Clinical practice of rTMS reveals a functional dissociation between agency and hallucinations in schizophrenia.
We report here the case of a hospitalized 11 year-old boy (YP) with a positive diagnosis of 'Childhood Onset Schizophrenia'. YP experienced verbal-auditory hallucinations, a delusion of alien control and hetero-aggressive behaviour. Antipsychotic drugs were unsuccessful and furthermore provoked severe acute dystonia. fMRI-guided rTMS applied over several cortical regions provided the means to reveal for the first time a functional dissociation between auditory-verbal hallucinations and agency. These results demonstrate the efficacy of rTMS for young patients suffering from drug-resistant hallucinations but they furthermore question the physiopathology of the hallucinatory process by suggesting that agency and hallucinations may be sub-served by different neural networks.
Jardri
Renaud
R
Université Lille Nord de France, CNRS UMR-8160, CHRU de Lille, 59037 Lille, France. r-jadri@chru-lille.fr
Delevoye-Turrell
Yvonne
Y
Lucas
Bernard
B
Pins
Delphine
D
Bulot
Virginie
V
Delmaire
Christine
C
Thomas
Pierre
P
Delion
Pierre
P
Goeb
Jean-Louis
JL
D001931:Brain Mapping; D002648:Child; D004213:Dissociative Disorders / Q000175:diagnosis* / Q000209:etiology; D004558:Electric Stimulation; D006212:Hallucinations / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009483:Neuropsychological Tests; D010100:Oxygen / Q000097:blood; D012561:Schizophrenia, Childhood / Q000150:complications* / Q000473:pathology; D012565:Schizophrenic Psychology; D050781:Transcranial Magnetic Stimulation / Q000379:methods*
D010100:Oxygen