IMR Press / JIN / Volume 23 / Issue 1 / DOI: 10.31083/j.jin2301007
Open Access Systematic Review
Efficacy of Noninvasive Brain Stimulation in Treating General Psychopathology Symptoms in Schizophrenia: A Meta-Analysis
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1 Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, 100191 Beijing, China
2 Early Childhood Integrated Development Center, Beijing Fengtai Maternal and Child Health Care Hospital, 100069 Beijing, China
3 Department of Psychiatry, Beijing Jishuitan Hospital, 102200 Beijing, China
4 Department of Psychiatry, Beijing Children’s Hospital, Capital Medical University, National Center for Children Healthy, 100101 Beijing, China
*Correspondence: fuquan_liu0901@163.com (Fuquan Liu); liying@bch.com.cn (Ying Li)
J. Integr. Neurosci. 2024, 23(1), 7; https://doi.org/10.31083/j.jin2301007
Submitted: 24 May 2023 | Revised: 9 August 2023 | Accepted: 17 August 2023 | Published: 11 January 2024
(This article belongs to the Special Issue Transcranial Magnetic Stimulation and Mental Disorders)
Copyright: © 2024 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Objectives: Noninvasive brain stimulation (NIBS) has been shown to effectively alleviate negative and positive symptoms in patients with schizophrenia. However, its impact on depressive symptoms and general psychopathology symptoms (GPSs), which are crucial for functional outcomes, remains uncertain. We aimed to compare the efficacy of various NIBS interventions in treating depressive symptoms and GPSs. Methods: We conducted a comprehensive search of multiple databases and performed a meta-analysis to evaluate the efficacy of NIBS in treating depressive symptoms and GPSs in schizophrenia. The effect sizes of NIBS for depression symptoms and GPSs were estimated using standard mean differences (SMDs) with 95% confidence intervals (CIs). Subgroup analyses were employed to examine potential influencing factors on the pooled SMD of NIBS for GPSs. Results: Our search yielded 35 randomized controlled trials involving 1715 individuals diagnosed with schizophrenia. The protocol of this systematic review was registered with INPLASY (protocol ID: INPLASY202320082). Neither repetitive transcranial magnetic stimulation (rTMS) nor transcranial direct current stimulation (tDCS) demonstrated significant improvements in depressive symptoms compared to sham controls. NIBS exhibited a small-to-moderate effect size for GPSs, with a pooled SMD of –0.2956 (95% CI: –0.459 to –0.132) and a heterogeneity (I2) of 58.9% (95% CI: 41.5% to 71.1%; p < 0.01) based on a random-effects model. Subgroup analyses of different types of NIBS, different frequencies of rTMS, and different stimulation sites of rTMS revealed no significant differences. Only sex had a significant influence on the effect size of NIBS for general psychopathology symptoms (p < 0.05). However, rTMS might be superior to tDCS, and high-frequency rTMS outperformed low-frequency rTMS in treating GPSs. Conclusions: We found a small-to-moderate effect size of NIBS in alleviating GPSs in patients with schizophrenia. Both rTMS and tDCS were more effective than sham stimulation in reducing GPSs in schizophrenia. The frequency used was associated with rTMS efficacy for GPSs.

Keywords
noninvasive brain stimulation
SMD
depressive symptoms
general psychopathology symptoms
schizophrenia
meta-analysis
Funding
82171538/National Natural Science Foundation of China (NSFC)
82001445/National Natural Science Foundation of China (NSFC)
7212035/Natural Science Foundation of Beijing Municipality
7232057/Natural Science Foundation of Beijing Municipality
QML20211203/Beijing Hospitals Authority Youth Programme
LY202103/Long Yue Program of Hospital Science Fund for Young Scholar
Figures
Fig. 1.
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