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The Journal of Clinical Psychiatry

Original Research Focus on Psychosis May 11, 2026

Effects of Experimental Intermittent Theta Burst Stimulation on Negative Symptoms of Schizophrenia: A Double-Blind Sham-Controlled Study

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J Clin Psychiatry 2026;87(2):25m16093

Abstract

Background: Negative symptoms remain among the most debilitating and treatment-resistant features of schizophrenia. Repetitive transcranial magnetic stimulation, particularly intermittent theta burst stimulation (iTBS), is emerging as a promising intervention targeting these domains.

Objective: This study aimed to evaluate the efficacy of experimental iTBS applied to the left dorsolateral prefrontal cortex (DLPFC) in ameliorating negative symptoms in patients with schizophrenia.

Methods: In a double-blind, randomized, sham-controlled design, patients with schizophrenia (active group = 71) received daily sessions of experimental iTBS or sham stimulation (sham group = 70) over the left DLPFC for 3 weeks. Clinical outcomes were assessed using the Scale for the Assessment of Negative Symptoms, with a focus on the negative subscale. Patients were diagnosed based on ICD-10 clinical criteria.

Results: Compared to sham, active experimental iTBS did not result in statistically significant improvements in negative symptoms at posttreatment or follow-up. However, the results indicate that experimental iTBS is a safe and well-tolerated intervention with minor adverse effects.

Conclusions: Consistent with several recent large-scale trials and meta-analyses, the findings suggest limited efficacy of experimental iTBS over the left DLPFC for negative symptoms. Future research may investigate alternative stimulation targets, protocols, or combined interventions to enhance treatment outcomes in this population.

Trial Registration: Clinical Trial Registry-India (CTRI) identifier: CTRI/2019/05 019099

J Clin Psychiatry 2026;87(2):25m16093

Author affiliations are listed at the end of this article.

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