Adjunctive transcranial direct current stimulation for cognitive improvement in schizophrenia: insights from a systematic review and exploratory meta-analysis

IntroductionTo objectively and accurately evaluate the clinical efficacy of transcranial direct current stimulation (tDCS) for schizophrenia, we conducted this systematic review and exploratory meta-analysis (PROSPERO: CRD420251002632).MethodsFirstly, randomized controlled trials (RCTs) related to t...

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Main Authors: Gaolei Yao, Yuan Huang, Junjiao Ping, Yixuan Han, Liming Lu, Xinxia Liu, Huipeng Lu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Psychiatry
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Online Access:https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1617068/full
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author Gaolei Yao
Gaolei Yao
Yuan Huang
Junjiao Ping
Yixuan Han
Liming Lu
Xinxia Liu
Huipeng Lu
author_facet Gaolei Yao
Gaolei Yao
Yuan Huang
Junjiao Ping
Yixuan Han
Liming Lu
Xinxia Liu
Huipeng Lu
author_sort Gaolei Yao
collection DOAJ
description IntroductionTo objectively and accurately evaluate the clinical efficacy of transcranial direct current stimulation (tDCS) for schizophrenia, we conducted this systematic review and exploratory meta-analysis (PROSPERO: CRD420251002632).MethodsFirstly, randomized controlled trials (RCTs) related to the adjunctive use of tDCS for schizophrenia were searched on PubMed, Embase and Web of Science databases according to search strategies developed in advance. Secondly, the eligible articles were screened according to the inclusion and exclusion criteria. Finally, the data were extracted and a complete meta-analysis was performed. Meanwhile, we also completed publication bias analysis and sensitivity analysis. Statistical analysis was conducted using RevMan software (version 5.4).ResultsWe ultimately included 11 eligible RCTs. The results of the exploratory meta-analysis indicated that the adjunctive use of tDCS seems to be able to enhance the cognitive function of patients (the Paced Auditory Serial Addition Task: standardized mean deviation (SMD) = 3.57, 95% confidence interval (CI) (2.60, 4.54), P < 0.00001). Subgroup analyses showed that the adjunctive use of tDCS at 15 sessions (Clinical Global Impression-Schizophrenia scale: SMD= -0.56, 95% CI (-0.87, -0.25), P=0.0004) or twice daily (Clinical Global Impression-Schizophrenia scale: SMD= -0.85, 95% CI (-1.67, -0.03), P=0.04) also decreased the disease severity.DiscussionThis exploratory meta-analysis revealed that tDCS in the treatment of schizophrenia appears capable of improving cognitive function and effectively reducing the severity of the disease. What’s more, tDCS has great development potential in schizophrenia, and it may be written into the guidelines for non-drug treatment of schizophrenia in the future. As a matter of fact, this exploratory study points out the direction for future scientific research and clinical practice.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251002632.
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spelling doaj-art-7c66c682a7d84fa09d52fe246bf6813c2025-08-20T02:35:57ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-07-011610.3389/fpsyt.2025.16170681617068Adjunctive transcranial direct current stimulation for cognitive improvement in schizophrenia: insights from a systematic review and exploratory meta-analysisGaolei Yao0Gaolei Yao1Yuan Huang2Junjiao Ping3Yixuan Han4Liming Lu5Xinxia Liu6Huipeng Lu7Clinical Research and Big Data Laboratory, South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, ChinaDepartment of Psychiatry, The Third People’s Hospital of Zhongshan, Zhongshan, ChinaDepartment of Acupuncture, Shaoguan Hospital of Traditional Chinese Medicine, Shaoguan, ChinaDepartment of Psychiatry, The Third People’s Hospital of Zhongshan, Zhongshan, ChinaEuropean Languages and Cultures, Beijing Foreign Studies University, Beijing, ChinaClinical Research and Big Data Laboratory, South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, ChinaDepartment of Psychiatry, The Third People’s Hospital of Zhongshan, Zhongshan, ChinaDepartment of Psychiatry, The Third People’s Hospital of Zhongshan, Zhongshan, ChinaIntroductionTo objectively and accurately evaluate the clinical efficacy of transcranial direct current stimulation (tDCS) for schizophrenia, we conducted this systematic review and exploratory meta-analysis (PROSPERO: CRD420251002632).MethodsFirstly, randomized controlled trials (RCTs) related to the adjunctive use of tDCS for schizophrenia were searched on PubMed, Embase and Web of Science databases according to search strategies developed in advance. Secondly, the eligible articles were screened according to the inclusion and exclusion criteria. Finally, the data were extracted and a complete meta-analysis was performed. Meanwhile, we also completed publication bias analysis and sensitivity analysis. Statistical analysis was conducted using RevMan software (version 5.4).ResultsWe ultimately included 11 eligible RCTs. The results of the exploratory meta-analysis indicated that the adjunctive use of tDCS seems to be able to enhance the cognitive function of patients (the Paced Auditory Serial Addition Task: standardized mean deviation (SMD) = 3.57, 95% confidence interval (CI) (2.60, 4.54), P < 0.00001). Subgroup analyses showed that the adjunctive use of tDCS at 15 sessions (Clinical Global Impression-Schizophrenia scale: SMD= -0.56, 95% CI (-0.87, -0.25), P=0.0004) or twice daily (Clinical Global Impression-Schizophrenia scale: SMD= -0.85, 95% CI (-1.67, -0.03), P=0.04) also decreased the disease severity.DiscussionThis exploratory meta-analysis revealed that tDCS in the treatment of schizophrenia appears capable of improving cognitive function and effectively reducing the severity of the disease. What’s more, tDCS has great development potential in schizophrenia, and it may be written into the guidelines for non-drug treatment of schizophrenia in the future. As a matter of fact, this exploratory study points out the direction for future scientific research and clinical practice.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251002632.https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1617068/fulltranscranial direct current stimulationcognitive functionschizophreniasystematic reviewmeta-analysis
spellingShingle Gaolei Yao
Gaolei Yao
Yuan Huang
Junjiao Ping
Yixuan Han
Liming Lu
Xinxia Liu
Huipeng Lu
Adjunctive transcranial direct current stimulation for cognitive improvement in schizophrenia: insights from a systematic review and exploratory meta-analysis
Frontiers in Psychiatry
transcranial direct current stimulation
cognitive function
schizophrenia
systematic review
meta-analysis
title Adjunctive transcranial direct current stimulation for cognitive improvement in schizophrenia: insights from a systematic review and exploratory meta-analysis
title_full Adjunctive transcranial direct current stimulation for cognitive improvement in schizophrenia: insights from a systematic review and exploratory meta-analysis
title_fullStr Adjunctive transcranial direct current stimulation for cognitive improvement in schizophrenia: insights from a systematic review and exploratory meta-analysis
title_full_unstemmed Adjunctive transcranial direct current stimulation for cognitive improvement in schizophrenia: insights from a systematic review and exploratory meta-analysis
title_short Adjunctive transcranial direct current stimulation for cognitive improvement in schizophrenia: insights from a systematic review and exploratory meta-analysis
title_sort adjunctive transcranial direct current stimulation for cognitive improvement in schizophrenia insights from a systematic review and exploratory meta analysis
topic transcranial direct current stimulation
cognitive function
schizophrenia
systematic review
meta-analysis
url https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1617068/full
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