Efficacy of fronto-temporal transcranial direct current stimulation for refractory auditory verbal hallucinations in schizophrenia: A randomized, double-blind, sham-controlled study

Bose, Anushree; Shivakumar, Venkataram; Agarwal, Sri Mahavir; Kalmady, Sunil V.; Shenoy, Sonia; Sreeraj, Vanteemar S.; Narayanaswamy, Janardhanan C.; Venkatasubramanian, Ganesan

doi:10.1016/j.schres.2017.08.047

Cited by 54 publications

(34 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A pilot trial based on the prior observations has examined the potential treatment effects of fronto-temporal tDCS (twice daily stimulation for total 10 sessions, with the anode placed over the left prefrontal cortex and the cathode over the left temporo-parietal junction) for treating medication-refractory AVHs in schizophrenia and the results are very promising, giving hope for future clinical application ( Brunelin et al, 2012 ). Some studies that successfully replicated the original pilot study have further confirmed a therapeutic benefit of tDCS, manifested by reductions in frequency and/or severity of AVHs in schizophrenic patients ( Mondino et al, 2015 , 2016 ; Bose et al, 2017 ). However, other studies that applied the stimulation once daily for 15 ( Fitzgerald et al, 2014 ) or 5 sessions ( Smith et al, 2015 ; Fröhlich et al, 2016 ) failed to replicate previous positive findings.…”

Section: Introductionmentioning

confidence: 83%

The Effects of Add-on Fronto-Temporal Transcranial Direct Current Stimulation (tDCS) on Auditory Verbal Hallucinations, Other Psychopathological Symptoms, and Insight in Schizophrenia: A Randomized, Double-Blind, Sham-Controlled Trial

Chang

Tzeng

Chao

et al. 2018

International Journal of Neuropsychopharmacology

View full text Add to dashboard Cite

BackgroundThe efficacy of fronto-temporal transcranial direct current stimulation in treating auditory verbal hallucinations and other psychopathological symptoms of schizophrenia patients has been examined in a small number of clinical trials with limited sample sizes, but the results are mixed. Fronto-temporal transcranial direct current stimulation has also been demonstrated to enhance patients’ insight into their mental illness in an open-label pilot study. The current investigation aimed to investigate the therapeutic effects of fronto-temporal transcranial direct current stimulation on the severity of auditory verbal hallucinations, other schizophrenia symptoms, and insight in a large double blind, randomized, sham-controlled trial.MethodsSixty patients with medication-refractory auditory verbal hallucinations were randomized over 2 conditions: transcranial direct current stimulation with 2-mA, twice-daily sessions for 5 consecutive days, with anodal stimulation to the left prefrontal cortex and cathodal stimulation to the left temporo-parietal junction, and sham treatment.ResultsFronto-temporal transcranial direct current stimulation failed to cause significant changes in the severity of auditory verbal hallucinations and other schizophrenia symptoms. The levels of insight into illness (effect size=0.511, P<.001) and positive symptoms (effect size=0.781, P<.001) were largely promoted by 5 days of transcranial direct current stimulation relative to sham treatment. The beneficial effects on the 2 insight dimensions remained 1 month after transcranial direct current stimulation.ConclusionsFronto-temporal transcranial direct current stimulation is not more effective for auditory verbal hallucinations and other schizophrenia symptoms than sham treatment. But the results of transcranial direct current stimulation-associated improvement in awareness of illness and positive symptoms show promise and provide a new direction for future research into insight promotion interventions in schizophrenia.

show abstract

Section: Introductionmentioning

confidence: 83%

The Effects of Add-on Fronto-Temporal Transcranial Direct Current Stimulation (tDCS) on Auditory Verbal Hallucinations, Other Psychopathological Symptoms, and Insight in Schizophrenia: A Randomized, Double-Blind, Sham-Controlled Trial

Chang

Tzeng

Chao

et al. 2018

International Journal of Neuropsychopharmacology

View full text Add to dashboard Cite

show abstract

“…tDCS is a form of non-invasive brain stimulation (NIBS) that has been used as a treatment adjunct for a range of psychiatric disorders, such as depression, schizophrenia and addictions 54–56. Preliminary evidence suggests that tDCS and other forms of NIBS are promising tools to reduce food cravings, ED symptoms and body weight in bulimic EDs, including BED, and obesity 57.…”

Section: Introductionmentioning

confidence: 99%

Combining cognitive bias modification training (CBM) and transcranial direct current stimulation (tDCS) to treat binge eating disorder: study protocol of a randomised controlled feasibility trial

et al. 2019

View full text Add to dashboard Cite

IntroductionBinge eating disorder (BED) is a common mental disorder, closely associated with obesity. Existing treatments are only moderately effective with high relapse rates, necessitating novel interventions. This paper describes the rationale for, and protocol of, a feasibility randomised controlled trial (RCT), evaluating the combination of transcranial direct current stimulation (tDCS) and a computerised cognitive training, namely approach bias modification training (ABM), in patients with BED who are overweight or obese. The aim of this trial is to obtain information that will guide decision-making and protocol development in relation to a future large-scale RCT of combined tDCS+ABM treatment in this group of patients, and also to assess the preliminary efficacy of this intervention.Methods and analysis66 participants with Diagnostic and Statistical Manual-5 diagnosis of BED and a body mass index (BMI) of ≥25 kg/m2 will be randomly allocated to one of three groups: ABM+real tDCS; ABM+sham tDCS or a wait-list control group. Participants in both intervention groups will receive six sessions of ABM+real/sham tDCS over 3 weeks; engaging in the ABM task while simultaneously receiving bilateral tDCS to the dorsolateral prefrontal cortex. ABM is based on an implicit learning paradigm in which participants are trained to enact an avoidance behaviour in response to visual food cues. Assessments will be conducted at baseline, post-treatment (3 weeks) and follow-up (7 weeks post-randomisation). Feasibility outcomes assess recruitment and retention rates, acceptability of random allocation, blinding success (allocation concealment), completion of treatment sessions and research assessments. Other outcomes include eating disorder psychopathology and related neurocognitive outcomes (ie, delay of gratification and inhibitory control), BMI, other psychopathology (ie, mood), approach bias towards food and surrogate endpoints (ie, food cue reactivity, trait food craving and food intake).Ethics and disseminationThis study has been approved by the North West-Liverpool East Research Ethics Committee. Results will be published in peer-reviewed journals.Trial registration number ISRCTN35717198

show abstract

“…Previous neuroimaging studies of humans revealed that anodal stimulation tends to increase the blood oxygen level-dependent (BOLD) signal, whereas cathodal stimulation decreases this signal [ 9 , 10 ]. Intriguingly, many previous studies have reported the effectiveness of left dorsolateral prefrontal anodal tDCS as a treatment for major depressive disorder [ 4 , 5 ] and schizophrenia [ 11 ], as well as working memory performance in healthy subjects [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Gamma-band auditory steady-state response after frontal tDCS: A double-blind, randomized, crossover study

et al. 2018

View full text Add to dashboard Cite

The effects of transcranial direct current stimulation (tDCS) likely depend on cortical N-methyl-D-aspartic acid (NMDA) neurotransmission; however, no previous studies have reported tDCS-mediated modulation of cortical NMDA neurotransmission in humans. The gamma-band auditory steady-state response (ASSR) to a 40 Hz stimulation likely reflects the integrity of cortical NMDA neurotransmission. The present study tested whether the effect of tDCS is reflected in gamma-band ASSRs during a 40 Hz stimulation. Using a double-blind, randomized, crossover study, we performed magnetoencephalography (MEG) and measured the ASSR in 24 healthy participants during 40 Hz of auditory stimulation after prefrontal tDCS (2 mA) or sham (i.e., placebo) treatment. Our results failed to reveal significant differences in any brain between the two conditions after the application of a frequency of approximately 40 Hz. Based on these results, the ASSR is an insufficient method to detect the effect of tDCS on cortical NMDA neurotransmission. Unexpectedly, the results revealed an enhanced beta-band event-related spectral perturbation (ERSP) in the left motor cortex after tDCS compared with that observed after the sham stimuli. Given that beta-band oscillations reflect many functions in motor cortices, the tDCS for the frontal areas had some effect on the left motor cortex while the participants were focusing on not pressing the button with their right index finger. An additional study with an adequate psychological task is necessary to draw a conclusion regarding this unexpected result.

show abstract

Efficacy of fronto-temporal transcranial direct current stimulation for refractory auditory verbal hallucinations in schizophrenia: A randomized, double-blind, sham-controlled study

Cited by 54 publications

References 44 publications

The Effects of Add-on Fronto-Temporal Transcranial Direct Current Stimulation (tDCS) on Auditory Verbal Hallucinations, Other Psychopathological Symptoms, and Insight in Schizophrenia: A Randomized, Double-Blind, Sham-Controlled Trial

The Effects of Add-on Fronto-Temporal Transcranial Direct Current Stimulation (tDCS) on Auditory Verbal Hallucinations, Other Psychopathological Symptoms, and Insight in Schizophrenia: A Randomized, Double-Blind, Sham-Controlled Trial

Combining cognitive bias modification training (CBM) and transcranial direct current stimulation (tDCS) to treat binge eating disorder: study protocol of a randomised controlled feasibility trial

Gamma-band auditory steady-state response after frontal tDCS: A double-blind, randomized, crossover study

Contact Info

Product

Resources

About