547. TRANSCRANIAL MAGNETIC STIMULATION IN LESS COMMON INDICATIONS - FOCUSED ON SCHIZOPHRENIA AND BORDERLINE PERSONALITY DISORDER

Abstract Background Repetitive transcranial magnetic stimulation (rTMS) is an established therapeutic method for the treatment of several neuropsychiatric disorders. This fully applies to the treatment of major depressive disorder, including patients with treatment-resistant depression. Aims & Objectives The efficacy of this non-invasive neurostimulation method in other indications including schizophrenia is less clear. In the case of negative symptoms, its efficacy was rated as B (probably effective) in the international guidelines (Lefaucheur et al., 2014). When these guidelines were updated six years later, the efficacy rating was downgraded to C (potentially effective) (Lefaucheur et al., 2020). This change was based on a large German study that did not demonstrate the efficacy of rTMS on negative symptoms (Wobrock et al., 2015). Method To verify these results, we therefore conducted another multicenter Czech-German study assessing high-frequency rTMS of the left dorsolateral prefrontal cortex and comparing it with intermittent theta-burst stimulation (iTBS) and sham stimulation. Patients underwent a total of twenty sessions in four consecutive weeks. Results A total of 54 patients were included in the study. At the end, we found a significant reduction in the severity of negative symptoms in all three groups, the difference between the groups was not significant. Discussion & Conclusions Even less is known about the potential use of rTMS in borderline personality disorder than in schizophrenia, although some pilot results are promising (Benster et al., 2023). In our ongoing study, we are assessing the efficacy of high-frequency rTMS targeted to the right dorsolateral prefrontal cortex with or without Dialectical behavior therapy (DBT) compared to sham stimulation (with or without DBT). Pilot results of rTMS (active and sham) without DBT will be presented for the first time at the conference.