SYSTEMATIC REVIEW article
Front. Psychiatry
Sec. Neurostimulation
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1491487
Accelerated Neurostimulation Protocols for Auditory Hallucinations: A Systematic Review and Meta-Analysis
Provisionally accepted
- The Institute of Living, Hartford, United States
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: To explore the efficacy and characteristics of accelerated (more than once daily) protocols of repetitive transcranial magnetic stimulation (rTMS) and transcranial Electrical Stimulation (tES) in treating auditory hallucinations (AH) and other psychotic symptoms.Methods:"We searched Pubmed" using relevant MeSH terms and keywords to identify relevant literature. Standard mean difference (SMD) and 95% confidence interval (CI) values were used to evaluate the effects of rTMS and tES.Results: Eighteen studies were included, eight which used rTMS and ten which used tES. AHs and positive psychotic symptoms (PPS) improved in all studies from before to after treatment (SMD = 0.64, 95%CI = 0.77 to 0.51). Superiority was seen in the groups using fMRI guidance and using cTBS. Thirteen studies used a sham group as a control, which collectively showed statistically significant improvement in AHs with a moderate effect size (SMD = 0.34, 95%CI -0.50 to 0.18). However, these studies included a high level of heterogeneity as measured by Cochran's Q and I 2 . Meta-analysis performed showed no consistent improvement of negative symptoms and did not differ significantly between the treatment and sham groups.Conclusion: There appears to be a therapeutic effect for accelerated neurostimulation protocols for AHs on par with non-accelerated approaches. These protocols take up less overall time and often provide less overall stimulus. This result needs to be confirmed by large-scale randomized controlled trials before this finding can be recommended in clinical practice.
Keywords: Transcranial magnetic stimulation (TMS), Theta burst stimulation (TBS), Accelerated, Auditory Hallucinations (AH), psychosis
Received: 04 Sep 2024; Accepted: 05 May 2025.
Copyright: © 2025 Hotz, Koysyakova and Sharma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Tremearne Hotz, The Institute of Living, Hartford, United States
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.