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Slow transcranial magnetic stimulation can rapidly reduce resistant auditory hallucinations in schizophrenia

2004; Elsevier BV; Volume: 57; Issue: 2 Linguagem: Inglês

10.1016/j.biopsych.2004.10.007

1873-2402

Emmanuel Poulet, Jérôme Brunelin, Benoit Bédiou, Rémy Bation, Louis Forgeard, J Daléry, Thierry d’Amato, Mohamed Saoud,

Motor Control and Adaptation

Almost a quarter of patients with schizophrenia present with resistant auditory verbal hallucinations (AVH), a phenomenon that may relate to activation of brain areas underlying speech perception. Repetitive transcranial magnetic stimulation (rTMS) at 1 Hz reduces cortical activation, and recent results have shown that 1-Hz left temporoparietal rTMS may reduce AVH. The aim of this study was to replicate recent data and investigate whether low-frequency rTMS with a high total stimulation number delivered in a shorter 5-day block produces similar benefit.Ten right-handed schizophrenia patients with resistant AVH received 5 days of active rTMS and 5 days of sham rTMS (2,000 stimulations per day at 90% of motor threshold) over the left temporoparietal cortex in a double-blind crossover design. The two weeks of stimulation were separated by a 1-week washout period.AVH were robustly improved (56%) by 5 days active rTMS, whereas no variation was observed after sham. Seven patients were responders to active treatment, five of whom maintained improvement for at least 2 months.These data confirm the efficiency of low-frequency rTMS applied to the left temporoparietal cortex, compared with sham stimulation, in reducing resistant AVH. This improvement can be obtained in only 5 days without serious initial adverse events.