Effect of repetitive transcranial magnetic stimulation (rTMS) over left dorsolateral prefrontal cortex (DLPFC) in negative symptoms of schizophrenia: A randomized, sham controlled study

ABSTRACT Background: Negative symptoms play an important role in functional outcome in patients with schizophrenia. Pharmacological treatments are often inadequate to manage negative symptoms and may sometimes worsen. Repetitive Transcranial Magnetic Stimulation (rTMS), which has been found effective in various psychiatric disorders, including resistant depression and obsessive-compulsive disorder, needs to be explored as a novel treatment option for negative symptoms in schizophrenia. Aims: To study the effect of rTMS over the left dorsolateral prefrontal cortex (DLPFC) in negative symptoms of schizophrenia. Materials and Methods: This was a hospital-based interventional, double blind, randomized, and sham-controlled study. Sixty patients with primary negative symptoms of schizophrenia were randomly assigned to two equal-sized groups. One group received rTMS and the other received sham treatment. The Positive and Negative Syndrome Scale-Negative sub-scale (PANSS-N), Scale for Assessment of Negative Symptoms (SANS), and Clinical Global Impression-Severity Scale (CGI-S) scales were applied to the patients on Day 1, Day 21, and Day 60 of treatment. Statistical Package for the Social Sciences version 20 (SPSS v20) was used to analyse data. Results: Multivariate analysis showed statistically significant improvement in the rTMS group over the sham control group. Conclusions: rTMS is an effective treatment option for negative symptoms of schizophrenia.