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We used 10-sessions of repetitive transcranial magnetic stimulation (rTMS; 2-weeks) over the right inferior parietal lobe (IPL) in combination with 16-sessions of social cognitive remediation group therapy (SCRT; 8-weeks) to examine improvements in hand gesture performance in schizophrenia. In this 3-arm, double-blind, randomized, sham-controlled trial, 89 patients were randomized and 73 received at least one session of rTMS\/SCRT: 19 patients were allocated to the real rTMS\u2009+\u2009real SCRT treatment, 26 to the sham rTMS\u2009+\u2009real SCRT treatment, and 28 to sham SCRT treatment. Hand gesture performance along with socio-cognitive and functional assessments were examined at 2-weeks, 8-weeks, and 32-weeks follow-up. Of 73 patients analyzed, (57% male), 53 completed the intervention and week-8 assessments. At week-8 no difference in overall hand gesture performance accuracy was observed across treatments. However, at week-32 follow-up the real rTMS\u2009+\u2009real group SCRT treatment showed significant improvements in novel unlearned gestures (F\n                    <jats:sub>(6, 210)<\/jats:sub>\n                    \u2009=\u20092.2; p-value\u2009=\u20090.04), and significant gains in social functioning\/personal performance at week-8 and sustained at week-32 follow-up (all F-values\u2009&gt;\u20092.6; all p-values\u2009&lt;\u20090.05). No treatment effects were found for overall hand gesture performance accuracy. However, improvements in secondary outcomes such as novel unlearned gestures and social\/personal functioning hold promise for testing optimized rTMS\u2009+\u2009group SCRT combinations. Future studies should explore the neural effects of rTMS over right IPL\u2009+\u2009group SCRT.\n                  <\/jats:p>","DOI":"10.1038\/s41380-025-03303-7","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T05:31:43Z","timestamp":1759901503000},"page":"5790-5799","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Gesture deficits in psychosis and the combination of group psychotherapy and transcranial magnetic stimulation: A randomized clinical trial"],"prefix":"10.1038","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4026-3561","authenticated-orcid":false,"given":"Sebastian","family":"Walther","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia","family":"Maderthaner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Chapellier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4875-7486","authenticated-orcid":false,"given":"Sofie","family":"von K\u00e4nel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel R.","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Bohlhalter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mischa","family":"Baer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5590-3456","authenticated-orcid":false,"given":"Anastasia","family":"Pavlidou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,8]]},"reference":[{"key":"3303_CR1","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1001\/jamapsychiatry.2019.3360","volume":"77","author":"RA McCutcheon","year":"2020","unstructured":"McCutcheon RA, Reis Marques T, Howes OD. 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