title: Functional connectivity of the temporo-parietal region in schizophrenia: effects of rTMS treatment of auditory hallucinations.
abstract: Auditory-verbal hallucinations are a hallmark symptom of schizophrenia. In recent years, repetitive transcranial magnetic stimulation (rTMS) targeting speech perception areas has been advanced as a potential treatment of medication-resistant hallucinations. However, the underlying neural processes remain unclear. This study aimed to assess whether 1 Hz rTMS treatment would affect functional connectivity of the temporo-parietal junction (TPJ). Resting state fMRI scans were obtained from 18 patients with schizophrenia. Patients were assessed before and after a 6 day treatment with 1 Hz rTMS to the left TPJ, or placebo treatment with sham rTMS to the same location. We assessed functional connectivity between a priori defined regions-of-interest (ROIs) comprising the putative AVH network and the bilateral TPJ seed regions, targeted with rTMS. Symptom improvement following rTMS treatment was observed in the left rTMS group, whereas no change at occurred in the placebo group. Although no corresponding changes were observed in the functional connections previously found to be associated with AVH severity, an increase in connectivity between the left TPJ and the right insula was observed in group receiving rTMS to the left TPJ. The placebo group conversely showed a decrease in connectivity between the left TPJ and left anterior cingulate. We conclude that application of 1 Hz rTMS to the left TPJ region may affect functional connectivity of the targeted region. However, the relationship between these functional changes during the resting state and the rate of clinical improvement needs further clarification.
authors.affiliation: Department of Neuroscience, University Medical Center Groningen, The Netherlands. a.vercammen@med.umcg.nl
authors.forename: Ans
authors.initials: A
authors.lastname: Vercammen
authors.forename: Henderikus
authors.initials: H
authors.lastname: Knegtering
authors.forename: Edith J
authors.initials: EJ
authors.lastname: Liemburg
authors.forename: Johannes A
authors.initials: JA
authors.lastname: den Boer
authors.forename: André
authors.initials: A
authors.lastname: Aleman
mesh_terms: D000328:Adult; D001931:Brain Mapping; D016022:Case-Control Studies; D005260:Female; D006212:Hallucinations / Q000209:etiology / Q000473:pathology* / Q000628:therapy*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000098:blood supply / Q000503:physiopathology; D010100:Oxygen / Q000097:blood; D010296:Parietal Lobe / Q000098:blood supply / Q000503:physiopathology*; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000150:complications; D013702:Temporal Lobe / Q000098:blood supply / Q000503:physiopathology*; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D055815:Young Adult
chemical_list: D010100:Oxygen