningbo University (Ningbo Kangning Hospital), Ningbo Key Laboratory for Physical Diagnosis and Treatment of Mental and Psychological Disorders , No.1 Zhuangyu Road, Zhenhai District, Ningbo, Zhejiang 315201 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,3,21]]},"reference":[{"key":"2026032106181571800_ref1","doi-asserted-by":"publisher","first-page":"5319","DOI":"10.1038\/s41380-023-02138-4","article-title":"Incidence, prevalence, and global burden of schizophrenia - data, with critical appraisal, from the global burden of disease 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