Please select the eligibility criteria that correspond to the clinical trial below.
Title: Repetitive Transcranial Magnetic Stimulation (rTMS) for the Treatment of Negative Symptoms in Schizophrenia - a Multicenter Study
Brief Summary: Schizophrenia is a major psychotic disorder that presents an enormous burden to the patients and their relatives. Despite treatment with second generation antipsychotics, negative symptoms and cognitive impairment often persist and determine an unfavourable course including reduction in life quality. Prefrontal repetitive transcranial magnetic stimulation (rTMS), a promising noninvasive biological technique, applied adjuvant to ongoing antipsychotic treatment was demonstrated to be safe and was associated with improvement in negative symptoms in the majority of the small placebo-controlled trials.

The primary objective of the trial is to investigate the efficacy of high-frequency rTMS (add-on to antipsychotic therapy) in the treatment of negative symptoms in schizophrenia compared to sham stimulation (placebo).


Options:
A: Inclusion Criteria:

* Patients will fulfill DSM-IV-TR diagnostic criteria for schizophrenia
* Patients reporting auditory hallucinations on average at least 5 times per day based on prospective assessment using a diary or handheld counter.
* Patients are maintained on their psychotropic medication at steady dosages for at least 4 weeks before study entry and for the duration of the trial.

Exclusion Criteria:

* Cardiac pacemaker implant, or a history of epilepsy, neurosurgery, or brain trauma patients suffering from chronic medical conditions of any sort
* History of current hypertension
* History of seizure or heat convulsion
* History of epilepsy or seizure in first degree relatives
* History of head injury
* History of any metal in the head (outside the mouth)
* Known history of any metallic particles in the eye
* Implanted cardiac pacemaker or any intra-cardiac lines
* Implanted neuro-stimulators
* Surgical clips or any medical pumps
* History of frequent or severe headaches
* History of migraine
* History of hearing loss
* Known history of cochlear implants
* History of drug abuse or alcoholism
* Pregnancy or not using a reliable method of birth control (non-pregnancy will be proved by beta-HCG test)
* Systemic and metabolic disorders
* Inadequate communication skills or under custodial care.
B: Inclusion Criteria:

* Male or female in-patients and out-patients, 18 - 60 years of age
* Diagnostic criteria for schizophrenia according to ICD-10/DSM IV
* PANSS negative sum score \> 20 points, 1 of items N1 - N7 (range 1 to 7) ≥ 4 (at least moderate)
* Improvement in PANSS negative sum score less than 10 % in the last 2 weeks prior to study entry, stable antipsychotic medication
* Informed Consent

Exclusion Criteria:

* Clinically relevant psychiatric comorbidity, verbal IQ \< 85
* History of epileptic seizures, organic brain disease
* Instable medical comorbidity or condition
* Previous treatment by rTMS
* Factors not compatible with the use of TMS, e.g. cardiac pace makers or other metallic implants, pregnancy
C: Inclusion Criteria:

* DSM-IV criteria for schizophrenia
* age between 18 and 60
* informed consent
* right handed patient
* no change of antipsychotic treatment \> 2 weeks before recruitment

Exclusion Criteria:

* seizures, epilepsy
* history of severe head injury
* status post implantation of a cardiac pacemaker or other electronic devi-ses
D: Inclusion Criteria for Schizophrenia Subjects:

* Voluntary and competent to consent
* SCID-IV Diagnosis of Schizophrenia or Schizoaffective Disorder
* Between the ages of 18 and 85

Inclusion Criteria for Healthy Subjects:

* voluntary and competent to consent
* between the ages of 18-85
* considered a healthy individual free of psychopathology based on the Personality Assessment Inventory
* right-handed determined by the TMS screening and demographic form
* self-reported non-smoker
* do not have a self-reported concomitant major medical or neurologic illness
* if a woman of childbearing potential, must be on an effective means of birth control determined through completion of the TMS screening and demographic form.

Exclusion Criteria for both Healthy Controls and Schizophrenia Subjects:

* Have a DSM-IV history of substance abuse or dependence in the last 6 months
* Have a concomitant major and unstable medical or neurologic illness
* Have a history of seizures
* Have a first degree relative with a history of a seizure disorder
* Are pregnant
* Have any clinically significant EEG activity indicating an increased risk of seizure, as confirmed by a neurologist.

Answer: B