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Deep transcranial magnetic stimulation for the treatment of auditory hallucinations: a preliminary open-label study.

Rosenberg O, Roth Y, Kotler M, Zangen A, Dannon P - Ann Gen Psychiatry (2011)

Bottom Line: Low-frequency deep TMS was applied for 10 min (600 pulses per session) to the left temporoparietal cortex for either 10 or 20 sessions.Deep TMS was applied using Brainsway's H1 coil apparatus.This preliminary study demonstrated a significant improvement in AHRS score (an average reduction of 31.7% ± 32.2%) and to a lesser extent improvement in SAPS results (an average reduction of 16.5% ± 20.3%).

View Article: PubMed Central - HTML - PubMed

Affiliation: Beer Ya'akov Mental Health Center affiliated to Sackler School of Medicine, University of Tel Aviv, Tel Aviv, Israel. odedaruna@gmail.com.

ABSTRACT

Background: Schizophrenia is a chronic and disabling disease that presents with delusions and hallucinations. Auditory hallucinations are usually expressed as voices speaking to or about the patient. Previous studies have examined the effect of repetitive transcranial magnetic stimulation (TMS) over the temporoparietal cortex on auditory hallucinations in schizophrenic patients. Our aim was to explore the potential effect of deep TMS, using the H coil over the same brain region on auditory hallucinations.

Patients and methods: Eight schizophrenic patients with refractory auditory hallucinations were recruited, mainly from Beer Ya'akov Mental Health Institution (Tel Aviv university, Israel) ambulatory clinics, as well as from other hospitals outpatient populations. Low-frequency deep TMS was applied for 10 min (600 pulses per session) to the left temporoparietal cortex for either 10 or 20 sessions. Deep TMS was applied using Brainsway's H1 coil apparatus. Patients were evaluated using the Auditory Hallucinations Rating Scale (AHRS) as well as the Scale for the Assessment of Positive Symptoms scores (SAPS), Clinical Global Impressions (CGI) scale, and the Scale for Assessment of Negative Symptoms (SANS).

Results: This preliminary study demonstrated a significant improvement in AHRS score (an average reduction of 31.7% ± 32.2%) and to a lesser extent improvement in SAPS results (an average reduction of 16.5% ± 20.3%).

Conclusions: In this study, we have demonstrated the potential of deep TMS treatment over the temporoparietal cortex as an add-on treatment for chronic auditory hallucinations in schizophrenic patients. Larger samples in a double-blind sham-controlled design are now being preformed to evaluate the effectiveness of deep TMS treatment for auditory hallucinations.

Trial registration: This trial is registered with clinicaltrials.gov (identifier: NCT00564096).

No MeSH data available.


Related in: MedlinePlus

Average scores of Auditory Hallucinations Rating Scale (AHRS), Scale for the Assessment of Positive Symptoms (SAPS) and Scale for Assessment of Negative Symptoms (SANS) (with standard error of mean (SEM)) 1 day before treatment (baseline), 1 day after last session (end of treatment), 1 week after last session and at 1 month after last session in the 20-session group.
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Figure 3: Average scores of Auditory Hallucinations Rating Scale (AHRS), Scale for the Assessment of Positive Symptoms (SAPS) and Scale for Assessment of Negative Symptoms (SANS) (with standard error of mean (SEM)) 1 day before treatment (baseline), 1 day after last session (end of treatment), 1 week after last session and at 1 month after last session in the 20-session group.

Mentions: In these patients (patients 6-8), average AHRS was improved at the end of treatment by 27.8% (SD ± 26.2%), average SAPS score improved by 13.75% (SD ± 12.3%), and there was also a minor reduction of 6.5% (SD ± 7.3) in SANS score. One patient did not improve and was lost to follow-up after treatment. However, in contrast to the first five patients, in the remaining two patients symptom scores kept improving such that at the 1 month follow-up the average change in AHRS and SAPS scores reached a reduction of 42.6% and 17.9%, respectively (Figure 3). Auditory hallucination scale paired t test values for all eight patients at baseline were as follows: P = 0.039 at 24 h follow-up, P = 0.004 at 1 week follow-up and P = 0.029 at 1 month follow-up (Table 3).


Deep transcranial magnetic stimulation for the treatment of auditory hallucinations: a preliminary open-label study.

Rosenberg O, Roth Y, Kotler M, Zangen A, Dannon P - Ann Gen Psychiatry (2011)

Average scores of Auditory Hallucinations Rating Scale (AHRS), Scale for the Assessment of Positive Symptoms (SAPS) and Scale for Assessment of Negative Symptoms (SANS) (with standard error of mean (SEM)) 1 day before treatment (baseline), 1 day after last session (end of treatment), 1 week after last session and at 1 month after last session in the 20-session group.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3045391&req=5

Figure 3: Average scores of Auditory Hallucinations Rating Scale (AHRS), Scale for the Assessment of Positive Symptoms (SAPS) and Scale for Assessment of Negative Symptoms (SANS) (with standard error of mean (SEM)) 1 day before treatment (baseline), 1 day after last session (end of treatment), 1 week after last session and at 1 month after last session in the 20-session group.
Mentions: In these patients (patients 6-8), average AHRS was improved at the end of treatment by 27.8% (SD ± 26.2%), average SAPS score improved by 13.75% (SD ± 12.3%), and there was also a minor reduction of 6.5% (SD ± 7.3) in SANS score. One patient did not improve and was lost to follow-up after treatment. However, in contrast to the first five patients, in the remaining two patients symptom scores kept improving such that at the 1 month follow-up the average change in AHRS and SAPS scores reached a reduction of 42.6% and 17.9%, respectively (Figure 3). Auditory hallucination scale paired t test values for all eight patients at baseline were as follows: P = 0.039 at 24 h follow-up, P = 0.004 at 1 week follow-up and P = 0.029 at 1 month follow-up (Table 3).

Bottom Line: Low-frequency deep TMS was applied for 10 min (600 pulses per session) to the left temporoparietal cortex for either 10 or 20 sessions.Deep TMS was applied using Brainsway's H1 coil apparatus.This preliminary study demonstrated a significant improvement in AHRS score (an average reduction of 31.7% ± 32.2%) and to a lesser extent improvement in SAPS results (an average reduction of 16.5% ± 20.3%).

View Article: PubMed Central - HTML - PubMed

Affiliation: Beer Ya'akov Mental Health Center affiliated to Sackler School of Medicine, University of Tel Aviv, Tel Aviv, Israel. odedaruna@gmail.com.

ABSTRACT

Background: Schizophrenia is a chronic and disabling disease that presents with delusions and hallucinations. Auditory hallucinations are usually expressed as voices speaking to or about the patient. Previous studies have examined the effect of repetitive transcranial magnetic stimulation (TMS) over the temporoparietal cortex on auditory hallucinations in schizophrenic patients. Our aim was to explore the potential effect of deep TMS, using the H coil over the same brain region on auditory hallucinations.

Patients and methods: Eight schizophrenic patients with refractory auditory hallucinations were recruited, mainly from Beer Ya'akov Mental Health Institution (Tel Aviv university, Israel) ambulatory clinics, as well as from other hospitals outpatient populations. Low-frequency deep TMS was applied for 10 min (600 pulses per session) to the left temporoparietal cortex for either 10 or 20 sessions. Deep TMS was applied using Brainsway's H1 coil apparatus. Patients were evaluated using the Auditory Hallucinations Rating Scale (AHRS) as well as the Scale for the Assessment of Positive Symptoms scores (SAPS), Clinical Global Impressions (CGI) scale, and the Scale for Assessment of Negative Symptoms (SANS).

Results: This preliminary study demonstrated a significant improvement in AHRS score (an average reduction of 31.7% ± 32.2%) and to a lesser extent improvement in SAPS results (an average reduction of 16.5% ± 20.3%).

Conclusions: In this study, we have demonstrated the potential of deep TMS treatment over the temporoparietal cortex as an add-on treatment for chronic auditory hallucinations in schizophrenic patients. Larger samples in a double-blind sham-controlled design are now being preformed to evaluate the effectiveness of deep TMS treatment for auditory hallucinations.

Trial registration: This trial is registered with clinicaltrials.gov (identifier: NCT00564096).

No MeSH data available.


Related in: MedlinePlus