title: Examining transcranial direct-current stimulation (tDCS) as a treatment for hallucinations in schizophrenia.
abstract: OBJECTIVE
  Some 25%–30% of patients with schizophrenia have auditory verbal hallucinations that are refractory to antipsychotic drugs. Outcomes in studies of repetitive transcranial magnetic stimulation suggest the possibility that application of transcranial direct-current stimulation (tDCS) with inhibitory stimulation over the left temporo-parietal cortex and excitatory stimulation over the left dorsolateral prefrontal cortex could affect hallucinations and negative symptoms, respectively. The authors investigated the efficacy of tDCS in reducing the severity of auditory verbal hallucinations as well as negative symptoms.
  
  
  METHODS
  Thirty patients with schizophrenia and medication-refractory auditory verbal hallucinations were randomly allocated to receive 20 minutes of active 2-mA tDCS or sham stimulation twice a day on 5 consecutive weekdays. The anode was placed over the left dorsolateral prefrontal cortex and the cathode over the left temporo-parietal cortex.
  
  
  RESULTS
  Auditory verbal hallucinations were robustly reduced by tDCS relative to sham stimulation, with a mean diminution of 31% (SD=14; d=1.58, 95% CI=0.76–2.40). The beneficial effect on hallucinations lasted for up to 3 months. The authors also observed an amelioration with tDCS of other symptoms as measured by the Positive and Negative Syndrome Scale (d=0.98, 95% CI=0.22–1.73), especially for the negative and positive dimensions. No effect was observed on the dimensions of disorganization or grandiosity/excitement.
  
  
  CONCLUSIONS
  Although this study is limited by the small sample size, the results show promise for treating refractory auditory verbal hallucinations and other selected manifestations of schizophrenia.
authors.affiliation: University of Lyon, Lyon, France. jerome.brunelin@ch-le-vinatier.fr
authors.forename: Jerome
authors.initials: J
authors.lastname: Brunelin
authors.forename: Marine
authors.initials: M
authors.lastname: Mondino
authors.forename: Leila
authors.initials: L
authors.lastname: Gassab
authors.forename: Frederic
authors.initials: F
authors.lastname: Haesebaert
authors.forename: Lofti
authors.initials: L
authors.lastname: Gaha
authors.forename: Marie-Françoise
authors.initials: MF
authors.lastname: Suaud-Chagny
authors.forename: Mohamed
authors.initials: M
authors.lastname: Saoud
authors.forename: Anwar
authors.initials: A
authors.lastname: Mechri
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Poulet
mesh_terms: D000328:Adult; D002540:Cerebral Cortex / Q000502:physiology*; D004599:Electric Stimulation Therapy / Q000379:methods / Q000523:psychology*; D006212:Hallucinations / Q000150:complications / Q000628:therapy*; D006801:Humans; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012559:Schizophrenia / Q000150:complications / Q000628:therapy*