[Non-invasive brain stimulation for treatment of schizophrenic psychoses].
Despite many different available pharmacological and psychosocial treatment options, an optimal control of symptoms is only partly possible for most schizophrenia patients. Especially, persistent auditory hallucinations, negative symptoms and cognitive impairment are difficult to treat symptoms. Several non-invasive brain stimulation techniques are increasingly being considered as new therapeutic add on options for the management of schizophrenia, targeting these symptom domains. The technique which has been available for the longest time and that is best established in clinical care is electroconvulsive therapy (ECT). New stimulation techniques, such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) allow a more pathophysiological-based approach. This review article introduces various non-invasive brain stimulation techniques and discusses recent treatment studies on schizophrenia. In total, the novel brain stimulation techniques discussed here can be considered relevant add on therapeutic approaches for schizophrenia. In this context, the best evidence is available for the application of rTMS for the treatment of negative symptoms and persistent auditory hallucinations; however, negative studies have also been published for both indications. Studies using other non-invasive brain stimulation techniques showed promising results but further research is needed to establish the clinical efficacy. Based on a growing pathophysiological knowledge, non-invasive brain stimulation techniques provide new treatment perspectives for patients with schizophrenia.
Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München Ludwig-Maximilians Universität, Nußbaumstr. 7, 80336, München, Deutschland. alkomiet.hasan@med.uni-muenchen.de.
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Hasan
Zentrum für seelische Gesundheit, Kreiskliniken Darmstadt-Dieburg, Darmstadt-Dieburg, Deutschland.|Klinik für Psychiatrie und Psychotherapie, Georg-August-Universität Göttingen, Göttingen, Deutschland.
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Wobrock
Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München Ludwig-Maximilians Universität, Nußbaumstr. 7, 80336, München, Deutschland.
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Palm
Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München Ludwig-Maximilians Universität, Nußbaumstr. 7, 80336, München, Deutschland.
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Strube
Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München Ludwig-Maximilians Universität, Nußbaumstr. 7, 80336, München, Deutschland.
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Padberg
Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München Ludwig-Maximilians Universität, Nußbaumstr. 7, 80336, München, Deutschland.
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Falkai
Klinik für Psychiatrie und Psychotherapie, Universitätsklinik Tübingen, Tübingen, Deutschland.
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Fallgatter
Klinik für Psychiatrie und Psychotherapie, Universitätsklinik Tübingen, Tübingen, Deutschland.
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Plewnia
D004565:Electroconvulsive Therapy / Q000379:methods*; D019317:Evidence-Based Medicine; D006801:Humans; D012559:Schizophrenia / Q000628:therapy*; D065908:Transcranial Direct Current Stimulation / Q000379:methods*; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome
Electroconvulsive therapy; Evidence-based psychiatry; Transcranial direct current stimulation; Transcranial magnetic stimulation, repetitive; Vagus nerve stimulation