title: [Negative symptoms of schizophrenia: from electrophysiology to electrotherapy].
abstract: The aim of this review of the literature is to summarize the state of the knowledge concerning the relationship between negative symptoms in schizophrenia, electrophysiology and electrotherapy. The scientific literature search of international articles was performed during August and September 2015 using the PubMed electronic database. We used the following MeSH terms: "Negative symptoms", "Schizophrenia", "Electrophysiology", "Neurophysiology", "EEG power", "Alpha rhythm", "Transcranial magnetic stimulation", "Transcranial direct current stimulation", "Electroconvulsive therapy", "Neurofeedback", "Vagus Nerve Stimulation", "Deep Brain Stimulation", and "State dependent". Negative symptoms in schizophrenia are associated with altered activity in prefrontal cortex in functional neuroimaging studies. This is in line with electrophysiological measurements that found a change in EEG spectral power in the alpha frequency band over prefrontal brain regions. The notion of functional hypofrontality has led to hypotheses that electrotherapy applied to the prefrontal cortex may be an effective treatment of negative symptoms in schizophrenia. Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) were used to increase cortical activity in schizophrenia and achieve a clinical effect on negative symptoms. Three meta-analyses confirmed, with a moderate effect size, that rTMS is an effective treatment option for negative symptoms in schizophrenia. The two subsequently published prospective multicenter studies, however, found opposite results from each other. Two randomized controlled studies suggested that tDCS is an effective treatment option for negative symptoms. There is no study on the efficacy of neurofeedback, vagal nerve stimulation or deep brain stimulation on negative symptoms in schizophrenia. Additional studies are needed to confirm the efficacy of rTMS and tDCS on negative symptoms in schizophrenia. Influencing factors, related to clinical and stimulation parameters, of rTMS and tDCS on negative symptoms should be better investigated. Effects related to electrophysiological brain activity of the patient, especially in the alpha band, during the stimulation should also be better investigated. The action of electrotherapy may be state dependent, and a better understanding of electrophysiological effects of electrotherapy techniques could enable their optimization.
authors.affiliation: Services d'explorations fonctionnelles du système nerveux, Clinique du sommeil, CHU de Bordeaux, Place Amélie Raba-Leon, 33076 Bordeaux, France; USR CNRS 3413 SANPSY, CHU Pellegrin, Université de Bordeaux, France. Electronic address: jarthur.micoulaud@gmail.com.
authors.forename: J-A
authors.initials: JA
authors.lastname: Micoulaud Franchi
authors.affiliation: Université de Bordeaux, 146 rue Léo-Saignat, 33076 Bordeaux cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Quiles
authors.affiliation: SHU Psychiatrie adultes, Hôpital Ste Marguerite, 13274 Marseille cedex 9, France.
authors.forename: R
authors.initials: R
authors.lastname: Belzeaux
authors.affiliation: SHU Psychiatrie adultes, Hôpital Ste Marguerite, 13274 Marseille cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Adida
authors.affiliation: SHU Psychiatrie adultes, Hôpital Ste Marguerite, 13274 Marseille cedex 9, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Azorin
mesh_terms: D004599:Electric Stimulation Therapy; D055724:Electrophysiological Phenomena; D006801:Humans; D012559:Schizophrenia / Q000503:physiopathology* / Q000628:therapy*; D012565:Schizophrenic Psychology; D065908:Transcranial Direct Current Stimulation; D050781:Transcranial Magnetic Stimulation
keywords: Alpha rhythm; Direct current stimulation; Electroencephalography; Negative symptoms; Rythme Alpha; Schizophrenia; Schizophrénie; Stimulation en courant continue; Stimulation magnétique transcrânienne; Symptômes négatifs; Transcranial magnetic stimulation; Électroencéphalographie