Efficacy and safety of continuous theta burst stimulation for auditory hallucinations: a GRADE-assessed meta-analysis of randomized sham-controlled trials

Background - Auditory hallucinations (AHs) represent a clinical burden and are refractory to antipsychotics in approximately 25% of cases. Continuous theta burst stimulation (cTBS) has been explored as a neuromodulation option in treating AHs. However, the current evidence regarding its efficacy is...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Hauptverfasser: Kassar, Omar (VerfasserIn) , Selim, Abdullah (VerfasserIn) , Insan, Shrabon (VerfasserIn) , Hassan, Osama (VerfasserIn) , Sartorius, Alexander (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: February 2026
In: Asian journal of psychiatry
Year: 2026, Jahrgang: 116, Pages: 1-14
ISSN:1876-2026
DOI:10.1016/j.ajp.2025.104822
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.ajp.2025.104822
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S1876201825004654
Volltext
Verfasserangaben:Omar Kassar, Abdullah Selim, Shrabon Insan, Osama Hassan, Alexander Sartorius

MARC

LEADER 00000naa a2200000 c 4500
001 1961778726
003 DE-627
005 20260219115330.0
007 cr uuu---uuuuu
008 260219s2026 xx |||||o 00| ||eng c
024 7 |a 10.1016/j.ajp.2025.104822  |2 doi 
035 |a (DE-627)1961778726 
035 |a (DE-599)KXP1961778726 
040 |a DE-627  |b ger  |c DE-627  |e rda 
041 |a eng 
084 |a 11  |2 sdnb 
100 1 |a Kassar, Omar  |e VerfasserIn  |0 (DE-588)1390725405  |0 (DE-627)1961779242  |4 aut 
245 1 0 |a Efficacy and safety of continuous theta burst stimulation for auditory hallucinations  |b a GRADE-assessed meta-analysis of randomized sham-controlled trials  |c Omar Kassar, Abdullah Selim, Shrabon Insan, Osama Hassan, Alexander Sartorius 
264 1 |c February 2026 
300 |b Diagramme 
300 |a 14 
336 |a Text  |b txt  |2 rdacontent 
337 |a Computermedien  |b c  |2 rdamedia 
338 |a Online-Ressource  |b cr  |2 rdacarrier 
500 |a Online verfügbar: 29. Dezember 2025, Artikelversion: 31. Dezember 2025 
500 |a Gesehen am 19.02.2026 
520 |a Background - Auditory hallucinations (AHs) represent a clinical burden and are refractory to antipsychotics in approximately 25% of cases. Continuous theta burst stimulation (cTBS) has been explored as a neuromodulation option in treating AHs. However, the current evidence regarding its efficacy is inconclusive. This is the first meta-analysis to synthesize evidence exclusively from sham-controlled trials. - Methods - We conducted comprehensive search until September 2025 to include randomized controlled trials (RCTs) that compared cTBS versus sham stimulation in patients experiencing AHs. The primary outcome was the change in AHs measured by validated scales, pooled using standardized mean difference (SMD). - Results - Five RCTs, including 326 patients with schizophrenia spectrum disorders, were included. cTBS demonstrated a statistically significant superiority over sham stimulation in reducing AHs (SMD = −0.34, 95% CI [-0.57, −0.12], P=0.002), with no heterogeneity (P=0.92, I2 = 0%), and moderate certainty of the current evidence. Sensitivity analysis and the Galbraith plot confirmed results robustness. No publication bias was observed. Subgroup analyses showed greater efficacy in patients with bilateral temporoparietal junctions stimulation, refractory AHs, and delivering 18,000 total pulses. cTBS and sham stimulation did not differ in discontinuation rates, serious adverse events, headache, dizziness, or gastrointestinal symptoms. - Conclusion - The findings of our study suggest that cTBS can be safely applied and may be effective in reducing auditory hallucinations in patients with schizophrenia spectrum disorders, particularly in patients with limited response to antipsychotic medication. Further RCTs are needed to confirm our results and identify the optimal treatment parameters. 
650 4 |a Auditory hallucinations 
650 4 |a CTBS 
650 4 |a Meta-analysis 
650 4 |a RTMS 
650 4 |a Schizophrenia 
650 4 |a Theta burst stimulation 
700 1 |a Selim, Abdullah  |e VerfasserIn  |4 aut 
700 1 |a Insan, Shrabon  |e VerfasserIn  |4 aut 
700 1 |a Hassan, Osama  |e VerfasserIn  |4 aut 
700 1 |a Sartorius, Alexander  |d 1966-  |e VerfasserIn  |0 (DE-588)1028604793  |0 (DE-627)732049350  |0 (DE-576)376099836  |4 aut 
773 0 8 |i Enthalten in  |t Asian journal of psychiatry  |d Amsterdam [u.a.] : Elsevier, 2008  |g 116(2026) vom: Feb., Artikel-ID 104822, Seite 1-14  |h Online-Ressource  |w (DE-627)582023726  |w (DE-600)2456678-0  |w (DE-576)302970622  |x 1876-2026  |7 nnas  |a Efficacy and safety of continuous theta burst stimulation for auditory hallucinations a GRADE-assessed meta-analysis of randomized sham-controlled trials 
773 1 8 |g volume:116  |g year:2026  |g month:02  |g elocationid:104822  |g pages:1-14  |g extent:14  |a Efficacy and safety of continuous theta burst stimulation for auditory hallucinations a GRADE-assessed meta-analysis of randomized sham-controlled trials 
856 4 0 |u https://doi.org/10.1016/j.ajp.2025.104822  |x Verlag  |x Resolving-System  |z lizenzpflichtig  |3 Volltext  |7 1 
856 4 0 |u https://www.sciencedirect.com/science/article/pii/S1876201825004654  |x Verlag  |z lizenzpflichtig  |3 Volltext  |7 1 
951 |a AR 
992 |a 20260219 
993 |a Article 
994 |a 2026 
998 |g 1028604793  |a Sartorius, Alexander  |m 1028604793:Sartorius, Alexander  |d 60000  |e 60000PS1028604793  |k 0/60000/  |p 5  |y j 
999 |a KXP-PPN1961778726  |e 4920251505 
BIB |a Y 
SER |a journal 
JSO |a {"physDesc":[{"extent":"14 S.","noteIll":"Diagramme"}],"name":{"displayForm":["Omar Kassar, Abdullah Selim, Shrabon Insan, Osama Hassan, Alexander Sartorius"]},"language":["eng"],"recId":"1961778726","type":{"bibl":"article-journal","media":"Online-Ressource"},"relHost":[{"id":{"zdb":["2456678-0"],"issn":["1876-2026"],"eki":["582023726"]},"part":{"year":"2026","extent":"14","volume":"116","text":"116(2026) vom: Feb., Artikel-ID 104822, Seite 1-14","pages":"1-14"},"pubHistory":["1.2008 -"],"origin":[{"publisher":"Elsevier","dateIssuedDisp":"2008-","publisherPlace":"Amsterdam [u.a.]","dateIssuedKey":"2008"}],"title":[{"subtitle":"the official journal of the Asian Federation of Psychiatric Associations","title":"Asian journal of psychiatry","title_sort":"Asian journal of psychiatry"}],"note":["Gesehen am 14.10.2020"],"disp":"Efficacy and safety of continuous theta burst stimulation for auditory hallucinations a GRADE-assessed meta-analysis of randomized sham-controlled trialsAsian journal of psychiatry","type":{"media":"Online-Ressource","bibl":"periodical"},"recId":"582023726","language":["eng"],"physDesc":[{"extent":"Online-Ressource"}]}],"note":["Online verfügbar: 29. Dezember 2025, Artikelversion: 31. Dezember 2025","Gesehen am 19.02.2026"],"person":[{"display":"Kassar, Omar","family":"Kassar","role":"aut","given":"Omar"},{"display":"Selim, Abdullah","family":"Selim","given":"Abdullah","role":"aut"},{"display":"Insan, Shrabon","given":"Shrabon","role":"aut","family":"Insan"},{"family":"Hassan","role":"aut","given":"Osama","display":"Hassan, Osama"},{"display":"Sartorius, Alexander","family":"Sartorius","given":"Alexander","role":"aut"}],"title":[{"title":"Efficacy and safety of continuous theta burst stimulation for auditory hallucinations","title_sort":"Efficacy and safety of continuous theta burst stimulation for auditory hallucinations","subtitle":"a GRADE-assessed meta-analysis of randomized sham-controlled trials"}],"origin":[{"dateIssuedKey":"2026","dateIssuedDisp":"February 2026"}],"id":{"doi":["10.1016/j.ajp.2025.104822"],"eki":["1961778726"]}} 
SRT |a KASSAROMAREFFICACYAN2026