High-Frequency Neuronavigated rTMS in Auditory Verbal Hallucinations: A Pilot Double-Blind Controlled Study in Patients With Schizophrenia

Dollfus, Sonia; Jaafari, Nemat; Guillin, Olivier; Trojak, Benoît; Plaze, Marion; Saba, Ghassen; Nauczyciel, Cécilia; Larmurier, A. Montagne; Chastan, Nathalie; Meille, Vincent; Krebs, Marie‐Odile; Ayache, Samar S.; Lefaucheur, Jean Pascal; Razafimandimby, Annick; Leroux, Elise; Morello, Rémy; Batail, Jean-Marie; Brazo, P.; Lafay, N.; Wassouf, Issa; Harika‐Germaneau, Ghina; Guillevin, Rémy; Guillevin, Carole Menuel; Gérardin, Emmanuel; Rothärmel, Maud; Crépon, Benoît; Gaillard, Raphaël; Delmas, C.; Fouldrin, Gaël; Laurent, Guillaume J.; Nathou, Clément; Etard, Olivier

doi:10.1093/schbul/sbx127

Cited by 37 publications

(30 citation statements)

References 64 publications

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“…Due to the anatomic variation between patients, rTMS efficacy may be improved through a precise target 21 . For instance, most studies have targeted to the left DLPFC due to its central role in working memory and in executive function 22 .…”

Section: Introductionmentioning

confidence: 99%

“…Several recent literatures have shown some efficacious results by combining the high-frequency rTMS with neuronavigated target on auditory verbal hallucinations in SCZ, relative to sham stimulation 21 . This study was the first one to assess the treatment efficiency of 20 Hz rTMS for the clinical symptoms and cognitive dysfunction in patients with SCZ.…”

Section: Introductionmentioning

confidence: 99%

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High-frequency neuronavigated rTMS effect on clinical symptoms and cognitive dysfunction: a pilot double-blind, randomized controlled study in Veterans with schizophrenia

et al. 2020

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Cognitive impairment is a central aspect of schizophrenia (SCZ) that occurs at the onset of the disease and is related to poor social function and outcome in patients with SCZ. Recent literatures have revealed repetitive transcranial magnetic stimulation (rTMS) to be one of the efficient medical interventions for cognitive impairments. However, no study has been conducted to investigate the treatment effectiveness of 20 Hz rTMS with neuronavigation system administered to the left dorsolateral prefrontal cortex (DLPFC) in patients with schizophrenia. In this randomized, double-blind and sham-controlled study, 56 patients were enrolled in 20 Hz rTMS (n = 28) or sham stimulation (n = 28) over left DLPFC for 8 weeks. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was performed to measure the cognitive function at baseline and after 8 weeks of rTMS treatment. The positive and negative syndrome scales (PANSS) was performed to assess the clinical symptoms at baseline, after 2-week treatment, 4-week treatment, 6-week treatment, and 8-week treatment. Totally, 15 subjects (seven in active group and eight in sham group) dropped out during the trial and the main findings were from completed 41 patients. At 2 weeks, 4 weeks, and 6 weeks, there were no significant differences in PANSS total score and subscores between the sham and treatment groups. At 8 weeks, the 20 Hz rTMS significantly increased the immediate memory score compared with the sham. Furthermore, the improvement in the immediate memory score was correlated with the decrease in the excitement factor score of the patients with SCZ. Our results suggest that 20 Hz rTMS appears to be an effective treatment for improving the cognitive performance and reducing the clinical symptoms of patients with SCZ.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

High-frequency neuronavigated rTMS effect on clinical symptoms and cognitive dysfunction: a pilot double-blind, randomized controlled study in Veterans with schizophrenia

et al. 2020

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“…Thus, more therapeutic options are needed. As recently demonstrated for AVH treatment in younger SZ patients (22) and in elderly depressed patients (58), non-invasive brain stimulation techniques (e.g., rTMS and TBS) are beneficial in terms of the tolerance, side-effect profile, and patient's acceptance. Therefore, they can be integrated into everyday clinical practice and might become an appropriate option to treat affective and psychotic symptoms occurring, particularly in elderly patients.…”

Section: Discussionmentioning

confidence: 91%

“…Recently, rTMS /TBS has been discussed to become a treatment option for managing positive and negative symptoms in schizophrenic patients (21). The promising clinical application of rTMS /TBS on AVH in early-onset SZ has recently been reported (22)(23)(24)(25). Favorable effects for treating AVH with rTMS /TBS in middle-aged SZ and late-onset SZ were also indicated by two previous case reports (26,27).…”

Section: Introductionmentioning

confidence: 90%

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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“…In accordance with previous studies (Haddock et al., 1999; Xu et al., 2012; Dollfus et al., 2018), we adopted the traditional Auditory-Verbal Hallucinations Rating Scale (AHRS) extracted from the Psychotic Symptom Rating Scales (PSYRATS) to assess the severity of the AVH symptoms. We enrolled 300 healthy people with diagnosed AVHs.…”

Section: Samples and Methodsmentioning

confidence: 99%

The Effect of Dopamine Antagonist Treatment on Auditory Verbal Hallucinations in Healthy Individuals Is Clearly Influenced by COMT Genotype and Accompanied by Corresponding Brain Structural and Functional Alterations: An Artificially Controlled Pilot Study

Zhuo

Zhang

et al. 2019

Front. Genet.

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Few studies have been conducted to explore the influence of the catechol-o-methyltransferase (COMT) genotype on the severity of and treatment efficacy on auditory verbal hallucination (AVH) symptoms in healthy individuals with AVHs (Hi-AVHs). We hypothesized that the efficacy of dopamine antagonist treatment on AVHs in Hi-AVHs may be influenced by their COMT genotype and may be accompanied by corresponding brain alterations. To preliminarily investigate and test our hypothesis in an artificially controlled pilot study, we enrolled 42 Hi-AVHs as subjects and used magnetic resonance imaging and genetic methods to explore the basis brain features to investigate whether the efficacy of dopamine antagonist treatment on AVHs in Hi-AVH subjects was influenced by their COMT genotype or not. We found that COMT-met genotype subjects’ treatment response was better than that of COMT-val subjects. Although COMT-met genotype subjects demonstrated an increase in global functional connectivity density (gFCD) but no difference on gray matter volume (GMV) compared to COMT-val genotype subjects at baseline, notably, we found that both groups demonstrated gFCD and GMV reduction after treatment, but the reduction was more widespread in COMT-met genotype subjects than in COMT-val genotype subjects. This is the first study to report that Hi-AVH subjects’ baseline brain functional features are influenced by their COMT genotypes and that the COMT-met genotype subjects exhibit better responses to dopamine antagonists but have more widespread GMV and gFCD reduction than subjects with the COMT-val genotype. Despite several limitations, these findings may provide auxiliary information to further explain the mechanisms of AVHs and provide a clue for scholars to further explore specific treatment targets for AVHs in Hi-AVH subjects or in schizophrenia patients.

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High-Frequency Neuronavigated rTMS in Auditory Verbal Hallucinations: A Pilot Double-Blind Controlled Study in Patients With Schizophrenia

Abstract: This controlled study reports negative results on the primary outcome but demonstrates a transient effect of 20 Hz rTMS guided by neuronavigation and targeted on an accurate anatomical site for the treatment of AVHs in schizophrenia patients.

Cited by 37 publications

References 64 publications

High-frequency neuronavigated rTMS effect on clinical symptoms and cognitive dysfunction: a pilot double-blind, randomized controlled study in Veterans with schizophrenia

High-frequency neuronavigated rTMS effect on clinical symptoms and cognitive dysfunction: a pilot double-blind, randomized controlled study in Veterans with schizophrenia

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

The Effect of Dopamine Antagonist Treatment on Auditory Verbal Hallucinations in Healthy Individuals Is Clearly Influenced by COMT Genotype and Accompanied by Corresponding Brain Structural and Functional Alterations: An Artificially Controlled Pilot Study

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