Repetitive Transcranial Magnetic Stimulation for Working Memory Deficits in Schizophrenia: A Systematic Review of...

Area of Science:

• Neuroscience
• Psychiatry
• Medical Imaging

Background:

• Working memory (WM) deficits are a core feature of neurocognitive impairment in schizophrenia (SCZ).
• Previous meta-analyses on repetitive transcranial magnetic stimulation (rTMS) for SCZ-related WM deficits yielded inconsistent results.
• Random effects (RE) models may underestimate statistical errors and overemphasize study quality variations.

Purpose of the Study:

• To evaluate the effectiveness of rTMS in treating WM deficits in SCZ patients.
• To compare outcomes using both random effects (RE) and quality effects (QE) models.
• To explore potential mechanisms and future directions for rTMS in SCZ.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials (RCTs).
• Included 13 RCTs comparing TMS with sham intervention for WM deficits in SCZ.
• Utilized both RE and QE models for data synthesis.

Main Results:

• Both RE and QE models indicated comparable therapeutic effects between TMS and sham groups post-treatment.
• Current research on rTMS for SCZ WM deficits is preliminary.
• Dorsolateral prefrontal cortex activation and gamma oscillation changes are potential mechanisms.

Conclusions:

• rTMS, as currently applied, does not demonstrate significant efficacy for improving WM deficits in SCZ compared to sham.
• Further research is warranted to refine rTMS protocols and explore its therapeutic potential.
• Closed-loop neuromodulation may offer a pathway to optimize rTMS for SCZ WM impairment.