Safety and efficacy of intermittent theta burst stimulation (iTBS) in schizophrenia with predominant negative symptoms: A brief review
Nand Kumar, Gagan Hans, Maria Madiha, Shiv Prasad, Shubham NarnoliABSTRACT
Background:
Negative symptoms of schizophrenia are challenging to treat, contributing to long-term disability and poor prognosis. While conventional TMS has shown proven effective, the evidence supporting intermittent Theta Burst Stimulation (iTBS) is still in the early stages of development.
Aim:
This review aims to accumulate existing evidence on the safety and effectiveness of iTBS for treating negative symptoms in schizophrenia. A better understanding of its effects and outcomes could lead to more targeted treatments, addressing a gap in current therapeutic strategies.
Methods:
Search was conducted in three electronic databases: PubMed, ScienceDirect, and Google Scholar, using “ITBS”, “Schizophrenia” and “Negative symptoms” as keywords, focusing on RCTs published in the past 10 years related to iTBS and negative symptoms of schizophrenia.
Results:
Out of 69 identified articles, 9 were included, involving 440 participants between the ages of 18 to 50 years. Total number of sessions ranged from 10-40 sessions. Stimulation sites varied, including bilateral dorsomedial prefrontal cortex (DMPFC), cerebellum (area VII B and midline), and left and right DLPFC. Most studies used stimulation at 100% or 80% motor threshold. All trials applied consistent iTBS parameters at 50 Hz inner train.
Conclusion:
The present review highlights iTBS as a promising non-invasive treatment for negative symptoms in schizophrenia, offering a novel approach for difficult to treat patients in the short duration of the sessions. Evidence supports its potential as part of an integrated treatment strategy, though further research is needed to confirm long-term safety and effectiveness.