ALPHA PSYCHIATRY
Systematic Reviews

Adjunctive Intermittent Theta-Burst Stimulation for Schizophrenia: A Systematic Review and Meta-analysis of Randomized Double-Blind Controlled Studies

1.

Clinical Medicine, Guangxi University of Traditional Chinese Medicine, Nanning, China

2.

Department of Psychiatry, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China

3.

Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China

4.

Clinical Medicine, Xinxiang Medical University, Xinxiang, China

5.

Department of Psychology, University of Macau, Macao SAR, China

6.

Unit of Psychiatry, Department of Public Health and Medicinal Administration, University of Macau, Macao SAR, China

7.

Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China

8.

Department of Psychiatry, Beijing Haidian Psychological Rehabilitation Hospital, Beijing, China

Alpha Psychiatry 2024; 25: 676-684
DOI: 10.5152/alphapsychiatry.2024.241799
Read: 2 Downloads: 2 Published: 13 December 2024

Objective: In order to determine whether intermittent theta-burst stimulation (iTBS) is a viable adjunct treatment for schizophrenia, a meta-analysis of double-blind, randomized clinical trials (RCTs) was performed.

Methods: Four independent researchers extracted and synthesized data from RCTs on adjunctive iTBS for patients suffering from schizophrenia. RevMan 5.3 software was used to calculate risk ratios (RRs) and standardized mean differences (SMDs) along with their 95% confidence intervals (CIs).

Results: Fifteen RCTs involving 671 patients with schizophrenia were included. Adjunctive iTBS was significantly superior to sham interventions for improvement in overall psycho- pathology (SMD=−0.75, 95% CI: −1.10, −0.41, I2=64%, P < .0001), negative symptoms (SMD=−0.76, 95% CI: −1.18, −0.35, I2=78%, P=.0003), and general psychopathology (SMD=−0.51, 95% CI: −0.88, −0.14, I2=71%, P=.007), though no significant group dif- ference was found regarding positive symptoms. Adjunctive iTBS also demonstrated superiority over control treatments in improving cognitive functions as measured by the Spatial Span Test (SMD = 0.83, 95% CI: 0.16, 1.49, I2 = 73%, P = .02) and Montreal Cognitive Assessment (SMD = 0.49, 95% CI: 0.11, 0.88, I2 = 0%, P = .01). Discontinuation rates (RR = 0.92, 95% CI: 0.57, 1.50, I2 = 0%, P = .75) and adverse events were comparable between groups.

Conclusion: The use of iTBS in patients with schizophrenia appears to be effective in improving psychiatric symptoms and cognitive function. To substantiate these prelimi- nary findings, future research involving larger participant cohorts is warranted.

Cite this article as: Wen K, Yang X, Zhang N, et al. Adjunctive intermittent theta-burst stimulation for schizophrenia: A systematic review and meta-analysis of randomized double-blind controlled studies. Alpha Psychiatry. 2024;25(6):676-684.

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