Aleman A, Brummelman J, Dlabac-de Lange J J, Koops S, Knegtering H, Neggers S F W, Sommer I E
Tijdschr Psychiatr. 2017;59(10):612-616.
New approaches are needed in the treatment of characteristic symptoms of schizophrenia such as hallucinations and negative symptoms. Non-invasive brain stimulation can make a useful contribution.
AIM: To discuss the published evidence regarding efficacy and safety of repetitive transcranial magnetic stimulation (rtms) and transcranial direct current stimulation (tdcs) when used in the treatment of auditory verbal hallucinations and negative symptoms.
METHOD: We review and discuss recent meta-analyses and we analyse relevant factors.
RESULTS: On average, when compared to sham-stimulation, rtms was found to have a significant effect on hallucinations and negative symptoms. Nevertheless, the results of some studies were variable and some studies did not report any improvement. There are indications that some factors such as age and distance between scalp and cortex may influence efficiency. There were only a few studies relating to the use of tdcs and none of these reported a clear effect.
CONCLUSION: There is reasonable evidence that rtms is an efficient treatment for hallucinations and negative symptoms, although some variable results have been reported. There is insufficient evidence for conclusions to be drawn about the efficacy of tdcs for the treatment of hallucinations and negative symptoms. However, both simulation methods are safe and largely without side-effects.
治疗精神分裂症的特征性症状（如幻觉和阴性症状）需要新的方法。非侵入性脑刺激可以发挥有益作用。
探讨重复经颅磁刺激（rtms）和经颅直流电刺激（tdcs）用于治疗幻听和阴性症状时已发表的关于疗效和安全性的证据。
我们回顾并讨论近期的荟萃分析，并分析相关因素。
平均而言，与假刺激相比，rtms被发现对幻觉和阴性症状有显著影响。然而，一些研究结果存在差异，一些研究未报告有任何改善。有迹象表明，年龄和头皮与皮层之间的距离等一些因素可能会影响疗效。关于tdcs使用的研究很少，且这些研究均未报告有明显效果。
有合理证据表明rtms是治疗幻觉和阴性症状的有效方法，尽管报告了一些不同的结果。关于tdcs治疗幻觉和阴性症状的疗效，尚无足够证据得出结论。然而，这两种模拟方法都是安全的，且基本无副作用。
