Repetitive transcranial magnetic stimulation (rTMS) for treating major depression and schizophrenia: A systematic review of recent meta-analyses

Annals of Medicine

Volumn 45, Issue 4, 2013, Pages 308-321

  Hovington, Cindy L ^a   McGirr, Alexander ^b   Lepage, Martin ^a   Berlim, Marcelo T ^a  

^a DOUGLAS MENTAL HEALTH UNIVERSITY INSTITUTE   (Canada)

^b UNIVERSITY OF BRITISH COLUMBIA   (Canada)

Author keywords

Major depression; Meta analysis; Neuromodulation; Repetitive transcranial magnetic stimulation; Schizophrenia; Systematic review

Indexed keywords

ANTIDEPRESSANT AGENT;

ARTICLE; DIZZINESS; HEADACHE; HUMAN; MAJOR DEPRESSION; META ANALYSIS; NEGATIVE SYNDROME; NEUROMODULATION; OUTCOME ASSESSMENT; PARIETAL CORTEX; POSITIVE SYNDROME; PREFRONTAL CORTEX; PRIORITY JOURNAL; PSYCHOPHARMACOTHERAPY; RANDOMIZED CONTROLLED TRIAL (TOPIC); SCHIZOPHRENIA; SIDE EFFECT; SYSTEMATIC REVIEW; TRANSCRANIAL MAGNETIC STIMULATION; TREATMENT DURATION; TREATMENT WITHDRAWAL;

CLINICAL TRIALS AS TOPIC; DEPRESSIVE DISORDER, MAJOR; HUMANS; RESEARCH DESIGN; SCHIZOPHRENIA; TRANSCRANIAL MAGNETIC STIMULATION; TREATMENT OUTCOME;

EID: 84878564177     PISSN: 07853890     EISSN: 13652060     Source Type: Journal    
DOI: 10.3109/07853890.2013.783993     Document Type: Article

References (107)

1. Depressive illness. Lancet. 1999; 354 : 1369 -75.
2. Jansson LB, Parnas J. Competing defi nitions of schizophrenia: what can be learned from polydiagnostic studies? Schizophr Bull. 2007; 33 : 1178 -200.
3. van Os J, Kapur S. Schizophrenia. Lancet. 2009; 374: 635 -45.
4. Ebmeier KP, Donaghey C, Steele JD. Recent developments and current controversies in depression. Lancet. 2006; 367: 153-67.
5. Sartorius N.-economic and social burden of depression. J Clin Psychiatry. 2001; 62(Suppl 15) : 8 -11.
6. Freedman R. S chizophrenia. N Engl J Med. 2 003; 3 49: 1 738-4
7. Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ. Global and regional burden of disease and risk factors, 2001 : systematic analysis of population health data. Lancet. 2006; 367 : 1747 -57.
8. Rush AJ, Th ase M E, D ube S. R esearch issues in the study of diffi cultto- treat depression. Biol Psychiatry. 2003; 53: 743-53.
9. Berlim MT, Fleck MP, Turecki G. Current trends in the assessment and somatic treatment of resistant/refractory major depression: an overview. Ann Med. 2008; 40: 149-59.
10. Elkis H. Treatment-resistant schizophrenia. Psychiatr Clin North Am. 2007; 30 : 511 -33.
11. Mann JJ.-medical management of depression. N Engl J Med. 2005; 353 : 1819 -34.
12. George MS, Aston-Jones G. Noninvasive techniques for probing neurocircuitry and treating illness: vagus nerve stimulation (VNS), transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS). Neuropsychopharmacology. 2010; 35: 301-16.
13. Rossi S, Hallett M, Rossini PM, Pascual-Leone A. Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clin Neurophysiol. 2009; 120 : 2008 -39.
14. Daskalakis ZJ, Levinson AJ, Fitzgerald PB. Repetitive transcranial magnetic stimulation for major depressive disorder: a review. Can J Psychiatry. 2008; 53: 555-66.
15. Kobayashi M, Pascual-Leone A. Transcranial magnetic stimulation in neurology. Lancet Neurol. 2003; 2: 145-56.
16. Fregni F, Pascual-Leone A. Technology insight: noninvasive brain stimulation in neurology-perspectives on the therapeutic potential of rTMS and tDCS. Nat Clin Pract Neurol. 2007; 3: 383-93.
17. Hallett M. Transcranial magnetic stimulation and the human brain. Nature. 2000; 406 : 147 -50.
18. Marangell LB, Martinez M, Jurdi RA, Zboyan H. Neurostimulation therapies in depression: a review of new modalities. Acta Psychiatr Scand. 2007; 116: 174-81.
19. Fitzgerald PB, Brown TL, Daskalakis ZJ.-application of transcranial magnetic stimulation in psychiatry and neurosciences research. Acta Psychiatr Scand. 2002; 105: 324-40.
20. In speech perception: evidence from fMRI and rTMS. J Physiol Paris. 2008; 102: 31-4.
21. Rushworth MFS, Hadland KA, Paus T, Sipila PK. Role of the human medial frontal cortex in task switching: a combined fMRI and TMS study. J Neurophysiol. 2002; 87: 2577-92.
22. Levkovitz Y, Roth Y, Harel EV, Braw Y, Sheer A, Zangen A. A randomized controlled feasibility and safety study of deep transcranial magnetic stimulation. Clin Neurophysiol. 2007; 118: 2730-44.
23. Levkovitz Y, Rabany L, Harel EV, Zangen A. Deep transcranial magnetic stimulation add-on for treatment of negative symptoms and cognitive defi cits of schizophrenia: a feasibility study. Int J Neuropsychopharmacol. 2011; 14: 991-6.
24. Slotema CW, Blom JD, Hoek HW, Sommer IE. Should we expand the toolbox of psychiatric treatment methods to include Repetitive Transcranial Magnetic Stimulation (rTMS)? A meta-analysis of the effi cacy of rTMS in psychiatric disorders. J Clin Psychiatry. 2010; 71: 873-84.
25. Blumberger DM, Fitzgerald PB, Mulsant BH, Daskalakis ZJ. Repetitive transcranial magnetic stimulation for refractory symptoms in schizophrenia. Curr Opin Psychiatry. 2010; 23 : 85 -90.
26. Ridding MC, Rothwell JC. Is there a future for therapeutic use of transcranial magnetic stimulation? Nat Rev Neurosci. 2007; 8: 559-67.
27. Pigot M, Loo C, Sachdev P. Repetitive transcranial magnetic stimulation as treatment for anxiety disorders. Expert Rev Neurother. 2008; 8 : 1449 -55.
28. Xia G, Gajwani P, Muzina DJ, Kemp DE, Gao K, Ganocy SJ, et al. Treatment-emergent mania in unipolar and bipolar depression: focus on repetitive transcranial magnetic stimulation. Int J Neuropsychopharmacol. 2008; 11: 119-30.
29. Takeshita S, Kurisu K, Trop L, Arita K, Akimitsu T, Verhoeff NP. effect of subthalamic stimulation on mood state in Parkinson ' s disease: evaluation of previous facts and problems. Neurosurg Rev. 2005; 28 : 179-86; discussion
30. Temel Y, Kessels A, Tan S, Topdag A, Boon P, Visser-Vandewalle V. Behavioural changes after bilateral subthalamic stimulation in advanced Parkinson disease: a systematic review. Parkinsonism Relat Disord. 2006; 12: 265-72.
31. Allan CL, Herrmann LL, Ebmeier KP. Transcranial magnetic stimulation in the management of mood disorders. Neuropsychobiology. 2011; 64 : 163 -9.
32. Fregni F, Marcolin MA, Myczkowski M, Amiaz R, Hasey G, Rumi DO, et al. Predictors of antidepressant response in clinical trials of transcranial magnetic stimulation. Int J Neuropsychopharmacol. 2006; 9 : 641 -54.
33. Brunoni AR, Lopes M, Kaptchuk TJ, Fregni F. Placebo response of non-pharmacological and pharmacological trials in major depression: a systematic review and meta-analysis. PloS One. 2009; 4: e4824.
34. Fitzgerald PB, Oxley TJ, Laird AR, Kulkarni J, Egan GF, Daskalakis ZJ. An analysis of functional neuroimaging studies of dorsolateral prefrontal cortical activity in depression. Psychiatry Res. 2006; 148 : 33 -45.
35. Appleby B S, Duggan P S, Regenberg A, Rabins P V. Psychiatric and neuropsychiatric adverse events associated with deep brain stimulation: A meta-analysis of ten years ' experience. Mov Disord. 2007; 22: 1722 -8.
36. McClintock SM, Tirmizi O, Chansard M, Husain MM. A systematic review of the neurocognitive eff ects of magnetic seizure therapy. Int Rev Psychiatry. 2011; 23 : 413 -23.
37. Kozel FA, George MS. Meta-analysis of left prefrontal repetitive transcranial magnetic stimulation (rTMS) to treat depression. J Psychiatr Pract. 2002; 8 : 270 -5.
38. Schutter DJ. Quantitative review of the effi cacy of slow-frequency magnetic brain stimulation in major depressive disorder. Psychol Med. 2010; 40 : 1789 -95.
39. Burt T, Lisanby SH, Sackeim HA. Neuropsychiatric applications of transcranial magnetic stimulation: a meta analysis. Int J Neuropsychopharmacol. 2002; 5: 73-103.
40. Couturier JL. Effi cacy of rapid-rate repetitive transcranial magnetic stimulation in the treatment of depression: a systematic review and meta-analysis. J Psychiatry Neurosci. 2005; 30: 83-90.
41. Herrmann LL, Ebmeier KP. Factors modifying the effi cacy of transcranial magnetic stimulation in the treatment of depression: a review. J Clin Psychiatry. 2006; 67: 1870-6.
42. Holtzheimer PE 3rd, Russo J, Avery DH. A meta-analysis of repetitive transcranial magnetic stimulation in the treatment of depression. Psychopharmacol Bull. 2001; 35: 149-69.
43. Lam RW, Chan P, Wilkins-Ho M, Yatham LN. Repetitive transcranial magnetic stimulation for treatment-resistant depression: a systematic review and metaanalysis. Can J Psychiatry. 2008; 53 : 621 -31.
44. Schutter DJ. Antidepressant effi cacy of high-frequency transcranial magnetic stimulation over the left dorsolateral prefrontal cortex in double-blind sham-controlled designs: a meta-analysis. Psychol Med. 2009; 39 : 65 -75.
45. Martin JL, Barbanoj MJ, Schlaepfer TE, Th ompson E, Perez V, Kulisevsky J. Repetitive transcranial magnetic stimulation for the treatment of depression. Systematic review and meta-analysis. Br J Psychiatry. 2003; 182 : 480 -91.
46. Gross M, Nakamura L, Pascual-Leone A, Fregni F. Has repetitive transcranial magnetic stimulation (rTMS) treatment for depression improved? A systematic review and meta-analysis comparing the recent vs. the earlier rTMS studies. Acta Psychiatr Scand. 2007; 116 : 165 -73.
47. Aleman A, Sommer IE, Kahn RS. Effi cacy of slow repetitive transcranial magnetic stimulation in the treatment of resistant auditory hallucinations in schizophrenia: a meta-analysis. J Clin Psychiatry. 2007; 68 : 416 -21.
48. Dlabac-de Lange JJ, Knegtering R, Aleman A. Repetitive transcranial magnetic stimulation for negative symptoms of schizophrenia: review and meta-analysis. J Clin Psychiatry. 2010; 71: 411-8.
49. Freitas C, Fregni F, Pascual-Leone A. M eta-analysis of the eff ects of repetitive transcranial magnetic stimulation (rTMS) on negative and positive symptoms in schizophrenia. Schizophr Res. 2009; 108: 11-24.
50. Tranulis C, Sepehry AA, Galinowski A, Stip E. Should we treat auditory hallucinations with repetitive transcranial magnetic stimulation? A metaanalysis. Can J Psychiatry. 2008; 53 : 577 -86.
51. McNamara B, Ray JL, Arthurs OJ, Boniface S. Transcranial magnetic stimulation for depression and other psychiatric disorders. Psychol Med. 2001; 31: 1141-6.
52. Kimbrell TA, Little JT, Dunn RT, Frye MA, Greenberg BD, Wassermann EM, et al. Frequency dependence of antidepressant response to left prefrontal repetitive transcranial magnetic stimulation (rTMS) as a function of baseline cerebral glucose metabolism. Biol Psychiatry. 1999; 46 : 1603 -13.
53. Loo C, Mitchell P, Sachdev P, McDarmont B, Parker G, Gandevia S. Double-blind controlled investigation of transcranial magnetic stimulation for the treatment of resistant major depression. Am J Psychiatry. 1999; 156 : 946 -8.
54. Padberg F, Zwanzger P, Thoma H, Kathmann N, Haag C, Greenberg BD, et al. Repetitive transcranial magnetic stimulation (rTMS) in pharmacotherapy- refractory major depression: comparative study of fast, slow and sham rTMSI. Psychiatry Res. 1999; 88: 163-71.
55. Hoppner J, Schulz M, Irmisch G, Mau R, Schlafk e D, Richter J. Antidepressant effi cacy of two diff erent rTMS procedures-High frequency over left versus low frequency over right prefrontal cortex compared with sham stimulation. Eur Arch Psychiatry Clin Neurosci. 2003; 253 : 103 -9.
56. Bagby RM, Ryder AG, Schuller DR, Marshall MB.-Hamilton Depression Rating Scale: has the gold standard become a lead weight? Am J Psychiatry. 2004; 161: 2163-77.
57. Rosenberg R. Outcome measures of antidepressive therapy. Acta Psychiatr Scand Suppl. 2000; 402: 41-4.
58. Holtzheimer PE 3rd, Russo J, Claypoole KH, Roy-Byrne P, Avery DH. Shorter duration of depressive episode may predict response to repetitive transcranial magnetic stimulation. Depress Anxiety. 2004; 19: 24 -30.
59. Berlim MT, Turecki G. Defi nition, assessment, and staging of treatment- resistant refractory major depression: a review of current concepts and methods. Can J Psychiatry. 2007; 52: 46-54.
60. Bench CJ, Frackowiak RS, Dolan RJ. Changes in regional cerebral blood fl ow on recovery from depression. Psychol Med. 1995; 25 : 247 -61.
61. Davidson RJ, Abercrombie H, Nitschke JB, Putnam K. Regional brain function, emotion and disorders of emotion. Curr Opin Neurobiol. 1999; 9 : 228 -34.
62. Drevets W C. Functional anatomical abnormalities in limbic and prefrontal cortical structures in major depression. Prog Brain Res. 2000; 126 : 413 -31.
63. Drevets W C. Neuroimaging and neuropathological studies of depression: implications for the cognitive-emotional features of mood disorders. Curr Opin Neurobiol. 2001; 11: 240-9.
64. Rogers MA, Kasai K, Koji M, Fukuda R, Iwanami A, Nakagome K, et al. Executive and prefrontal dysfunction in unipolar depression: a review of neuropsychological and imaging evidence. Neurosci Res. 2004; 50 : 1 -11.
65. Schutter DJ, van Honk J. A framework for targeting alternative brain regions with repetitive transcranial magnetic stimulation in the treatment of depression. J Psychiatry Neurosci. 2005; 30: 91-7.
66. Pascual-Leone A, Rubio B, Pallardo F, Catala MD. Rapid-rate transcranial magnetic stimulation of left dorsolateral prefrontal cortex in drug-resistant depression. Lancet. 1996; 348: 233-7.
67. Herbsman T, Avery D, Ramsey D, Holtzheimer P, Wadjik C, Hardaway F, et al. More lateral and anterior prefrontal coil location is associated with better repetitive transcranial magnetic stimulation antidepressant response. Biol Psychiatry. 2009; 66: 509-15.
68. Herwig U, Padberg F, Unger J, Spitzer M, Schonfeldt-Lecuona C. Transcranial magnetic stimulation in therapy studies: examination of the reliability of "standard" coil positioning by neuronavigation. Biol Psychiatry. 2001; 50: 58-61.
69. Daskalakis ZJ, Farzan F, Barr MS, Maller JJ, Chen R, Fitzgerald PB. Long-interval cortical inhibition from the dorsolateral prefrontal cortex: a TMS-EEG study. Neuropsychopharmacology. 2008; 33: 2860-9.
70. Padberg F, Zwanzger P, Keck ME, Kathmann N, Mikhaiel P, Ella R, et al. Repetitive transcranial magnetic stimulation (rTMS) in major depression: relation between effi cacy and stimulation intensity. Neuropsychopharmacology. 2002; 27: 638-45.
71. Herwig U, Fallgatter AJ, Hoppner J, Eschweiler GW, Kron M, Hajak G, et al. Antidepressant eff ects of augmentative transcranial magnetic stimulation: randomised multicentre trial. Br J Psychiatry. 2007; 191: 441 -8.
72. Avery DH, Isenberg KE, Sampson SM, Janicak PG, Lisanby SH, Maixner DF, et al. Transcranial magnetic stimulation in the acute treatment of major depressive disorder: clinical response in an open-label extension trial. J Clin Psychiatry. 2008; 69: 441-51.
73. George MS, Lisanby SH, Sackeim HA. Transcranial magnetic stimulation-applications in neuropsychiatry. Arch Gen Psychiatry. 1999; 56 : 300 -11.
74. Garcia-Toro M, Pascual-Leone A, Romera M, Gonzalez A, Mico J, Ibarra O, et al. Prefrontal repetitive transcranial magnetic stimulation as add on treatment in depression. J Neurol Neurosurg Psychiatry. 2001; 71 : 546 -8.
75. Rumi DO, Gattaz WF, Rigonatti SP, Rosa MA, Fregni F, Rosa MO, et al. Transcranial magnetic stimulation accelerates the antidepressant effect of amitriptyline in severe depression: a double-blind placebo-controlled study. Biol Psychiatry. 2005; 57: 162-6.
76. Downar J, Daskalakis Z J. New targets for rTMS in depression: a review of convergent evidence. Brain Stimul. 2012 Sep 7 [Epub ahead of print].
77. van Honk J, Schutter DJ, Putman P, de Haan EH, d'Alfonso AA. Reductions in phenomenological, physiological and attentional indices of depressive mood after 2 Hz rTMS over the right parietal cortex in healthy human subjects. Psychiatry Res. 2003; 120: 95-101.
78. Roth Y, Amir A, Levkovitz Y, Zangen A. Th ree-dimensional distribution of the electric fi eld induced in the brain by transcranial magnetic stimulation using fi gure-8 and deep H-coils. J Clin Neurophysiol. 2007; 24: 31 -8.
79. Harel EV, Zangen A, Roth Y, Reti I, Braw Y, Levkovitz Y. H-coil repetitive transcranial magnetic stimulation for the treatment of bipolar depression: an add-on, safety and feasibility study. World J Biol Psychiatry. 2011; 12: 119-26.
80. Levkovitz Y, Harel EV, Roth Y, Braw Y, Most D, Katz LN, et al. Deep transcranial magnetic stimulation over the prefrontal cortex: Evaluation of antidepressant and cognitive eff ects in depressive patients. Brain Stimul. 2009; 2 : 188 -200.
81. Slotema CW, Blom JD, de Weijer AD, Diederen KM, Goekoop R, Looijestijn J, et al. Can low-frequency repetitive transcranial magnetic stimulation really relieve medication-resistant auditory verbal hallucinations? Negative results from a large randomized controlled trial. Biol Psychiatry. 2011; 69 : 450 -6.
82. Murphy BP, Chung YC, Park TW, McGorry PD. Pharmacological treatment of primary negative symptoms in schizophrenia: a systematic review. Schizophr Res. 2006; 88 : 5 -25.
83. Pantelis C, Lambert TJ. Managing patients with "treatment- resistant" schizophrenia. Med J Aust. 2003; 178(Suppl): S62-6.
84. Edwards J, McGorry PD, Waddell FM, Harrigan SM. Enduring negative symptoms in fi rst-episode psychosis: comparison of six methods using follow-up data. Schizophr Res. 1999; 40 : 147 -58.
85. Hovington CL, Lepage M. Neurocognition and neuroimaging of persistent negative symptoms of schizophrenia. Expert Rev Neurother. 2012; 12 : 53 -69.
86. Buchanan RW. Persistent negative symptoms in schizophrenia: an overview. Schizophr Bull. 2007; 33 : 1013 -22.
87. Foussias G, Remington G. Negative symptoms in schizophrenia: avolition and Occam's razor. Schizophr Bull. 2010; 36 : 359 -69.
88. L, Scholten D, et al. Can patients at risk for persistent negative symptoms be identifi ed during their fi rst episode of psychosis? J Nerv Ment Dis. 2004 ; 192 : 455 -63.
89. Dickey CC, McCarley RW, Voglmaier MM, Niznikiewicz MA, Seidman LJ, Hirayasu Y, et al. Schizotypal personality disorder and MRI abnormalities of temporal lobe gray matter. Biol Psychiatry. 1999; 45 : 1393-402.
90. Gaser C, Nenadic I, Volz HP, Buchel C, Sauer H. Neuroanatomy of ' hearing voices ' : a frontotemporal brain structural abnormality associated with auditory hallucinations in schizophrenia. Cereb Cortex. 2004; 14 : 91 -6.
91. Onitsuka T, Shenton ME, Salisbury DF, Dickey CC, Kasai K, Toner SK, et al. Middle and inferior temporal gyrus gray matter volume abnormalities in chronic schizophrenia: an MRI study. Am J Psychiatry. 2004; 161 : 1603 -11.
92. Schonfeldt-Lecuona C, Gron G, Walter H, Buchler N, Wunderlich A, Spitzer M, et al. Stereotaxic rTMS for the treatment of auditory hallucinations in schizophrenia. Neuroreport. 2004; 15 : 1669 -73.
93. Shergill SS, Brammer MJ, Williams SC, Murray RM, McGuire PK. Mapping auditory hallucinations in schizophrenia using functional magnetic resonance imaging. Arch Gen Psychiatry. 2000; 57: 1033-8.
94. Choi JS, Kang DH, Kim JJ, Ha TH, Roh KS, Youn T, et al. Decreased caudal anterior cingulate gyrus volume and positive symptoms in schizophrenia. Psychiatry Res. 2005; 139: 239-47.
95. Korsnes MS, Hugdahl K, Nygard M, Bjornaes H. An fMRI study of auditory hallucinations in patients with epilepsy. Epilepsia. 2010; 51 : 610 -7.
96. Koutsouleris N, Gaser C, Jager M, Bottlender R, Frodl T, Holzinger S, et al. Structural correlates of psychopathological symptom dimensions in schizophrenia: a voxel-based morphometric study. Neuroimage. 2008; 39 : 1600 -12.
97. Quarantelli M, Larobina M, Volpe U, Amati G, Tedeschi E, Ciarmiello A, et al. Stereotaxy-based regional brain volumetry applied to segmented MRI: validation and results in defi cit and nondefi cit schizophrenia. Neuroimage. 2002; 17: 373-84.
98. Yoshida T, McCarley RW, Nakamura M, Lee K, Koo MS, Bouix S, et al. A prospective longitudinal volumetric MRI study of superior temporal gyrus gray matter and amygdala-hippocampal complex in chronic schizophrenia. Schizophr Res. 2009; 113 : 84 -94.
99. Brunelin J, Poulet E, Bediou B, Kallel L, Dalery J, D' Amato T, et al. Low frequency repetitive transcranial magnetic stimulation improves source monitoring defi cit in hallucinating patients with schizophrenia. Schizophr Res. 2006; 81 : 41 -5.
100. Chibbaro G, Daniele M, Alagona G, Di Pasquale C, Cannavo M, Rapisarda V, et al. Repetitive transcranial magnetic stimulation in schizophrenic patients reporting auditory hallucinations. Neurosci Lett. 2005; 383 : 54 -7.
101. Goyal N, Nizamie SH, Desarkar P. Effi cacy of adjuvant high frequency repetitive transcranial magnetic stimulation on negative and positive symptoms of schizophrenia: preliminary results of a double-blind sham-controlled study. J Neuropsychiatry Clin Neurosci. 2007; 19 : 464 -7.
102. Fitzgerald PB, Herring S, Hoy K, McQueen S, Segrave R, Kulkarni J, et al. A study of the eff ectiveness of bilateral transcranial magnetic stimulation in the treatment of the negative symptoms of schizophrenia. Brain Stimul. 2008; 1: 27-32.
103. Prikryl R, K asparek T, S kotakova S, U stohal L, K ucerova H, C eskova E. Treatment of negative symptoms of schizophrenia using repetitive transcranial magnetic stimulation in a double-blind, randomized controlled study. Schizophr Res. 2007; 95 : 151 -7.
104. Holi MM, Eronen M, Toivonen K, Toivonen P, Marttunen M, Naukkarinen H. Left prefrontal repetitive transcranial magnetic stimulation in schizophrenia. Schizophr Bull. 2004; 30 : 429 -34.
105. Jandl M, Bittner R, Sack A, Weber B, Gunther T, Pieschl D, et al. Changes in negative symptoms and EEG in schizophrenic patients after repetitive Transcranial Magnetic Stimulation (rTMS): an openlabel pilot study. J Neural Transm. 2005; 112: 955-67.
106. Sachdev P, Loo C, Mitchell P, Malhi G. Transcranial magnetic stimulation for the defi cit syndrome of schizophrenia: a pilot investigation. Psychiatry Clin Neurosci. 2005; 59: 354-7.
107. Ferreira Gonzalez I, Urrutia G, Alonso-Coello P. [ Systematic reviews and meta-analysis: scientifi c rationale. and interpretation]. Rev Esp Cardiol. 2011; 64: 688-96.