Abstract
Introduction About 40–80% of patients with schizophrenia suffer from auditory verbal hallucinations (AVH). In about a third of these AVH patients, hallucinations remain even with antipsychotic drug treatment. Transcranial magnetic stimulation (TMS) offers a potential treatment for these patients. However, its efficacy is discussed in the literature as several studies found no difference in effects of verum and sham TMS treatment. Thus, TMS response seems to be highly variable in patients with AVH. Since neuronal activity in the superior temporal lobe has been related to the occurrence of AVH, we postulate that neuronal activity in this area is a key factor in this variation in treatment response. We therefore investigated neuronal activity measured indirectly by brain perfusion (cerebral blood flow, CBF) as potential treatment response marker for TMS in AVH treatment. Objectives Investigation of neuronal activity assessed by CBF as potential treatment response marker for TMS treatment in AVH. Patients and methods 24 patients with schizophrenia suffering from medication-resistant AVH underwent psychopathological assessments and resting-state magnetic resonance imaging (MRI) with perfusion measured by arterial spin labeling (ASL) before and after TMS treatment for 10 days. Responders were defined by a clinically relevant reduction of hallucination change scale (HCS) ratings of 50%. Results 9 of 24 patients were defined as responders. Responders could be differentiated by a higher CBF in the left superior temporal gyrus (STG), in an area located very close to the TMS targeted area. Additionally, CBF values before treatment correlated positively with amount of improvement in HCS scores. Thus, patients with higher perfusion in STG before treatment showed a higher reduction in symptom severity. Conclusion In this study, neuronal activity measured by regional cerebral blood flow correlated with response to TMS treatment in patients with schizophrenia suffering from medication-resistant AVH. This suggests that MRI resting-state perfusion measurement could be used to identify patients benefitting from TMS treatment in advance of treatment.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
