This study presents the results of transcranial magnetic stimulation of DLPFC in four patients with catatonia. The uniqueness of these observations arises from three factors. First, rehabilitation neuromodulation of catatonia was used in a personalized course of exposure to magnetic pulses, considering the intensity of regional cerebral blood flow (rCBF) in the affected area. Secondly, the entire course of treatment was carried out on an outpatient basis. Thirdly, the content of GABA and glutamate in the cerebral cortex was additionally studied before and after the course of TMS. All four patients were diagnosed with catatonia as part of schizophrenia spectrum disorders in three cases and in one case within the structure of recurrent depression phase. All patients took monotherapy with atypical antipsychotics as the main psychopharmacotherapy, were compliant and gave informed voluntary consent. The effectiveness of TMS was recorded in three cases. There were no adverse events or complications in all 20 sessions.

Natalia Zakharova is an experienced researcher and psychiatrist with more than 15 years ofexperience. Natalya holds a PhD degree in psychiatry and has also authored more than 45 articles, having participated in several grants, and presented at over 100 international and Russian conferences, showcasing her deep understanding and expertise in clinical psychiatry, neuroscience, and neurovisualization. She is the head of laboratory for Fundamental Research Methods of the Scientific Research Center of Neuropsychiatry, Moscow, Russian Federation.