rTMS for the treatment of psychotic disorders

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive method for the modulation of cortical excitability. Stimulation effects outlast the stimulation period and depend strongly on stimulation parameters, especially on coil position and stimulation frequency. Low frequency rTMS reduces cortical excitability and was demonstrated to reduce acoustic hallucinations when applied to the left temporoparietal cortex. High frequency rTMS of the prefrontal cortex modulates mesolimbic and mesostriatal dopaminergic systems. These areas are central parts of the human dopaminergic reward system and involved in the genesis of negative symptoms in schizophrenic patients. Negative symptoms were significantly reduced in schizophrenic patients after two weeks of 10 Hz rTMS of the dorsolateral prefrontal cortex.