title: Treating auditory hallucinations by transcranial magnetic stimulation: a randomized controlled cross-over trial.
abstract: 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.
authors.affiliation: Department of Psychiatry I, University of Ulm, Ulm, Germany. martin.jandl@uni-ulm.de
authors.forename: Martin
authors.initials: M
authors.lastname: Jandl
authors.forename: Juergen
authors.initials: J
authors.lastname: Steyer
authors.forename: Martin
authors.initials: M
authors.lastname: Weber
authors.forename: David E J
authors.initials: DE
authors.lastname: Linden
authors.forename: Johannes
authors.initials: J
authors.lastname: Rothmeier
authors.forename: Konrad
authors.initials: K
authors.lastname: Maurer
authors.forename: Wolfgang P
authors.initials: WP
authors.lastname: Kaschka
mesh_terms: 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