13–16In an update (2014–2018) of the evidence-based guidelines on the therapeutic use of rTMS, experts reviewed its curative effect on AH and negative symptoms unfortunately, the strong heterogeneity between studies failed to support an extensive clinical application of such treatment. 9 Data from several studies using functional MRI (fMRI) have supported that rTMS on language-perception area can alleviate AH without any impact on functional connectivity (FC) within the language network, 10–12 while few other studies have found the FC alteration as the symptom relieved.

7 8 However, a randomised, double-blind and sham-controlled trial suggested that therapeutic rTMS administered to the DLPFC in SZ did not result in evident cognitive enhancing effects. 6 For instance, 20 Hz repetitive TMS (rTMS) over left dorsolateral prefrontal cortex (DLPFC) was considered a safe and well-tolerated treatment for negative symptoms and cognitive deficit of SZ. A number of previous studies have explored the role of TMS in the treatment of cognitive deficit, 5 auditory hallucinations (AH) and negative symptoms. 4 As a non-invasive neurostimulation technique, transcranial magnetic stimulation (TMS) seems to be a promising add-on therapy that regulates brain function by activating or suppressing neural activity in an effective and safe manner, even though the evidences are controversial. Since a substantial proportion of patients are resistant to first-line antipsychotics, pharmacological interventions are sometimes insufficient in the treatment for SZ.

Known for its prominent psychotic symptoms such as hallucination and delusion, schizophrenia (SZ), with a lifetime prevalence of 0.30%–0.66% in the general population, 1–3 is a severe psychiatric illness that tends to be chronic and recurrent, leading to varying degrees of cognitive impairment and social disability.

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