First, neuroimaging studies of patients during AH periods have identified activation in brain regions involving speech perception, including right and left superior temporal cortex, 10 - 13 Broca's area, 13, 14 and left temporoparietal cortex. The study described herein is based on 2 sets of findings. 9 Effective treatment alternatives for AHs would benefit patients and their communities.
6 - 8 In about 25% of cases, AHs respond only partially to drug therapy. 3 - 5 Auditory hallucinations disrupt social functioning and are associated with acts of violence and suicide. One-hertz rTMS deserves additional study as a possible treatment for this syndrome.ĪUDITORY HALLUCINATIONS (AHs) are reported by 50% to 70% of patients with schizophrenia 1, 2 and generally consist of spoken speech or "voices." A large percentage of these patients experience AHs as highly distressing, especially when verbal content is negative or intrusive. Repetitive transcranial magnetic stimulation was well tolerated, without evidence of neuropsychological impairment.Ĭonclusions These data suggest that the mechanism of AHs involves activation of the left temporoparietal cortex. Duration of putative treatment effects ranged widely, with 52% of patients maintaining improvement for at least 15 weeks. Frequency and attentional salience were the 2 aspects of hallucinatory experience that showed greatest improvement. Results Auditory hallucinations were robustly improved with rTMS relative to sham stimulation. Neuropsychological assessments were administered at baseline and during and following each arm of the trial.
#AUDITORY HALLUCINATION END OF LIFE TRIAL#
Patients receiving sham stimulation were subsequently offered an open-label trial of rTMS. Methods Twenty-four patients with schizophrenia or schizoaffective disorder and medication-resistant AHs were randomly allocated to receive rTMS or sham stimulation for 9 days at 90% of motor threshold. We sought to determine if a more extended trial of rTMS could significantly reduce AHs that were resistant to antipsychotic medication. Recent results of 4-day administration of 1-Hz rTMS to left temporoparietal cortex were superior to those of sham stimulation in reducing AHs. One-hertz repetitive transcranial magnetic stimulation (rTMS) produces sustained reductions in cortical activation.
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