What Is the Real Effect of 1-Hz Repetitive Transcranial Magnetic Stimulation on Hallucinations? Controlling for Publication Bias in Neuromodulation Trials

Demeulemeester, Morgane; Amad, Ali; Bubrovszky, Maxime; Pins, Delphine; Thomas, Pierre; Jardri, Renaud

doi:10.1016/j.biopsych.2011.10.010

Cited by 46 publications

(25 citation statements)

References 22 publications

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“…This is in line with findings from rTMS, as lowfrequency, inhibitory rTMS is applied over this region to effectively treat auditory hallucinations as demonstrated by recent several meta-analyses [54,59,60]. Neuroimaging studies also point out that the left temporal cortex is critical in the pathophysiology of positive symptoms [61], with activation of a specific left temporal area -the Heschl's gyrus -during auditory hallucinations [62].…”

Section: Discussionsupporting

confidence: 64%

Understanding tDCS effects in schizophrenia: a systematic review of clinical data and an integrated computation modeling analysis

Brunoni

Shiozawa²,

Truong

et al. 2014

Expert Review of Medical Devices

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Although recent clinical studies using transcranial direct current stimulation (tDCS) for schizophrenia showed encouraging results, several tDCS montages were employed and their current flow pattern has not been investigated. We performed a systematic review to identify clinical tDCS studies in schizophrenia. We then applied computer head modeling analysis for prediction of current flow. Out of 41 references, we identified 12 relevant studies. The most employed montage was anode and cathode over the left dorsolateral prefrontal and temporoparietal cortex, respectively. Computational model analysis predicted activation and under-activation under the anode and the cathode, respectively, occurring in areas respectively associated with negative and positive symptoms. We also identified tDCS-induced electrical currents in cortical areas between the electrodes (frontoparietal network) and, to a lesser extent, in deeper structures involved in schizophrenia pathophysiology. Mechanisms of tDCS effects in schizophrenia and the usefulness of computer modeling techniques for planning tDCS trials in schizophrenia are discussed.

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Section: Discussionsupporting

confidence: 64%

Understanding tDCS effects in schizophrenia: a systematic review of clinical data and an integrated computation modeling analysis

Brunoni

Shiozawa²,

Truong

et al. 2014

Expert Review of Medical Devices

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“…A significant effect size was also found in a meta-analysis that included 17 studies of rTMS as a treatment for AVH, in which control subjects received sham stimulation. 13 Another meta-analysis that used Bayesian approaches 14 observed a significant effect size with rTMS treatment of refractory AVH and confirmed the stability of this effect, controlling both for publication bias and variable sham conditions.…”

Section: Introductionmentioning

confidence: 99%

Placebo Response in Repetitive Transcranial Magnetic Stimulation Trials of Treatment of Auditory Hallucinations in Schizophrenia: A Meta-Analysis

Dollfus¹,

Lecardeur²,

Morello³

et al. 2015

SCHBUL

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Several meta-analyses have assessed the response of patients with schizophrenia with auditory verbal hallucinations (AVH) to treatment with repetitive transcranial magnetic stimulation (rTMS); however, the placebo response has never been explored. Typically observed in a therapeutic trial, the placebo effect may have a major influence on the effectiveness of rTMS. The purpose of this metaanalysis is to evaluate the magnitude of the placebo effect observed in controlled studies of rTMS treatment of AVH, and to determine factors that can impact the magnitude of this placebo effect, such as study design considerations and the type of sham used. The study included twenty-one articles concerning 303 patients treated by sham rTMS. A meta-analytic method was applied to obtain a combined, weighted effect size, Hedges's g. The mean weighted effect size of the placebo effect across these 21 studies was 0.29 (P < .001). Comparison of the parallel and crossover studies revealed distinct results for each study design; placebo has a significant effect size in the 13 parallel studies (g = 0.44, P < 10 −4 ), but not in the 8 crossover studies (g = 0.06, P = .52). In meta-analysis of the 13 parallel studies, the 45° position coil showed the highest effect size. Our results demonstrate that placebo effect should be considered a major source of bias in the assessment of rTMS efficacy. These results fundamentally inform the design of further controlled studies, particularly with respect to studies of rTMS treatment in psychiatry.

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“…In fact, low-frequency, inhibitory rTMS over the temporo-parietal cortex, an area directly involved with auditory hallucinations, is an effective treatment for such hallucinations, as demonstrated by recent several meta-analyses (Demeulemeester et al, 2012;Freitas, Fregni, & Pascual-Leone, 2009;Prikryl, 2011). On the other hand, studies using high-frequency rTMS over the DLPFC did not show improvement of cognitive and negative symptoms (see, for instance, Barr, Farzan, Tran, Fitzgerald, & Daskalakis, 2012), possibly due to the severity of the disorder and/or the need to further optimize stimulation parameters.…”

Section: Mechanisms Of Actionmentioning

confidence: 95%

Clinical use of Transcranial Direct Current Stimulation in Psychiatry

Brunoni

Boggio

2014

The Stimulated Brain

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What Is the Real Effect of 1-Hz Repetitive Transcranial Magnetic Stimulation on Hallucinations? Controlling for Publication Bias in Neuromodulation Trials

Cited by 46 publications

References 22 publications

Understanding tDCS effects in schizophrenia: a systematic review of clinical data and an integrated computation modeling analysis

Understanding tDCS effects in schizophrenia: a systematic review of clinical data and an integrated computation modeling analysis

Placebo Response in Repetitive Transcranial Magnetic Stimulation Trials of Treatment of Auditory Hallucinations in Schizophrenia: A Meta-Analysis

Clinical use of Transcranial Direct Current Stimulation in Psychiatry

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