**Author details**

rTMS using five domains of SANS (affective flattening/blunting, alogia, avolition/apathy, anhedonia, and impaired attention). The stimulation improved all domains, except for alogia [4]. To improve the results with rTMS, the definition and the prediction of responders are needed. This could be achieved using markers of impaired cortical inhibition and neuroplas‐ ticity—especially when TMS (with the potential to measure cortical inhibition and its changes) and EEG or other neuroimaging methods (MRI, fMRI, SPECT, PET) are combined. Tikka et al. described significant correlation between the reduction in negative and depressive symptoms in patients with schizophrenia and the reduction in gamma spectral power in left frontal and temporal segments after cerebellar rTMS. The authors suggest resting state gamma spectral power in frontal and temporal regions for a biomarker of treatment response [55]. Homan et al. described that responders were robustly differentiated from nonresponders to rTMS by the higher regional blood flow in the left superior temporal gyrus before treatment for AVH. The authors conclude that resting perfusion measurement before treatment might be a clinically

relevant way to identify possible responders and nonresponders to rTMS [56].

schizophrenia.

144 Schizophrenia Treatment - The New Facets

**6. Conclusion**

**Acknowledgements**

The optimization of stimulation parameters is another important issue. New stimulation targets (for example, the cerebellum or anterior cingulate), better and more precise methods of stimulation coil placement (stereotactic navigation), new coil types (double cone coil, maybe H‐coils for deep TMS), stimulation frequency (individual frequency), intensity, number of pulses (higher number of pulses), and the number of stimulation sessions (intensive stimula‐ tion) are also subjects of current research. This research can provide data for new and inno‐ vative stimulation paradigms, which are needed for a more robust clinical effect of TMS in

TMS is a very promising research and therapeutic method for patients with schizophrenia. It is a useful tool for researching cortical inhibition and neuroplasticity. The most important application of TMS (or rTMS) is in the treatment of some symptoms or syndromes, especially negative symptoms (high‐frequency rTMS at the left DLPFC) and auditory hallucinations (low‐frequency rTMS at the left TPC), and maybe even cognitive deficit. The results of clinical studies are promising, but further research is needed to optimize the treatment results.

This work was supported by research grants from the Grant Agency of the Ministry of Health of the Czech Republic (AZV) NV15–30062A and NV15–31063A and by the Ministry of Health of the Czech Republic—conceptual development of research organization (FNBr, 65269705).

The authors like to thank Ms. Anne Johnson for proof‐reading.

Libor Ustohal1,2\*, Tomas Sverak1,2, Lenka Albrechtova1 , Marie Hojgrova1 , Veronika Hublova1 and Tomas Kasparek1,2

\*Address all correspondence to: ustohal.libor@fnbrno.cz

1 Department of Psychiatry, Masaryk University and University Hospital Brno, Brno, Czech Republic

2 Central European Institute of Technology (CEITEC MU), Masaryk University, Brno, Czech Republic
