Single Session Transcranial Magnetic Stimulation Ameliorates Hand Gesture Deficits in Schizophrenia.

Walther, Sebastian; Kunz, Maribel; Müller, Manuela; Zürcher, Caroline; Vladimirova, Irena; Bachofner, Hanta; Scherer, Konstantin A; Nadesalingam, Niluja; Stegmayer, Katharina; Bohlhalter, Stephan; Viher, Petra (2020). Single Session Transcranial Magnetic Stimulation Ameliorates Hand Gesture Deficits in Schizophrenia. Schizophrenia bulletin, 46(2), pp. 286-293. Oxford University Press 10.1093/schbul/sbz078

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Social interaction is impaired in schizophrenia, including the use of hand gestures, which is linked to poor social perception and outcome. Brain imaging suggests reduced neural activity in a left-lateralized frontoparietal network during gesture preparation; therefore, gesturing might be improved through facilitation of left hemispheric brain areas or via disruption of interhemispheric inhibition from the right homolog. This study tested whether repetitive transcranial magnetic stimulation (rTMS) protocols would improve gesture performance in schizophrenia. This randomized, placebo-controlled, double-blind, crossover trial applied 3 different protocols of rTMS separated by 48 h. Twenty right-handed schizophrenia patients and 20 matched healthy controls received facilitatory intermittent theta burst stimulation (iTBS) over the left inferior frontal gyrus (IFG), inhibitory continuous theta burst stimulation (cTBS) over right inferior parietal lobe (IPL), and placebo over left IPL in randomized order. Primary outcome was change in the test of upper limb apraxia (TULIA), rated from video recordings of hand gesture performance. Secondary outcome was change in manual dexterity using the coin rotation task. Participants improved on both tasks following rTMS compared with baseline. Only patients improved gesture performance following right IPL cTBS compared with placebo (P = .013). The results of the coin rotation parallel those of the TULIA, with improvements following right IPL cTBS in patients (P = .001). Single sessions of cTBS on the right IPL substantially improved both gesture performance accuracy and manual dexterity. The findings point toward an inhibition of interhemispheric rivalry as a potential mechanism of action.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > Translational Research Center
04 Faculty of Medicine > University Psychiatric Services

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Walther, Sebastian, Vladimirova, Irena, Bachofner, Hanta, Nadesalingam, Niluja, Stegmayer, Katharina Deborah Lena, Bohlhalter, Stephan, Viher, Petra


600 Technology > 610 Medicine & health




Oxford University Press




Sebastian Walther

Date Deposited:

04 Nov 2019 14:47

Last Modified:

05 Dec 2022 15:31

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

RCT dexterity gesture motor domain nonverbal skills praxis network




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