Repetitive transcranial magnetic stimulation for treating the symptoms of schizophrenia: A PRISMA compliant meta-analysis.

OBJECTIVE

To explore the efficacies of 1-Hz (low frequency) and 10-Hz (high frequency) repetitive transcranial magnetic stimulation (rTMS) in treating auditory hallucinations and negative symptoms of schizophrenia, respectively.

METHODS

Electronic databases were searched to identify relevant literature. Standard mean difference (SMD) and 95% confidence interval (CI) values were used to evaluate the effects of rTMS. The stability and sensitivity of the results, the source of heterogeneity, and the recommended grade of the evidence were also analyzed.

RESULTS

Thirteen studies of 1-Hz rTMS were included. The auditory hallucinations improved more in the rTMS group than in the sham group (SMD=-0.29, 95%CI=-0.57 to -0.01). However, this result was not stable after sensitivity analysis, and publication bias had a substantial impact on the results. Meta-analysis performed for seven studies of 10-Hz rTMS found that improvement of negative symptoms did not differ significantly between the real rTMS and sham groups. Finally, the grade of evidence for this meta-analysis was found to be low.

CONCLUSION

Although there may appear to be a therapeutic effect for 1-Hz rTMS on auditory hallucinations of schizophrenia, this needs to be confirmed by large-scale randomized controlled trials before this finding can be recommended in clinical practice.

SIGNIFICANCE: 1-Hz rTMS might have an effect on auditory hallucinations of schizophrenia.