Treating auditory hallucinations by transcranial magnetic stimulation: a randomized controlled cross-over trial.
BACKGROUND
In a previous functional magnetic resonance imaging study, the authors succeeded in demonstrating the activation of Heschl's gyrus during auditory hallucinations (AH).


OBJECTIVE
This study aims to treat AH specifically by repetitive transcranial magnetic stimulation (rTMS).


METHODS
16 patients with AH were included in a randomized, cross-over, sham-controlled trial. 1 Hz rTMS was administered over the left and right temporo-parietal cortex and sham position, respectively, on 5 consecutive days; 900 stimuli each, strength 100% of motor threshold. Using the Psychotic Symptom Rating Scales (PSYRATS), the hallucinations during the stimulation periods and 4-week follow-ups were quantified. Electroencephalograms (EEG) were acquired before and after each period.


RESULTS
Treatment responses were observed after left hemisphere rTMS only. The 5 patients who showed a response did so already after 2 days. However, group mean hallucination scores did not differ across treatment conditions. No significant changes were found in EEG after rTMS.


CONCLUSIONS
A subgroup of patients suffering from AH benefits soon after treatment start from rTMS over the left superior temporal gyrus as revealed by the decrease of AH scores compared to right-sided and sham procedures.
Jandl
Martin
M
Department of Psychiatry I, University of Ulm, Ulm, Germany. martin.jandl@uni-ulm.de
Steyer
Juergen
J
Weber
Martin
M
Linden
David E J
DE
Rothmeier
Johannes
J
Maurer
Konrad
K
Kaschka
Wolfgang P
WP
D000704:Analysis of Variance; D018592:Cross-Over Studies; D004569:Electroencephalography; D005260:Female; D007839:Functional Laterality; D006212:Hallucinations / Q000628:therapy*; D006801:Humans; D008297:Male; D010296:Parietal Lobe / Q000503:physiopathology; D011618:Psychotic Disorders / Q000628:therapy*; D013702:Temporal Lobe / Q000503:physiopathology*; D050781:Transcranial Magnetic Stimulation