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Bosch et al. Neuroimmunol Neuroinflammation 2017;4:258-9 Neuroimmunology and
DOI: 10.20517/2347-8659.2017.48
Neuroinflammation

www.nnjournal.net
Letter to Editor Open Access

Transcranial magnetic stimulation for

schizophrenia: potential and risks

Peggy Bosch , Sujung Yeo , Heike Staudte , Pia Barisch , Sabina Lim , Maurits van den Noort 5,6
1,2
3
5
1
1,4
1 Psychiatric Research Group, LVR-Klinik Bedburg-Hau, 47511 Bedburg-Hau, Germany.
2 Centre for Cognition, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, 6500 GL Nijmegen, Gelderland, The
Netherlands.
3 College of Korean Medicine, Sang Ji University, Wonju 26339, South Korea.
4 Institute of Experimental Psychology, Heinrich Heine University, 40225 Düsseldorf, Germany.
5 Research Group of Pain and Neuroscience, Kyung Hee University, Seoul 130-701, South Korea.
6 Brussels Institute for Applied Linguistics, Vrije Universiteit Brussel, 1050 Brussels, Belgium.
Correspondence to: Dr. Peggy Bosch, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Montessorilaan 3, 6500
GL Nijmegen, Gelderland, The Netherlands. E-mail: p.bosch@donders.ru.nl; Prof. Maurits van den Noort, Research Group of Pain and Neuroscience,
Kyung Hee University, #47 Gyeonghuidae-Gil, Dongdaemun-Gu, Seoul 130-701, South Korea. E-mail: info@mauritsvandennoort.com
How to cite this article: Bosch P, Yeo S, Staudte H, Barisch P, Lim S, van den Noort M. Transcranial magnetic stimulation for schizophrenia:
potential and risks. Neuroimmunol Neuroinflammation 2017;4:258-9.

Article history: Received: 9 Sep 2017 Accepted: 11 Sep 2017 Published: 6 Dec 2017

Recently, transcranial magnetic stimulation (TMS) as was recently concluded in a large systematic
[2]
has increasingly been used to investigate the review of forty-one trials by Dougall and colleagues .
neurobiology of schizophrenia. In those studies, Studies differ in numerous variables, for example, the
researchers applied TMS in combination with motor stimulation intensity or length, the areas of the brain
evoked potentials (TMS/MEPs) and high density that are stimulated, and the design of the same TMS
[1]
electroencephalograms (TMS/hd-EEG) . The condition. Those variables could have great impact on
studies revealed significant impairments in cortical the effects of TMS in the studied population. Therefore,
excitability, inhibition, and oscillatory activity, which are better, well-developed TMS studies that test specific
more prominent in the frontal brain areas, in patients underlying neurobiological working mechanisms in
suffering from schizophrenia compared to healthy schizophrenia are warranted. Moreover, schizophrenia
[1]
controls . Future TMS studies may help explain the is not a static, but rather a dynamic, disorder; therefore,
underlying neurobiology of schizophrenia, and TMS TMS studies should focus more on patients with different
may help monitor and perhaps further optimize the stages of schizophrenia, i.e. patients experiencing
effectiveness of treatment interventions in patients with their first episode of schizophrenia versus patients with
this disease. However, despite the potential of using chronic schizophrenia.
TMS in the investigation of the underlying neurobiology
of schizophrenia, three critical notes are essential. Second, within the studies, insufficient attention has
been paid to the safety of using TMS on patients with
First, so far, TMS studies on schizophrenia have schizophrenia. This is remarkable considering that
been neither robust, consistent, nor standardized a vivid discussion of the risks of using TMS to treat
[3]
enough and have had high risks of publication bias, psychiatric patients is ongoing . From the literature, for
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