A simple, repeated rTMS protocol effectively removes auditory verbal hallucinations in a single patient study

Blanco-Lopez, Maria Jose; Cudeiro-Blanco, Javier; Iglesias, Guillermo R.; Gago, Ana Rosa Arias; Cudeiro, Javier

doi:10.1016/j.schres.2016.02.024

Cited by 4 publications

(9 citation statements)

References 6 publications

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“…The current case report also indicates that the treatment known to be efficient in SZ was also successful in VLOSLP. A positive effect of TBS on AVH relief in VLOSLP supplements earlier reports of TBS-induced improvement of AVH in younger patients (49,50). This might be interpreted that the use of rTMS/TBS may effectively treat AVH for a wide range of age groups.…”

Section: Possibly Common Pathway and Distant Originssupporting

confidence: 81%

Theta-Burst Stimulation for Auditory-Verbal Hallucination in Very-Late-Onset Schizophrenia-Like Psychosis—A Functional Magnetic Resonance Imaging Case Study

et al. 2020

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Background: Treating very-late-onset (>60 years) schizophrenia-like psychosis (VLOSLP) is challenging. Age-related factors in elderly individuals (e.g., metabolism, medication side effects, drug-interaction, somatic morbidity) may adversely affect treatment. Novel therapeutic approaches are needed to ensure the favorable therapeutic outcome in geriatric patients. Previously, theta-burst stimulation (TBS), a novel form of repetitive transcranial magnetic stimulation, was reported being beneficial in the treatment for auditory-verbal hallucination (AVH) in young and middle-aged schizophrenia (SZ) patients. Case Presentation: Here we present a case of a male patient aged 73. His first psychotic episode manifested with paranoid delusions, auditory-verbal and tactile hallucinations at the age of 66, and first remitted following a second-generation antipsychotics (SGA). Years later, after a relapse the AVH did not respond to previously effective olanzapine, whereas its augmentation with an inhibitory TBS over the left temporal lobe led to a stable remission. During his second relapse, TBS was again capable of facilitating therapeutic action of SGA in the same patient. Extending to our clinical observation, a series of functional MRI scans employing a tonal activation paradigm depicted altered auditory processing during AVH as well as brain activation change during remission. Conclusions: The current case might indicate to favorable effects of combining conventional medicament therapy and non-invasive brain stimulation techniques for elderly patients. Also, we speculate that despite obviously distinct etiologies, the present functional imaging and clinical observation may also demonstrate a possible common pathophysiological pathway underlying AVH in VLOSLP and SZ.

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Section: Possibly Common Pathway and Distant Originssupporting

confidence: 81%

Theta-Burst Stimulation for Auditory-Verbal Hallucination in Very-Late-Onset Schizophrenia-Like Psychosis—A Functional Magnetic Resonance Imaging Case Study

et al. 2020

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“…Trial designs were diverse with minimal replication: two of the studies adopted an ABAB crossover design, 19 , 20 two an ABA reversal design, 21 , 22 one an ABAC design 23 and one a BAB design. 24 The nature of interventions trialled was also wide ranging: two studies investigated pharmacological interventions (L-dopa 21 and donepezil 20 ), two a psychological intervention (‘social reinforcement-assisted cognitive intervention’ 19 and exercise counselling 22 ), and two a physical intervention (ear plug and transcranial magnetic stimulation). Comparison phases were varied, comprising a mixture of placebos (inactive tablet, 21 ear plug in opposite ear, 23 normal conversation 19 ) and treatment as usual.…”

Section: Resultsmentioning

confidence: 99%

“…Comparison phases were varied, comprising a mixture of placebos (inactive tablet, 21 ear plug in opposite ear, 23 normal conversation 19 ) and treatment as usual. 20 , 22 , 24 …”

Section: Resultsmentioning

confidence: 99%

“… 19 Of the other four studies, one discloses that no blinding occurred 20 and the others fail to declare whether or not any measures of blinding were applied. 22 – 24 …”

Section: Resultsmentioning

confidence: 99%

“…Two studies reported blinding measures, with one blinding both the patient and the evaluating physician, 21 and the other only blinding the secondary outcome assessors 19 . Of the other four studies, one discloses that no blinding occurred 20 and the others fail to declare whether or not any measures of blinding were applied 22 – 24 …”

Section: Resultsmentioning

confidence: 99%

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Application of n-of-1 treatment trials in schizophrenia: systematic review

et al. 2018

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BackgroundSingle patient or ‘n-of-1’ trials are a pragmatic method to achieve optimal, evidence-based treatments for individual patients. Such trials could be particularly valuable in chronic, heterogeneous, difficult to treat illnesses such as schizophrenia.AimsTo identify how often, and in what way, n-of-1 trials have been used in schizophrenia.MethodWe performed a systematic search in the major electronic databases for studies adopting n-of-1 methodology in schizophrenia, published in English from the start of records until the end of January 2017.ResultsWe identified six studies meeting inclusion criteria. There was wide variability in study methodology and analysis. Each trial reported positive outcomes for their respective intervention, but all studies were at high risk of bias.ConclusionsIn conclusion, n-of-1 trials are currently underutilised in schizophrenia. Existing trials suggest the method is well tolerated and potentially effective in achieving optimal treatments for patients, but more standardised methods of design, execution and analysis are required in future trials.Declaration of interestS.M.L. has received grants and personal fees from Janssen, and personal fees from Otsuka and Sunovion, in the past 3 years, outside the submitted work.

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Effects of repetitive transcranial magnetic stimulation in children and young people with psychiatric disorders: a systematic review

Gallop,

Westwood,

Hemmings

et al. 2024

Eur Child Adolesc Psychiatry

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Repetitive transcranial magnetic stimulation (rTMS) has demonstrated benefits in adults with psychiatric disorders, but its clinical utility in children and young people (CYP) is unclear. This PRISMA systematic review used published and ongoing studies to examine the effects of rTMS on disorder-specific symptoms, mood and neurocognition in CYP with psychiatric disorders. We searched Medline via PubMed, Embase, PsychINFO via OVID, and Clinicaltrials.gov up to July 2023. Eligible studies involved multiple-session (i.e., treatment) rTMS in CYP (≤ 25 years-old) with psychiatric disorders. Two independent raters assessed the eligibility of studies and extracted data using a custom-built form. Out of 78 eligible studies (participant N = 1389), the majority (k = 54; 69%) reported an improvement in at least one outcome measure of disorder-specific core symptoms. Some studies (k = 21) examined rTMS effects on mood or neurocognition,: findings were largely positive. Overall, rTMS was well-tolerated with minimal side-effects. Of 17 ongoing or recently completed studies, many are sham-controlled RCTs with better blinding techniques and a larger estimated participant enrolment. Findings provide encouraging evidence for rTMS-related improvements in disorder-specific symptoms in CYP with different psychiatric disorders. However, in terms of both mood (for conditions other than depression) and neurocognitive outcomes, evidence is limited. Importantly, rTMS is well-tolerated and safe. Ongoing studies appear to be of improved methodological quality; however, future studies should broaden outcome measures to more comprehensively assess the effects of rTMS and develop guidance on dosage (i.e., treatment regimens).

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A simple, repeated rTMS protocol effectively removes auditory verbal hallucinations in a single patient study

Cited by 4 publications

References 6 publications

Theta-Burst Stimulation for Auditory-Verbal Hallucination in Very-Late-Onset Schizophrenia-Like Psychosis—A Functional Magnetic Resonance Imaging Case Study

Theta-Burst Stimulation for Auditory-Verbal Hallucination in Very-Late-Onset Schizophrenia-Like Psychosis—A Functional Magnetic Resonance Imaging Case Study

Application of n-of-1 treatment trials in schizophrenia: systematic review

Effects of repetitive transcranial magnetic stimulation in children and young people with psychiatric disorders: a systematic review

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