Repetitive transcranial magnetic stimulation for hallucination in schizophrenia spectrum disorders: A meta-analysis

Yingli Zhang; Wei Liang; Shichang Yang; Ping Dai; Lijuan Shen; Changhong Wang

doi:10.3969/j.issn.1673-5374.2013.28.009

Repetitive transcranial magnetic stimulation for hallucination in schizophrenia spectrum disorders: A meta-analysis

Neural Regen Res. 2013 Oct 5;8(28):2666-76. doi: 10.3969/j.issn.1673-5374.2013.28.009.

Authors

Yingli Zhang¹, Wei Liang², Shichang Yang³, Ping Dai⁴, Lijuan Shen⁵, Changhong Wang⁶

Affiliations

¹ Psychological Counseling Center, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, Henan Province, China.
² Department of Clinical Psychology, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, Henan Province, China.
³ Department of Psychology, Xinxiang Medical University, Xinxiang 453000, Henan Province, China.
⁴ Library of Sichuan University, Chengdu 610041, Sichuan Province, China.
⁵ Mental Health Institute, Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China.
⁶ Department of Psychiatry, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, Henan Province, China.

PMID: 25206578
PMCID: PMC4146020
DOI: 10.3969/j.issn.1673-5374.2013.28.009

Abstract

Objective: This study assessed the efficacy and tolerability of repetitive transcranial magnetic stimulation for treatment of auditory hallucination of patients with schizophrenia spectrum disorders.

Data sources: Online literature retrieval was conducted using PubMed, ISI Web of Science, EMBASE, Medline and Cochrane Central Register of Controlled Trials databases from January 1985 to May 2012. Key words were "transcranial magnetic stimulation", "TMS", "repetitive transcranial magnetic stimulation", and "hallucination".

Study selection: Selected studies were randomized controlled trials assessing therapeutic efficacy of repetitive transcranial magnetic stimulation for hallucination in patients with schizophrenia spectrum disorders. Experimental intervention was low-frequency repetitive transcranial magnetic stimulation in left temporoparietal cortex for treatment of auditory hallucination in schizophrenia spectrum disorders. Control groups received sham stimulation.

Main outcome measures: The primary outcome was total scores of Auditory Hallucinations Rating Scale, Auditory Hallucination Subscale of Psychotic Symptom Rating Scale, Positive and Negative Symptom Scale-Auditory Hallucination item, and Hallucination Change Scale. Secondary outcomes included response rate, global mental state, adverse effects and cognitive function.

Results: Seventeen studies addressing repetitive transcranial magnetic stimulation for treatment of schizophrenia spectrum disorders were screened, with controls receiving sham stimulation. All data were completely effective, involving 398 patients. Overall mean weighted effect size for repetitive transcranial magnetic stimulation versus sham stimulation was statistically significant (MD = -0.42, 95%CI: -0.64 to -0.20, P = 0.000 2). Patients receiving repetitive transcranial magnetic stimulation responded more frequently than sham stimulation (OR = 2.94, 95%CI: 1.39 to 6.24, P = 0.005). No significant differences were found between active repetitive transcranial magnetic stimulation and sham stimulation for positive or negative symptoms. Compared with sham stimulation, active repetitive transcranial magnetic stimulation had equivocal outcome in cognitive function and commonly caused headache and facial muscle twitching.

Conclusion: Repetitive transcranial magnetic stimulation is a safe and effective treatment for auditory hallucination in schizophrenia spectrum disorders.

Keywords: auditory hallucination; cognitive func-tion; grants-supported paper; meta-analysis; neural regeneration; neuroregeneration; positive symptom; schizophre-nia; schizophrenia spectrum disorders; schizophreniform disorder; temporoparietal cortex; transcranial magnetic stimulation.