Slow transcranial magnetic stimulation can rapidly reduce resistant auditory hallucinations in schizophrenia.
BACKGROUND
Almost a quarter of patients with schizophrenia present with resistant auditory verbal hallucinations (AVH), a phenomenon that may relate to activation of brain areas underlying speech perception. Repetitive transcranial magnetic stimulation (rTMS) at 1 Hz reduces cortical activation, and recent results have shown that 1-Hz left temporoparietal rTMS may reduce AVH. The aim of this study was to replicate recent data and investigate whether low-frequency rTMS with a high total stimulation number delivered in a shorter 5-day block produces similar benefit.


METHODS
Ten right-handed schizophrenia patients with resistant AVH received 5 days of active rTMS and 5 days of sham rTMS (2,000 stimulations per day at 90% of motor threshold) over the left temporoparietal cortex in a double-blind crossover design. The two weeks of stimulation were separated by a 1-week washout period.


RESULTS
AVH were robustly improved (56%) by 5 days active rTMS, whereas no variation was observed after sham. Seven patients were responders to active treatment, five of whom maintained improvement for at least 2 months.


CONCLUSIONS
These data confirm the efficiency of low-frequency rTMS applied to the left temporoparietal cortex, compared with sham stimulation, in reducing resistant AVH. This improvement can be obtained in only 5 days without serious initial adverse events.
Poulet
Emmanuel
E
Vulnérabilité à la Psychose de la Prédiction à la Prévention, UCBL, France.
Brunelin
Jérôme
J
Bediou
Benoit
B
Bation
Rémi
R
Forgeard
Louis
L
Dalery
Jean
J
d'Amato
Thierry
T
Saoud
Mohamed
M
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004351:Drug Resistance; D004599:Electric Stimulation Therapy / Q000379:methods; D004574:Electromagnetic Fields; D005260:Female; D007839:Functional Laterality; D006212:Hallucinations / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010296:Parietal Lobe / Q000503:physiopathology; D012559:Schizophrenia / Q000628:therapy*; D012565:Schizophrenic Psychology; D013702:Temporal Lobe / Q000503:physiopathology; D050781:Transcranial Magnetic Stimulation / Q000627:therapeutic use*; D016896:Treatment Outcome
D014150:Antipsychotic Agents