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.
Highlights
Repeated transcranial magnetic stimulation is a non-invasive brain stimulation tool, which has shown efficiency in the treatment of some resistant neuropsychiatric disorders, depression and auditory hallucinations in schizophrenia
Five meta-analyses have reported the effectiveness of 1 Hz repeated transcranial magnetic stimulation over the temporoparietal cortex on refractory auditory hallucinations (AH) in schizophrenia [1,2,3,4]
The TMS coil was positioned on the left left temporoparietal cortex (LTPC) through a neuronavigation method using the Brainsight Software system. 360 pulses were administered daily at a frequency of 1 Hz, at 100% of the motor threshold (MT) through 6 trains of 60 seconds, with an inter-train interval of 30 seconds. repeated transcranial magnetic stimulation (rTMS) was given to patients over the period of one month with five rTMS sessions each week
Summary
Repeated transcranial magnetic stimulation is a non-invasive brain stimulation tool, which has shown efficiency in the treatment of some resistant neuropsychiatric disorders, depression and auditory hallucinations in schizophrenia. Five meta-analyses have reported the effectiveness of 1 Hz repeated transcranial magnetic stimulation (rTMS) over the temporoparietal cortex on refractory auditory hallucinations (AH) in schizophrenia [1,2,3,4]. Double blind, controlled study, Poulet et al [6] reported that after 5 days of low frequency rTMS, 5 of the 7 patients who responded to active treatment maintained clinical improvement for at least two months. 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. Conclusion: 1 Hz rTMS using parameters mentioned above has no statistically significant effect on AH; evidences about the potential benefit of rTMS in the treatment of AH negative results suggest the need for further studies in this area
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