title: Active and placebo transcranial magnetic stimulation effects on external and internal auditory hallucinations of schizophrenia.
abstract: OBJECTIVE
  Repetitive transcranial magnetic stimulation (rTMS) over the left temporo-parietal region has been proposed as a treatment for resistant auditory verbal hallucinations (AVH), but which patients are more likely to benefit from rTMS is still unclear. This study sought to assess the effects of rTMS on AVH, with a focus on hallucination phenomenology.
  
  
  METHODS
  Twenty-seven patients with schizophrenia and medication-resistant AVH participated to a randomized, double-blind, placebo-controlled, add-on rTMS study. The stimulation targeted a language-perception area individually determined using functional magnetic resonance imaging and a language recognition task. AVH were assessed using the hallucination subscale of the Scale for the Assessment of Positive Symptoms (SAPS). The spatial location of AVH was assessed using the Psychotic Symptom Rating Scales.
  
  
  RESULTS
  A significant improvement in SAPS hallucination subscale score was observed in both actively treated and placebo-treated groups with no difference between both modalities. Patients with external AVH were significantly more improved than patients with internal AVH, with both modalities.
  
  
  CONCLUSIONS
  A marked placebo effect of rTMS was observed in patients with resistant AVH. Patients with prominent external AVH may be more likely to benefit from both active and placebo interventions. Cortical effects related to non-magnetic stimulation of the auditory cortex are suggested.
authors.affiliation: AP-HP, Department of Adolescent Psychopathology and Medicine, Maison de Solenn, Cochin Hospital, Paris, France.|INSERM, U 1000, Research unit 'Imaging & Psychiatry', Service Hospitalier Frédéric Joliot, Orsay, France.|Université Paris Descartes, Paris, France.|University Paris-Sud, and University Paris-Saclay, Orsay, France.
authors.forename: M-L
authors.initials: ML
authors.lastname: Paillère-Martinot
authors.affiliation: INSERM, U 1000, Research unit 'Imaging & Psychiatry', Service Hospitalier Frédéric Joliot, Orsay, France.|Université Paris Descartes, Paris, France.|University Paris-Sud, and University Paris-Saclay, Orsay, France.|SHU Department of Psychiatry, Sainte-Anne Hospital, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Galinowski
authors.affiliation: INSERM, U 1000, Research unit 'Imaging & Psychiatry', Service Hospitalier Frédéric Joliot, Orsay, France.|Université Paris Descartes, Paris, France.|SHU Department of Psychiatry, Sainte-Anne Hospital, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Plaze
authors.affiliation: INSERM, U 1000, Research unit 'Imaging & Psychiatry', Service Hospitalier Frédéric Joliot, Orsay, France.|Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Andoh
authors.affiliation: INSERM, U 1000, Research unit 'Imaging & Psychiatry', Service Hospitalier Frédéric Joliot, Orsay, France.|Department of Psychiatry and Clinical Psychobiology, Faculty of Medicine, University of Barcelona, Barcelona, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Bartrés-Faz
authors.affiliation: AP-HP, Department of Psychiatry, Henri Mondor-Albert Chenevier Hospital, Créteil, France.|INSERM, U1144, Université Paris Diderot, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Bellivier
authors.affiliation: AP-HP, Physiology Department, Henri Mondor - Albert Chenevier Hospital, Créteil, France.|Université Paris 12, Créteil, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Lefaucheur
authors.affiliation: CEA, LNAO, NeuroSpin, Gif-sur-Yvette, France.
authors.forename: D
authors.initials: D
authors.lastname: Rivière
authors.affiliation: Université Paris Descartes, Paris, France.|SHU Department of Psychiatry, Sainte-Anne Hospital, Paris, France.
authors.forename: T
authors.initials: T
authors.lastname: Gallarda
authors.affiliation: INSERM, U 1000, Research unit 'Imaging & Psychiatry', Service Hospitalier Frédéric Joliot, Orsay, France.|Université Paris Descartes, Paris, France.|University Paris-Sud, and University Paris-Saclay, Orsay, France.
authors.forename: J-L
authors.initials: JL
authors.lastname: Martinot
authors.affiliation: INSERM, U 1000, Research unit 'Imaging & Psychiatry', Service Hospitalier Frédéric Joliot, Orsay, France.|Université Paris Descartes, Paris, France.|University Paris-Sud, and University Paris-Saclay, Orsay, France.|Psychiatry Department 91G16, GH Nord Essonne, Orsay, France.
authors.forename: E
authors.initials: E
authors.lastname: Artiges
mesh_terms: D000328:Adult; D017668:Age of Onset; D004311:Double-Blind Method; D005260:Female; D006212:Hallucinations / Q000628:therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012559:Schizophrenia / Q000628:therapy*; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: auditory hallucinations; functional magnetic resonance imaging; randomized placebo-controlled trial; repetitive transcranial magnetic stimulation; schizophrenia