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Domain-Specific Efficacy of Accelerated Repetitive Transcranial Magnetic Stimulation in Neuropsychiatric Disorders: A
Hangbin Zhang1, Jacob Green1, Shraddha Dwivedi1
1Brain Imaging and TMS Laboratory, Department of Psychology, University of Arizona, Tucson, Arizona.
Biological Psychiatry
|December 3, 2025
Summary
Accelerated repetitive transcranial magnetic stimulation (arTMS) shows rapid, domain-specific benefits for psychiatric conditions and cognitive functions. This meta-analysis confirms its efficacy and identifies parameters influencing neuroplasticity for personalized treatment.
Area of Science:
- Neuroscience
- Psychiatry
- Neuromodulation
Background:
- Accelerated repetitive transcranial magnetic stimulation (arTMS) offers high neuromodulatory doses for psychiatric conditions.
- Its efficacy and dose-dependent neuroplastic mechanisms require further understanding.
Purpose of the Study:
- To systematically review and meta-analyze the efficacy of arTMS across various symptom domains.
- To investigate dose-dependent neuroplastic mechanisms and moderating factors.
Main Methods:
- Systematic review and random-effects meta-analysis of 44 randomized controlled trials (n=1,671).
- Searches conducted across major databases (PubMed, Embase, Web of Science, Cochrane Library).
- Meta-regressions used to examine moderators of treatment effects.
Main Results:
- arTMS demonstrated moderate antidepressant effects (g=0.61) and significant improvements in anxiety, OCD, working memory, and declarative memory.
- Stimulation parameters and participant demographics moderated outcomes, suggesting dose- and sex-linked plasticity.
- Adverse events were mild and transient with low risk of bias.
Conclusions:
- arTMS provides rapid, domain-specific, transdiagnostic benefits with a good safety profile.
- Findings support a mechanistic model of stimulation-induced plasticity interacting with individual neurobiology.
- arTMS is a scalable, circuit-targeted intervention with parameters guiding precision medicine.
