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Experimental Somatic Treatments: Transcranial Magnetic Stimulation in the Treatment of Auditory Verbal Hallucinations – A Meta-Analysis and Review

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Hallucinations

Abstract

Since 1999, repetitive transcranial magnetic stimulation (rTMS) has been investigated as a treatment method for auditory verbal hallucinations (AVH). In this chapter, an up-to-date meta-analysis is presented. Most rTMS studies have applied low-frequency stimulation, with 1 Hz, usually to the left temporoparietal region. We found that repetitive TMS has a medium-sized effect on the severity of AVH; this effect is decreasing over time, probably due to the publication of studies with larger patient samples and more negative results in recent years. It would be interesting to investigate whether patients with medication-resistant AVH may benefit more from rTMS when other paradigms are used. Therefore, more studies are needed to explore alternative rTMS paradigms, such as high-frequency TMS or burst sequences, the usage of higher motor thresholds, and/or the application of rTMS with the aid of an H-coil.

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References

  • Aleman, A., Sommer, I.E., Kahn, R.S. (2007). Efficacy of slow repetitive transcranial magnetic stimulation in the treatment of resistant auditory hallucinations in schizophrenia: a meta-analysis. Journal of Clinical Psychiatry, 68, 416–421.

    Article  PubMed  Google Scholar 

  • Barker, A.T., Freeston, I.L., Jarratt, J.A., Jalinous, R. (1990). Magnetic stimulation of the human nervous system: An introduction and basic principles. In: Magnetic stimulation in clinical neurophysiology. Edited by Chokroverty, S. Boston, MA: Butterworth’s, pp. 55–72.

    Google Scholar 

  • Barker, A.T., Jalinous, R., Freeston, I.L. (1985). Non-invasive magnetic stimulation of human motor cortex. Lancet, 11, 1106–1107.

    Article  Google Scholar 

  • Benson, R.R., Whalen, D.H., Richardson, M., Swainson, B., Clark, V.P., Lai, S., Liberman, A.M. (2001). Parametrically dissociating speech and nonspeech perception in the brain using fMRI. Brain and Language, 78, 364–396.

    Article  PubMed  CAS  Google Scholar 

  • Brunelin, J., Poulet, E., Bediou, B., Kallel, L., Dalery, J., D’Amato, T., Saoud, M. (2006). Low frequency repetitive transcranial magnetic stimulation improves source monitoring deficit in hallucinating patients with schizophrenia. Schizophrenia Research, 81, 41–45.

    Article  PubMed  Google Scholar 

  • Chibbaro, G., Daniele, M., Alagona, G., Di Pascuale, C., Cannavò, M., Rapisarda, V., Bella, R., Pennisi, G. (2005). Repetitive transcranial magnetic stimulation in schizophrenic patients reporting auditory hallucinations. Neuroscience Letters, 383, 54–57.

    Article  PubMed  CAS  Google Scholar 

  • De Jesus, D.R., Gil, A., Barbosa, L., Lobato, M.I., Magalhães, P.V., Favalli, G.P., Marcolin, M.A., Daskalakis, Z.J., Belmonte-de-Abreu, P.D. (2011). A pilot double-blind sham-controlled trial of repetitive transcranial magnetic stimulation for patients with refractory schizophrenia treated with clozapine. Psychiatry Research, 188, 203–207.

    Google Scholar 

  • De Weijer, A., Neggers, S.F., Diederen, K.M., Mandl, R.C., Kahn, R.S., Hulshoff Poll, H.E., Sommer, I.E. (2011). Aberrations in the arcuate fasciculus are associated with auditory verbal hallucinations in psychotic and in non-psychotic individuals. Human Brain Mapping, doi: 10.1002/hbm.21463.

    Google Scholar 

  • Eberle, M.-C., Wildgruber, D., Wasserka, B., Fallgatter, A.J., Plewnia, C. (2010). Relief from chronic intractable auditory hallucinations after long-term bilateral theta burst stimulation. American Journal of Psychiatry, 167, 1410.

    Article  PubMed  Google Scholar 

  • Emerson, G.B., Warme, W.J., Wolf, F.M., Heckman, J.D., Brand, R.A., Leopold, S.S. (2010). Testing for the presence of positive-outcome bias in peer review. A randomized controlled trial. Archives of Internal Medicine, 170, 1934–1939.

    Article  PubMed  Google Scholar 

  • Fitzgerald, P.B., Fountain, S., Daskalakis, Z.J. (2006). A comprehensive review of the effects of rTMS on motor cortical excitability and inhibition. Clinical Neurophysiology, 117, 2584–2596.

    Article  PubMed  Google Scholar 

  • Freitas, C., Fregni, F., Pascual-Leone, A. (2009). Meta-analysis of the effects of repetitive transcranial magnetic stimulation (rTMS) on negative and positive symptoms in schizophrenia. Schizophrenia Research, 108, 11–24.

    Article  PubMed  Google Scholar 

  • George, M.S., Wassermann, E.M., Williams, W.A., Callahan, A., Ketter, T.A., Basser, P., Hallett, M., Post, R.M. (1995). Daily repetitive transcranial magnetic stimulation (rTMS) improves mood in depression. Neuroreport, 6, 1853–1856.

    Article  PubMed  CAS  Google Scholar 

  • Higgins, J.P.T., Thompson, S.G., Deeks, J.J., Altman, D.G. (2003). Measuring inconsistency in meta-analyses. British Medical Journal, 327, 557–560.

    Article  PubMed  Google Scholar 

  • Hoffman, R.E., Boutros, N.N., Berman, R.M., Roessler, E., Belger, A., Krystal, J.H., Charney, D.S. (1999). Transcranial magnetic stimulation of left temporoparietal cortex in three patients reporting hallucinated “voices”. Biological Psychiatry, 46, 130–132.

    Article  PubMed  CAS  Google Scholar 

  • Hoffman, R.E., Gueorguieva, R., Hawkins, K.A., Varanko, M., Boutros, N.N., Wu, Y., Carroll, K., Krystal, J.H. (2005). Temporoparietal transcranial magnetic stimulation for auditory hallucinations: safety, efficacy and moderators in a fifty patient sample. Biological Psychiatry, 58, 97–104.

    Article  PubMed  Google Scholar 

  • Hoffman, R.E., Hampson, M., Wu, K., Anderson, A.W., Gore, J.C., Buchanan, R.J. Constable, R.T., Hawkins, K.A., Neayka, S. (2007). Probing the pathophysiology of auditory/verbal hallucinations by combining functional magnetic resonance imaging and transcranial magnetic stimulation. Cerebral Cortex, 17, 2733–2743.

    Article  PubMed  Google Scholar 

  • Homan, R.W., Herman, J., Purdy, P. (1987). Cerebral location of international 10–20 system electrode placement. Electroencephalography and Clinical Neurophysiology, 66, 376–382.

    Article  PubMed  CAS  Google Scholar 

  • Jandl, M., Steyer, J., Weber, M., Linden, D.E., Rothmeier, J., Maurer, K., Kaschka, W.P. (2006). Treating auditory hallucinations by transcranial magnetic stimulation: a randomized controlled cross-over trial. Neuropsychobiology, 53, 63–69.

    Article  PubMed  Google Scholar 

  • Lee, S.-H., Kim, W., Chung, Y.-C., Jung, K.-H., Bahk, W.-M., Yun, T.-Y., Kim, K.-S., George, M.S., Chae, J.-H. (2005). A double blind study showing that two weeks of daily repetitive TMS over the left or right temporoparietal cortex reduces symptoms in patients with schizophrenia who are having treatment-refractory auditory hallucinations. Neuroscience Letters, 376, 177–181.

    Article  PubMed  CAS  Google Scholar 

  • Loo, C.K., Sainsbury, K., Mitchell, P., Hadzi-Pavlovic, D., Sachdev, P.S. (2009). A sham-controlled trial of left and right temporal rTMS for the treatment of auditory hallucinations. Psychological Medicine, 40, 541–546.

    Article  PubMed  Google Scholar 

  • Montagne-Larmurier, A., Etard, O., Razafimandimby, A., Morello, R., Dollfus, S. (2009). Two-day treatment of auditory hallucinations by high frequency rTMS guided by cerebral imaging: a 6 month follow-up pilot study. Schizophrenia Research, 113, 77–83.

    Article  PubMed  CAS  Google Scholar 

  • Munafo, M.R., Flint J. (2010). How reliable are scientific studies? The British Journal of Psychiatry, 197, 257–258.

    Article  PubMed  CAS  Google Scholar 

  • Poulet, E., Brunelin, J., Ben Makhlouf, W., D’Amato, T., Saoud, M. (2009). A case report of cTBS for the treatment of auditory hallucinations in a patient with schizophrenia. Brain Stimulation, 2, 118–119.

    Article  PubMed  Google Scholar 

  • Rosa, M.O., Gattaz, W.F., Rosa, M.A., Rumi, D.O., Tavares, H., Myckowski, M., Sartorelli, M.C., Rigonatti, S.P., Elkis, H., Cabral, S.B., Teixeira, M.J., Marcolin, M.A. (2007). Effects of repetitive transcranial magnetic stimulation on auditory hallucinations refractory to clozapine. Journal of Clinical Psychiatry, 68, 1528–1532.

    Article  PubMed  CAS  Google Scholar 

  • Rosenberg, O., Roth, Y., Kotler, M., Zangen, A., Dannon, P. (2011). Deep transcranial magnetic stimulation for the treatment of auditory hallucinations: a preliminary open-label study. Annals of General Psychiatry, 10, 3.

    Article  PubMed  Google Scholar 

  • Rosenthal, R. (1979). The file drawer problem and tolerance for null results. Psychological Bulletin, 86, 638–641.

    Article  Google Scholar 

  • Saba, G., Verdon, C.M., Kalalou, K., Rocamora, J.F., Dumortier, G., Benadhira, R., Stamatiadis, L. Vicaut, E., Lipski, H., Januel, D. (2006). Transcranial magnetic stimulation in the treatment of schizophrenic symptoms: a double blind sham controlled study. Journal of Psychiatric Research, 40, 147–152.

    Article  PubMed  CAS  Google Scholar 

  • Schönfeldt-Lecuona, C., Grön, G., Walter, H., Büchler, N., Wunderlich, A., Spitzer, M., Herwig, U. (2004). Stereotaxic rTMS for the treatment of auditory hallucinations in schizophrenia. Neuroreport, 15, 1669–1673.

    Article  PubMed  Google Scholar 

  • Siebner, H.R., Rothwell, J. (2003). Transcranial magnetic stimulation: new insights into representational cortical plasticity. Experimental Brain Research, 148, 1–16.

    Article  Google Scholar 

  • Slotema, C.W., Blom, J.D., De Weijer, A.D., Diederen, K.M., Goekoop, R., Looijestijn, J., Daalman, K., Rijkaart, A.-M., Kahn, R.S., Hoek, H.W., Sommer, I.E.C. (2011). Can low-frequency repetitive transcranial magnetic stimulation really relieve medication-resistant auditory verbal hallucinations? Negative results from a large randomized controlled trial. Biological Psychiatry, 69, 450–456.

    Article  PubMed  Google Scholar 

  • Slotema, C.W., Blom, J.D., De Weijer, A.D., Kahn, R.S., Hoek, H.W., Sommer, I.E.C. Priming does not enhance the efficacy of one-hertz repetitive transcranial magnetic stimulation for the treatment of auditory verbal hallucinations: results of a randomized controlled study (submitted).

    Google Scholar 

  • Slotema, C.W., Blom, J.D., Hoek, H.W., Sommer, I.E.C. (2010). Should we expand the toolbox of psychiatric treatment methods to include repetitive transcranial magnetic stimulation? A meta-analysis of the efficacy of rTMS for psychiatric disorders. Journal of Clinical Psychiatry, 71, 873–884.

    Article  PubMed  Google Scholar 

  • Sommer, I.E.C., Diederen, K.M.J., Blom, J.-D., Willems, A., Kushan, L., Slotema, K., Boks, M.P.M., Daalman, K., Hoek, H.W., Neggers, S.F.W., Kahn, R.S. (2008). Auditory verbal hallucinations predominantly activate the right inferior frontal area. Brain, 131, 3169–3177.

    Article  PubMed  Google Scholar 

  • Tranulis, C., Sepehry, A.A., Galinowski, A., Stip, E. (2008). Should we treat auditory hallucinations with repetitive transcranial magnetic stimulation? A meta-analysis. Canadian Journal of Psychiatry, 53, 577–586.

    Google Scholar 

  • Vercammen, A., Knegtering, H., Bruggeman, R., Westenbroek, H.M., Jenner, J.A., Slooff, C.J., Wunderink, L., Aleman, A. (2009). Effects of bilateral repetitive transcranial magnetic stimulation on treatment resistant auditory-verbal hallucinations in schizophrenia: a randomized controlled trial. Schizophrenia Research, 114, 172–179.

    Article  PubMed  Google Scholar 

  • Wassermann, E.M. (1998). Risk and safety of repetitive transcranial magnetic stimulation: report and suggested guidelines from the International Workshop on the Safety of Repetitive Transcranial Magnetic Stimulation, June 5–7, 1996. Electroencephalography and Clinical Neurophysiology, 108, 1–16.

    Article  Google Scholar 

  • Zangen, A., Roth, Y., Voller, B., Hallett, M. (2005). Transcranial magnetic stimulation of deep brain regions: evidence for efficacy of the H-coil. Clinical Neurophysiology, 116, 775–779.

    Article  PubMed  Google Scholar 

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Correspondence to Christina W. Slotema M.D., Ph.D. .

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Slotema, C.W., Daskalakis, Z.J. (2012). Experimental Somatic Treatments: Transcranial Magnetic Stimulation in the Treatment of Auditory Verbal Hallucinations – A Meta-Analysis and Review. In: Blom, J., Sommer, I. (eds) Hallucinations. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-0959-5_25

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