Repetitive transcranial magnetic stimulation for refractory symptoms in schizophrenia.
OBJECTIVE
Schizophrenia is an illness associated with a substantial degree of treatment resistance and suboptimal therapeutic response. In recent years, novel brain stimulation technologies have been identified as potential treatments for schizophrenia and related disorders. Several published studies have assessed the use of repetitive transcranial magnetic stimulation (rTMS) in patients with schizophrenia.


RESULTS
Most published studies have focused on the use of low-frequency rTMS to treat refractory auditory hallucinations. These studies support the efficacy of stimulation over the temporoparietal cortex. Several other studies have assessed high-frequency stimulation of the prefrontal cortex in the treatment of negative symptoms. Novel protocols to treat auditory hallucinations have been piloted and case reports are emerging on the use of maintenance rTMS to treat auditory hallucinations.


CONCLUSIONS
Overall, rTMS studies have demonstrated some promise in the treatment of schizophrenia. However, more research is required to delineate the role of this technique in clinical practice and to explore novel stimulation techniques that may ultimately lead to improved therapeutic efficacy.
Blumberger
Daniel M
DM
Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.
Fitzgerald
Paul B
PB
Mulsant
Benoit H
BH
Daskalakis
Zafiris J
ZJ
D007839:Functional Laterality / Q000502:physiology; D006212:Hallucinations / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D010296:Parietal Lobe / Q000503:physiopathology; D012032:Refractory Period, Electrophysiological; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D013702:Temporal Lobe / Q000503:physiopathology; D050781:Transcranial Magnetic Stimulation / Q000379:methods*