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Published on: August 11, 2015
MRI-Guided rTMS Targeting the Dorsolateral Prefrontal Cortex Improves Negative Symptoms and Cognitive Function in
Yujuan Guo1, Chengrui Jin, Xiaomin Chen
1Department of Psychiatry, The Third People's Hospital of Fuyang District, Hangzhou City, Zhejiang Province, China.
The Journal of ECT
|June 1, 2026
Summary
MRI-guided repetitive transcranial magnetic stimulation (rTMS) effectively reduced negative symptoms in schizophrenia patients over four weeks. This treatment was well-tolerated and showed improvements in cognitive and functional measures.
Area of Science:
- Neuroscience
- Psychiatry
- Medical Imaging
Background:
- Negative symptoms of schizophrenia are notoriously difficult to treat with medication.
- Repetitive transcranial magnetic stimulation (rTMS) targeting the dorsolateral prefrontal cortex (DLPFC) shows promise but has variable efficacy, often due to targeting inaccuracies.
- MRI-guided rTMS offers a potential solution for precise targeting in treating schizophrenia's negative symptoms.
Purpose of the Study:
- To evaluate the efficacy and safety of MRI-guided rTMS for treating negative symptoms in schizophrenia patients.
- To compare MRI-guided rTMS with sham stimulation in a randomized, controlled trial.
- To explore the relationship between targeting accuracy and treatment outcomes.
Main Methods:
- A single-center, randomized, assessor-blinded, sham-controlled trial involving 100 schizophrenia patients.
- Participants received 4 weeks of either active or sham MRI-guided neuronavigated rTMS targeting the left DLPFC.
- Primary outcome was the change in the Positive and Negative Syndrome Scale (PANSS) negative factor score; secondary outcomes included SANS, MoCA, and PSP scores.
Main Results:
- Active MRI-guided rTMS significantly reduced negative symptoms compared to sham (ΔPANSS-N: -6.5 vs. -2.7, P<0.001).
- Improvements were also observed in Montreal Cognitive Assessment (MoCA) and PSP scores compared to sham (P=0.01; P=0.005).
- The treatment was well-tolerated, with minor, transient adverse events; smaller targeting deviations correlated with greater symptom improvement (r=-0.42, P=0.002).
Conclusions:
- MRI-guided rTMS is an effective and safe treatment for negative symptoms in schizophrenia over a 4-week period.
- Secondary improvements in cognitive and functional measures suggest broader benefits, though these require further investigation.
- Exploratory findings indicate that precise targeting may enhance treatment efficacy, warranting further hypothesis-generating research.
