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Temporoparietal transcranial magnetic stimulation for auditory hallucinations: safety, efficacy and moderators in a fifty patient sample.

AbstractBACKGROUND:
Auditory hallucinations are often resistant to treatment and can produce significant distress and behavioral difficulties. A preliminary report based on 24 patients with schizophrenia or schizoaffective disorder indicated greater improvement in auditory hallucinations following 1-hertz left temporoparietal repetitive transcranial magnetic stimulation (rTMS) compared to sham stimulation. Data from the full 50-subject sample incorporating 26 new patients are now presented to more comprehensively assess safety/tolerability, efficacy and moderators of this intervention.
METHODS:
Right-handed patients experiencing auditory hallucinations at least 5 times per day were randomly allocated to receive either rTMS or sham stimulation. A total of 132 minutes of rTMS was administered over 9 days at 90% motor threshold using a double-masked, sham-controlled, parallel design.
RESULTS:
Hallucination Change Score was more improved for rTMS relative to sham stimulation (p = .008) as was the Clinical Global Impressions Scale (p = .0004). Hallucination frequency was significantly decreased during rTMS relative to sham stimulation (p = .0014) and was a moderator of rTMS effects (p = .008). There was no evidence of neurocognitive impairment associated with rTMS.
CONCLUSIONS:
Left temporoparietal 1-hertz rTMS warrants further study as an intervention for auditory hallucinations. Data suggest that this intervention selectively alters neurobiological factors determining frequency of these hallucinations.
AuthorsRalph E Hoffman, Ralitza Gueorguieva, Keith A Hawkins, Maxine Varanko, Nash N Boutros, Yu-te Wu, Kathleen Carroll, John H Krystal
JournalBiological psychiatry (Biol Psychiatry) Vol. 58 Issue 2 Pg. 97-104 (Jul 15 2005) ISSN: 0006-3223 [Print] United States
PMID15936729 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S., Research Support, U.S. Gov't, P.H.S.)
Topics
  • Adult
  • Double-Blind Method
  • Electric Stimulation Therapy (instrumentation, methods)
  • Electromagnetic Fields
  • Female
  • Functional Laterality
  • Hallucinations (etiology, physiopathology, therapy)
  • Humans
  • Male
  • Middle Aged
  • Parietal Lobe (physiopathology)
  • Psychotic Disorders (complications, physiopathology, therapy)
  • Schizophrenic Psychology
  • Statistics, Nonparametric
  • Temporal Lobe (physiopathology)
  • Transcranial Magnetic Stimulation (therapeutic use)
  • Treatment Outcome

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