Cerebellar theta burst stimulation for the treatment of negative symptoms of schizophrenia: A multicenter, double-blind, randomized controlled trial
Open accessAbstract
Given the importance of the cerebellum in the pathophysiology of schizophrenia, the cerebellar vermis has been proposed as a new rTMS stimulation site for negative symptoms. In this study, 64 patients from 7 psychiatric hospitals were randomized into the study (n=32) or control (n=32) group. Intermittent theta burst stimulation (iTBS) (or sham stimulation) to the cerebellar midline was administered 5 times/week for 2 weeks. Psychotic symptoms were assessed with the Positive and Negative Symptoms Scale (PANSS) at baseline, the end of treatment, and 2, 6, 12, and 24 weeks after the treatment. Regarding the negative symptoms, the interaction effect between group and time was statistically significant, with the scores in the study group significantly lower than those in the control group at the 4 follow-ups after treatment, and the group difference was maximal at 24 weeks of follow-up. The main effect of time was significant; however, the main effect of group did not show statistical significance. Our study revealed that cerebellar iTBS may improve negative symptoms in schizophrenia patients, and the effect was more pronounced at 24 weeks after the end of treatment, which provides preliminary empirical evidence for the maintenance of efficacy after stimulation of this new site.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In controlled trials, CBM-iTBS in schizophrenia has significant findings up to 24 weeks following treatment.
“Specifically, a protocol of ten sessions of CBM-iTBS (delivered over 1–2 weeks) in patients with schizophrenia has demonstrated safety and tolerability (Demirtas-Tatlidede et al., 2010), reduced negative symptoms, improvements in mood, and improvements in cognitive functioning (Garg et al., 2016), with significant findings up to 24 weeks following treatment in controlled trials (Zhu et al., 2021).”
From A double-blind, randomized, sham-controlled clinical trial of cerebellar intermittent theta burst stimulation for bipolar disorder: Safety, tolerability, mood and cognitive effects (2025) · cites this paper as Zhu et al., 2021
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The Positive and Negative Syndrome Scale (PANSS) for schizophrenia.
Kay, S. R., Fiszbein, A., & Opler, L. A. (1987) · Schizophrenia Bulletin · doi:10.1093/schbul/13.2.261 · Cited by 21,378 · see citing works
Theta Burst Stimulation of the Human Motor Cortex
Huang, Y.-Z., Edwards, M. J., Rounis, E., Bhatia, K. P., & Rothwell, J. C. (2005) · Neuron · doi:10.1016/j.neuron.2004.12.033 · Cited by 4,158 · see citing works
International Statistical Classification of Diseases and Related Health Problems
Eisfeld, J. (2014) · TSQ Transgender Studies Quarterly · doi:10.1215/23289252-2399740 · Cited by 3,570 · see citing works
Functional topography in the human cerebellum: A meta-analysis of neuroimaging studies
STOODLEY, C., & SCHMAHMANN, J. (2009) · NeuroImage · doi:10.1016/j.neuroimage.2008.08.039 · Cited by 2,183 · see citing works
Lefaucheur, J.-P., André-Obadia, N., Antal, A., Ayache, S. S., Baeken, C., Benninger, D. H., Cantello, R. M., Cincotta, M., de Carvalho, M., De Ridder, D., et al. (2014) · Clinical Neurophysiology · doi:10.1016/j.clinph.2014.05.021 · Cited by 2,119 · see citing works
The role of the cerebellum in schizophrenia
Andreasen, N. C., & Pierson, R. (2008) · Biological Psychiatry · doi:10.1016/j.biopsych.2008.01.003 · Cited by 669 · see citing works
Hasan, A., Falkai, P., Wobrock, T., Lieberman, J. A., Glenthoj, B. Y., Gattaz, W. F., Thibaut, F., Möller, H., & the Wfsbp Task Force on Treatment Guidelines for Schizophrenia (2012) · The World Journal of Biological Psychiatry · doi:10.3109/15622975.2012.696143 · Cited by 637 · see citing works
Andreasen, N. C., O'Leary, D. S., Cizadlo, T., Arndt, S., Rezai, K., Ponto, L. L., Watkins, G. L., & Hichwa, R. D. (1996) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.93.18.9985 · Cited by 625 · see citing works
Krueger, C., & Tian, L. (2004) · Biological Research For Nursing · doi:10.1177/1099800404267682 · Cited by 561 · see citing works
Cerebellar-Prefrontal Network Connectivity and Negative Symptoms in Schizophrenia
Brady, R. O., Gonsalvez, I., Lee, I., Öngür, D., Seidman, L. J., Schmahmann, J. D., Eack, S. M., Keshavan, M. S., Pascual-Leone, A., & Halko, M. A. (2019) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2018.18040429 · Cited by 372 · see citing works
Brain Network Connectivity in Individuals with Schizophrenia and Their Siblings
Repovš, G., Csernansky, J. G., & Barch, D. M. (2010) · Biological Psychiatry · doi:10.1016/j.biopsych.2010.11.009 · Cited by 292 · see citing works
Chronic Cerebellar Stimulation in Epilepsy
Cooper, I. S. (1976) · Archives of Neurology · doi:10.1001/archneur.1976.00500080037006 · Cited by 269 · see citing works
KaSP, Moberget, T., Doan, N. T., Alnæs, D., Kaufmann, T., Córdova‐Palomera, A., Lagerberg, T. V., Diedrichsen, J., Schwarz, E., Zink, M., et al. (2017) · Molecular Psychiatry · doi:10.1038/mp.2017.106 · Cited by 228 · see citing works
Goghari, V. M., Sponheim, S. R., & MacDonald, A. W. (2009) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2009.09.004 · Cited by 224 · see citing works
Demirtas-Tatlidede, A., Freitas, C., Cromer, J. R., Safar, L., Ongur, D., Stone, W. S., Seidman, L. J., Schmahmann, J. D., & Pascual-Leone, A. (2010) · Schizophrenia Research · doi:10.1016/j.schres.2010.08.015 · Cited by 185 · see citing works
Cerebellum and psychiatric disorders
Baldaçara, L., Borgio, J. G. F., Lacerda, A. L. T. D., & Jackowski, A. P. (2008) · Revista Brasileira de Psiquiatria · doi:10.1590/s1516-44462008000300016 · Cited by 183 · see citing works
Wobrock, T., Guse, B., Cordes, J., Wölwer, W., Winterer, G., Gäebel, W., Langguth, B., Landgrebe, M., Eichhammer, P., Frank, E., et al. (2014) · Biological Psychiatry · doi:10.1016/j.biopsych.2014.10.009 · Cited by 170 · see citing works
Cerebellum and Schizophrenia: A Selective Review
Martin, P., & Albers, M. (1995) · Schizophrenia Bulletin · doi:10.1093/schbul/21.2.241 · Cited by 128 · see citing works
Fatemi, S. H., Folsom, T. D., Rooney, R. J., & THURAS, P. D. (2013) · Translational Psychiatry · doi:10.1038/tp.2013.64 · Cited by 125 · see citing works
Schmahmann, J. D. (2001) · International Review of Psychiatry · doi:10.1080/09540260120082092 · Cited by 122 · see citing works
Impaired cerebellar functional connectivity in schizophrenia patients and their healthy siblings
Collin, G. (2011) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2011.00073 · Cited by 115 · see citing works
Hajak, G., Marienhagen, J., Langguth, B., WERNER, S., Binder, H., & Eichhammer, P. (2004) · Psychological Medicine · doi:10.1017/s0033291704002338 · Cited by 106 · see citing works
Garg, S., Sinha, V. K., Tikka, S. K., Mishra, P., & Goyal, N. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.07.023 · Cited by 95 · see citing works
Theta-burst stimulation: Remote physiological and local behavioral after-effects
Stefan, K., Gentner, R., Zeller, D., Dang, S., & Claßen, J. (2007) · NeuroImage · doi:10.1016/j.neuroimage.2007.11.037 · Cited by 94 · see citing works
Repetitive transcranial magnetic stimulation: a tool for human cerebellar plasticity.
Koch, G. (2011) · PubMed · Cited by 68 · see citing works
Cerebellar pathology in schizophrenia—Cause or consequence?
Snider, S. R. (1982) · Neuroscience & Biobehavioral Reviews · doi:10.1016/0149-7634(82)90006-9 · Cited by 67 · see citing works
Treatment of Cognitive Dysfunction in Psychiatric Disorders
Medalia, A. A., & Lim, R. (2004) · Journal of Psychiatric Practice · doi:10.1097/00131746-200401000-00003 · Cited by 64 · see citing works
Brain stem nuclei giving fibers to lobules VI and VII of the cerebellar vermis
Batini, C., Buisseret-Delmas, C., Corvisier, J., Hardy, O., & Jassik-Gerschenfeld, D. (1978) · Brain Research · doi:10.1016/0006-8993(78)90405-5 · Cited by 61 · see citing works
Tikka, S. K., Garg, S., Sinha, V. K., Nizamie, S. H., & Goyal, N. (2015) · Journal of Ect · doi:10.1097/yct.0000000000000242 · Cited by 36 · see citing works
Emotional management in stable patient with schizophrenia
Zheng, M., Shi, C., Kang, L., Yao, S., Xu, Y., Xu, X., Shi, J., & Zhang, C. (2015) · Chin J Psychiatry · doi:10.3760/cma.j.issn.1006-7884.2015.04.008 · Cited by 4 · see citing works
Flagged first, then by citations
Research works printed but not linked: 2
- Li-Li, Z., Feng, Y.I., Xing-Fu, Z., Xing-Yan, J., 2015. Effects of repetitive transcranial magnetic stimulation with theta burst stimulation paradigm on executive function in patients with chronic schizophrenia. Chin. J. Rehabilit. Theory Pract. 21 (6), 689-694.
- Zhang, Q., Cai, J., Ge, C.C., Liu, Y., 2017. New progress in clinical research of repetitive transcranial magnetic stimulation in schizophrenia. Chin. J. Rehabil. 32 (4), 343-346.
Cited by
Sorted by citations
Assessment of Noninvasive Brain Stimulation Interventions for Negative Symptoms of Schizophrenia
Tseng, P., Zeng, B., Hung, C., Liang, C., Stubbs, B., Carvalho, A. F., Brunoni, A. R., Su, K., Tu, Y., Wu, Y., et al. (2022) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2022.1513 · Cited by 142 · see citing works
Yoshida, J., Oñate, M., Khatami, L., Vera, J. R., Farzan Nadim, A., & Khodakhah, K. (2022) · Journal of Neuroscience · doi:10.1523/jneurosci.1535-22.2022 · Cited by 96 · see citing works
Hua, J. P. Y., Abram, S. V., & Ford, J. M. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.1069488 · Cited by 35 · see citing works
Cerebellar Structure and Cognitive Ability in Psychosis
Moussa‐Tooks, A. B., Rogers, B. P., Huang, A., Sheffield, J. M., Heckers, S., & Woodward, N. D. (2022) · Biological Psychiatry · doi:10.1016/j.biopsych.2022.03.013 · Cited by 32 · see citing works
Theta Burst Stimulation Protocols for Schizophrenia
Kishi, T., Ikuta, T., Sakuma, K., Hamanaka, S., Nishii, Y., Hatano, M., Kito, S., & Iwata, N. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.41159 · Cited by 24 · see citing works
Goh, K. K., Chen, C.-H., Wu, T., Chiu, Y.-H., & Lu, M. (2022) · Frontiers in Pharmacology · doi:10.3389/fphar.2022.944437 · Cited by 24 · see citing works
The use of theta burst stimulation in patients with schizophrenia – A systematic review
Poorganji, M., Göke, K., Zomorrodi, R., Voineskos, D., Rajji, T. K., Daskalakis, Z. J., & Blumberger, D. M. (2023) · Schizophrenia Research · doi:10.1016/j.schres.2023.10.005 · Cited by 22 · see citing works
Tan, X. W., Goh, S. E., Lee, J. J., Vanniasingham, S. D., Brunelin, J., Lee, J., & Tor, P. C. (2023) · Brain Sciences · doi:10.3390/brainsci14010018 · Cited by 15 · see citing works
An Update on the Use of Neuromodulation Strategies in the Treatment of Schizophrenia
Neufeld, N. H., & Blumberger, D. M. (2025) · American Journal of Psychiatry · doi:10.1176/appi.ajp.20250068 · Cited by 14 · see citing works
Advances in Cerebellar TMS Therapy: An Updated Systematic Review on Multi-Session Interventions
Ciricugno, A., Paternò, S., Barbati, N., Borgatti, R., Cattaneo, Z., & Ferrari, C. (2025) · Biomedicines · doi:10.3390/biomedicines13071578 · Cited by 12 · see citing works
Wang, L., Zhao, P., Zhang, J., Zhang, R., Liu, J., Duan, J., Zhang, X., Zhu, R., & Wang, F. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.07.054 · Cited by 12 · see citing works
Shinn, A. K., Puerto, A. M. H., Roh, Y. S., Ho, V. M., Hwang, M., Cohen, B. M., Öngür, D., & Camprodon, J. A. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1218321 · Cited by 12 · see citing works
Abram, S. V., Hua, J. P. Y., Nicholas, S., Roach, B., Keedy, S., Sweeney, J. A., Mathalon, D., & Ford, J. M. (2024) · Biological Psychiatry: Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2024.01.010 · Cited by 12 · see citing works
Wang, M., Lu, S., Hao, L., Xia, Y., Shi, Z., & Su, L. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1377257 · Cited by 11 · see citing works
Motor actions across psychiatric disorders: a research domain criteria (RDoC) perspective
Osborne, K. J., Walther, S., & Mittal, V. A. (2024) · Clinical Psychology Review · doi:10.1016/j.cpr.2024.102511 · Cited by 9 · see citing works
Étrendi tényezők és tápanyagok szerepe rheumatoid arthritisben
Polyák, É., Müller, H., Figler, M., Sütő, G., Herman, V., & Breitenbach, Z. (2023) · Orvosi Hetilap · doi:10.1556/650.2023.32797 · Cited by 7 · see citing works
The Therapeutic Role of Intermittent Theta Burst Stimulation in Schizophrenia
Salabat, D., Pourebrahimi, A., Mayeli, M., & Cattarinussi, G. (2024) · Journal of Ect · doi:10.1097/yct.0000000000000972 · Cited by 7 · see citing works
Cerebellar–Basal Ganglia Dysconnectivity in Schizophrenia: Insights into Motivational Deficits
Wang, X., Guo, X., Cai, X., Huang, B., Wang, Y., Pu, C., Yu, X., Lui, S. S. Y., & Chan, R. C. K. (2025) · Schizophrenia Bulletin · doi:10.1093/schbul/sbaf087 · Cited by 7 · see citing works
Self-citationCao, H., Árgyelán, M., Yan, J., Velioğlu, H. A., Fang, F., Joanlanne, A., Kang, S., Prizgint, L., Schugart, J., Brown, K., et al. (2025) · Biological Psychiatry · doi:10.1016/j.biopsych.2025.06.023 · Cited by 6 · see citing works
Chen, R., Gao, Q., Wu, D.-W., Hao, J., Zhao, J., Wang, X., He, J.-H., Yuan, F., Kang, X., Wang, L., et al. (2025) · Neurotherapeutics · doi:10.1016/j.neurot.2025.e00635 · Cited by 6 · see citing works
Purushotham, A., Goyal, N., Sinha, V. K., Tikka, S. K., Garg, S., & Desarkar, P. (2022) · International Journal of Developmental Neuroscience · doi:10.1002/jdn.10210 · Cited by 5 · see citing works
Xiao, Y., Kandala, S., Huang, J., Liu, J., McGonigle, T., Barch, D. M., Tang, Y., Fan, G., Wang, F., & Womer, F. Y. (2024) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2024.11.023 · Cited by 4 · see citing works
Illuminating posterior targets for transcranial magnetic stimulation beyond the prefrontal cortex
McCalley, D. M., Sanderson, L. L., Dowdle, L. T., Padula, C. B., Siddiqi, S., Ellard, K. K., & Taylor, J. J. (2025) · Nature Mental Health · doi:10.1038/s44220-025-00433-3 · Cited by 4 · see citing works
Wen, K.-S., Yang, X.-H., Zhang, N., Lin, S., Huang, X., Jackson, T., Xiang, Y., & Zheng, W. (2024) · ALPHA PSYCHIATRY · doi:10.5152/alphapsychiatry.2024.241799 · Cited by 4 · see citing works
Trapp, N. T., Muller Ewald, V. A., Pace, B. D., Wendt, L., Garrett, L., Penaluna, B., Miller, J., Purgianto, A., van der Plas, E., Magnotta, V. A., et al. (2025) · Transcranial Magnetic Stimulation · doi:10.1016/j.transm.2024.100082 · Cited by 3 · see citing works
Hu, Q., Jiao, X., Tang, X., Hu, Y., Xu, L., Wei, Y., Cui, H., Tang, Y., Chen, T., Liu, H., et al. (2025) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2025.05.045 · Cited by 3 · see citing works
Cerebellar Transcranial Magnetic Stimulation in Psychiatric Disorders: A Systematic Review
Basavaraju, R., Kaur, S., & Mehta, U. M. (2024) · Current Behavioral Neuroscience Reports · doi:10.1007/s40473-024-00270-1 · Cited by 3 · see citing works
Tong, S., Chen, S., Chen, J., Tong, Z., Li, W., Liu, S., Shi, H., Yao, L., Zhang, C., & Zhang, X. (2026) · Brain Communications · doi:10.1093/braincomms/fcag027 · Cited by 2 · see citing works
de Freitas, S. H. C., Mendonça, J. D. D. O., LIMA, L. M. R. D., & SILVA, K. K. S. D. (2023) · Congresso Nacional de Inovações em Saúde · doi:10.51161/conais2023/22979 · Cited by 1 · see citing works
Emerging Non-invasive Brain Stimulations for Schizophrenia
Wang, X., Blumberger, D. M., Ismail, P., & Foll, B. L. (2024) · Royal Society of Chemistry eBooks · doi:10.1039/9781837672059-00156 · Cited by 1 · see citing works
Personalization and network specificity of cerebellar TMS in schizophreniaPreprint
Joncas, E., Payne, E., Lee, E., Demo, I., Nye, M., Chouinard, V., Dannhauer, M., Brady, R. O., Halko, M. A., & Parlikar, R. U. (2025) · medRxiv · doi:10.64898/2025.12.19.25342404 · Cited by 1 · see citing works
Rôle du cervelet dans les émotions
Thomasson, M., & Péron, J. (2023) · Revue de neuropsychologie · doi:10.1684/nrp.2023.0739
Taiar, I., Gomes, J. S., Jorge, L., Ziebold, C., Fernandes, A., Biokino, R. M., Lorencetti, P. G., Brunoni, A. R., & Gadelha, A. (2025) · Brain Sciences · doi:10.3390/brainsci15091021
Xu, M., Singavarapu, A., Philips, R., Zheng, M., Martin, D. M., Nikolin, S., Mutz, J., Becker, A., Firenze, R. M., & Tsai, L. (2026) · medRxiv · doi:10.64898/2026.04.10.26350641
Kumar, N., Hans, G., Madiha, M., Prasad, S. K., & Narnoli, S. (2026) · Indian Journal of Psychiatry · doi:10.4103/indianjpsychiatry_494_25
Ghaffarvand-Mokari, M., Najafi, Z. S., Heysieattalab, S., & Navi, F. F. T. (2026) · The Cerebellum · doi:10.1007/s12311-026-02079-y
Liu, X., Dong, D., Song, C., Ma, Y., Wu, D.-W., Wang, X., Hao, J., Li, H., Zhao, J., Hu, G., et al. (2026) · CNS Neuroscience & Therapeutics · doi:10.1002/cns.71231
- Authors
- Zhu, L., Zhang, W., Zhu, Y., Mu, X., Zhang, Q., Wang, Y., Cai, J., & Xie, B.
- Affiliations
- Shanghai Jiao Tong University (CN)
- Tongji University (CN)
- Corresponding author
- Cai, Jun
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2021-11
- Volume
- 305
- Pages
- 114204
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W3198292874
- Cited by
- 37
- References
- 30
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 10 · 2023: 7 · 2022: 6
- FWCI
- 2.30
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Psychiatry Research (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Keywords
- intermittent theta burst stimulation, negative symptoms, schizophrenia, cerebellar vermis, repetitive transcranial magnetic stimulation, sham stimulation, cerebellum
- MeSH terms
- Double-Blind Method, Humans, Schizophrenia, Theta Rhythm, Treatment Outcome, Transcranial Magnetic Stimulation, Cerebellar Vermis
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
