OJPsych  Vol.4 No.1 , January 2014
Treatment of refractory auditory hallucinations in schizophrenia by rTMS: Positive impact of negative double blind controlled study
ABSTRACT

Background: Several studies reported on the effectiveness of 1 Hz repeated transcranial magnetic stimulation (rTMS) over the temporoparietal cortex (TPC) on refractory auditory hallucinations (AH) in schizophrenia but little is known about the long-term therapeutic effect of this tool. Aim: The aim of this study was to evaluate rTMS’ impact on auditory hallucinations (AH) and cognitive functions in patients with schizophrenia with a three-month follow-up. Methods: In a randomized double blind sham controlled study, 26 patients with refractory schizophrenia received 1 Hz rTMS applied on TPC for four weeks. rTMS was given to patients over one month with five rTMS sessions each week. Patients were evaluated via AHRS (Auditory Hallucination Rating Scale, Hoffman et al.), PANSS (Positive and Negative Syndrome Scale, Kay et al. 1988), and CGI (Clinical Global Impression) before treatment by rTMS every week during the first month, and every month until the third month. Results: Neither clinical nor cognitive differences were found between rTMS and placebo. Conclusion: 1 Hz rTMS using parameters mentioned above has no statistically significant effect on AH; although evidences about the potential benefit of rTMS in the treatment of AH negative results suggest the need for further studies in this area.


Cite this paper
Bouaziz, N. , Sidhoumi, D. , Braha, S. , Kallel, G. , Andrianisaina, P. , Moulier, V. , Benadhira, R. and Januel, D. (2014) Treatment of refractory auditory hallucinations in schizophrenia by rTMS: Positive impact of negative double blind controlled study. Open Journal of Psychiatry, 4, 75-78. doi: 10.4236/ojpsych.2014.41011.
References
[1]   Aleman, A., Sommer, I.E. and Kahn, R.S. (2007) Efficacy of slow repetitive trans-cranial magnetic stimulation in the treatment of resistant auditory hallucinations in schizophrenia: A meta-analysis. Journal of Clinical Psychiatry, 68, 416-421. http://dx.doi.org/10.4088/JCP.v68n0310

[2]   Tranulis, C., Sepehry, A.A., Galinowski, A. and Stip, E. (2008) Should we treat auditory hallucinations with repetitive transcranial magnetic stimulation? A metaanalysis. Canadian Journal of Psychiatry, 53, 577-586.

[3]   Freitas, C., Fregni, F. and Pascual-Leone, A. (2009) Meta-analysis of the effects of repetitive transcranial magnetic stimulation (rTMS) on negative and positive symptoms in schizophrenia. Schizophrenia Research, 108, 11-24. http://dx.doi.org/10.1016/j.schres.2008.11.027

[4]   Slotema, C.W., Blom, J.D., Hoek, H.W. and Sommer, I.E.C. (2010) Should we expand the toolbox of psychiatric treatment methods to include repetitive transcranial magnetic stimulation? A meta-analysis of the efficacy of rTMS for psychiatric disorders. Journal of Clinical Psychiatry, 71, 873-884. http://dx.doi.org/10.4088/JCP.08m04872gre

[5]   Hoffman, R.E., Boutros, N.N., Berman, R.M., Roessler, E., Belger, A., Krystal, J.H. and Charney, D.S. (1999) Transcranial magnetic stimulation of left temporoparietal cortex in three patients reporting hallucinated “voices”. Biological Psychiatry, 46, 130-132. http://dx.doi.org/10.1016/S0006-3223(98) 00358-8

[6]   Poulet, E., Brunelin, J., Bediou, B., Bation, R., Forgeard, L., Dalery, J., d’Amato, T. and Saoud, M. (2005) Slow transcranial magnetic stimulation can rapidly reduce resistant auditory hallucinations in schizophrenia. Biological Psychiatry, 57, 188-191. http://dx.doi.org/10.1016/j.biopsych.2004.10.007

[7]   Montagne-Larmurier, A., Etard, O., Razafimandimby, A., Morello, R. and Dollfus, S. (2009) Two-day treatment of auditory hallucinations by high frequency rTMS guided by cerebral imaging: A 6 month follow-up pilot study. Schizophrenia Research, 113, 77-83. http://dx.doi.org/10.1016/j.schres. 2009.05.006

[8]   Slotema, C.W., Blom, J.D., de Weijer, A.D., Diederen, K.M., Goekoop, R., Looijestijn, J., Daalman, K., Rijkaart, A.M., Kahn, R.S., Hoek, H.W. and Sommer, I.E. (2011) Can low-frequency repetitive transcranial magnetic stimulation really relieve medication-resistant auditory verbal hallucinations? Negative results from a large randomized controlled trial. Biological Psychiatry, 69, 450-456. http://dx.doi.org/10.1016/j.biopsych.2010.09.051

[9]   Mittrach, M., Thünker, J., Winterer, G., Agelink, M.W., Regenbrecht, G., Arends, M., Mobascher, A., Kim, S.J., Wolwer, W., Brinkmeyer, J., Gaebel, W. and Cordes, J. (2010) The tolerability of rTMS treatment in schizophrenia with respect to cognitive function. Pharmacopsychiatry, 43, 110-117.
http://dx.doi.org/10.1055/s-0029-1242824

[10]   Ho, B.C., Flaum, M., Hubbard, W., Arndt, S. and Andreasen, N.C. (2004) Validity of symptom assessment in psychotic disorders: Information variance across different sources of history. Schizophrenia Research, 68, 299-307. http://dx.doi.org/10.1016/j.schres.2003.07.006

[11]   Hoffman, R.E., Boutros, N.N., Hu, S., Berman, R.M., Krystal, J.H. and Charney, D.S. (2000) Transcranial magnetic stimulation and auditory hallucinations in schizophrenia. Lancet, 9209, 1073-1075. http://dx.doi.org/10.1016/S0140-6736(00)02043-2

[12]   Hoffman, R.E., Gueorguieva, R., Hawkins, K.A., Varanko, M., Boutros, N.N., Wu, Y.T., Carroll, K. and Krystal, J.H. (2005) Temporoparietaltranscranial magnetic stimulation for auditory hallucinations: Safety, efficacy and moderators in a fifty patient sample. Biological Psychiatry, 58, 97-104. http://dx.doi.org/10.1016/j.biopsych.2005.03.041

[13]   Hoffman, R.E., Hampson, M., Wu, K., Anderson, A.W., Gore, J.C., Buchanan, R.J., Constable, R.T., Hawkins, K.A., Sahay, N. and Krystal, J.H. (2007) Probing the pathophysiology of auditory/verbal hallucinations by combining functional magnetic resonance imaging and transcranial magnetic stimulation. Cerebral Cortex, 11, 2733-2743. http://dx.doi.org/10.1093/cercor/bhl183

[14]   Fitzgerald, P.B., Benitez, J., Daskalakis, J.Z., Brown, T.L., Marston, N.A.U., de Castella, A., et al. (2005) A double-blind sham-controlled trial of repetitive transcranial magnetic stimulation in the treatment of refractory auditory hallucinations. Journal of Clinical Psychopharmacology, 25, 358-362. http://dx.doi.org/10.1097/01.jcp.0000168487.22140.7f

[15]   Brunelin, J., Poulet, E., Bediou, B., Kallel, L., Dalery, J,, D’Amato, T., et al. (2006) Low frequency repetitive transcranial magnetic stimulation improvessource monitoring deficit in hallucinating patients with schizophrenia. Schizophrenia Research, 81, 41-45. http://dx.doi.org/10.1016/j.schres. 2005.10.009

[16]   McIntosh, A.M., Semple, D., Tasker, K., Harrison, L.K., Owens, D.G.C., Johnstone, E.C., et al. (2004) Transcranial magnetic stimulation for auditory hallucinations in schizophrenia. Psychiatry Research, 127, 9-17. http://dx.doi.org/10.1016/j.psychres.2004.03.005

[17]   De Jesus, D.R., Gil, A., Barbosa, L., Lobato, M.I., Magalh?es, P.V., Favalli, G.P., Marcolin, M.A., Daskalakis, Z.J. and Belmonte-de-Abreu Pda, S. (2011) A pilot doubleblind sham-controlled trial of repetitive transcranial magnetic stimulation for patients with refractory schizophrenia treated with clozapine. Psychiatry Research, 188, 203-207. http://dx.doi.org/10.1016/j.psychres.2010.11.022

[18]   Huang, Y.Z., Edwards, M.J., Rounis, E., Bhatia, K.P. and Rothwell, J.C. (2005) Theta burst stimulation of the human motor cortex. Neuron, 45, 201-206. http://dx.doi.org/10.1016/j.neuron.2004.12.033

[19]   Sommer, I.E.C., Diederen, K.M.J., Blom, J.-D., Willems, A., Kushan, L., Slotema, K., Boks, M.P., Daalman, K., Hoek, H.W., Neggers, S.F. and Kahn, R.S. (2008) Auditory verbal hallucinations predominantly activate the right inferior frontal area. Brain, 131, 3169-3168. http://dx.doi.org/ 10.1093/brain/awn251

 
 
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