loading page

rTMS Shows Efficacy in Improving Negative Symptoms in Early Psychosis: A Systematic Review
  • Marianne Hrabok,
  • Anthony K. Hinde,
  • Wei-Yi Song
Marianne Hrabok
The University of British Columbia Faculty of Medicine

Corresponding Author:[email protected]

Author Profile
Anthony K. Hinde
The University of British Columbia Faculty of Medicine
Author Profile
Wei-Yi Song
The University of British Columbia Faculty of Medicine
Author Profile

Abstract

Introduction: This systematic review aims to synthesize evidence for use of repetitive transcranial magnetic stimulation (rTMS) in recently diagnosed psychotic disorders to determine whether rTMS could be an effective treatment for early psychosis. Methods: PubMed, CINAHL, and PsycInfo were searched to obtain relevant articles published between 2012 and 2023. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Articles was used as a guideline for reporting. Two authors independently screened articles using inclusion/exclusion criteria. Those meeting criteria were examined in detail, with bias scoring via the Cochrane Risk of Bias tool. Results: Of 2155 articles yielded from the initial search, fifteen ultimately met inclusion/exclusion criteria and were examined further. Most of the studies used the PANSS to assess outcome, and the majority (89%) reported significant effects on negative symptoms following rTMS, with mixed outcomes for positive symptoms. The most common neural target for stimulation was the dorsolateral prefrontal cortex. Seventy-three percent of articles examined neural correlates of outcome, linking outcome to functional connectivity, grey matter volume, and BDNF levels. The majority of studies were rated as some or high bias, due to lack of rigorous controls, lack of blinding, or lack of randomization. Conclusions: Our systematic review suggests that rTMS is effective for treatment of negative symptoms of early psychosis. Negative symptoms are of particular clinical import as a treatment target, given their impact on function, their resistance to conventional treatments, and prognostic significance. Limitations and future directions are discussed.