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Exploratory study of once-daily transcranial direct current stimulation (tDCS) as a treatment for auditory hallucinations in schizophrenia

Published online by Cambridge University Press:  23 March 2020

F. Fröhlich ,
T.N. Burrello ,
J.M. Mellin ,
A.L. Cordle ,
C.M. Lustenberger ,
J.H. Gilmore  and
L.F. Jarskog
F. Fröhlich*
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel HillNC27599USA Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel HillNC27599USA Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel HillNC27599USA Neuroscience Center, University of North Carolina at Chapel Hill, Chapel HillNC27599USA Department of Neurology, University of North Carolina at Chapel Hill, Chapel HillNC27599USA
T.N. Burrello
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel HillNC27599USA
J.M. Mellin
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel HillNC27599USA
A.L. Cordle
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel HillNC27599USA
C.M. Lustenberger
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel HillNC27599USA
J.H. Gilmore
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel HillNC27599USA
L.F. Jarskog
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel HillNC27599USA
*
⁎ Corresponding author. Tel.: +39 3 213 758 27; fax: +39 3 213 758 21. E-mail address:[email protected]
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Abstract

Background

Auditory hallucinations are resistant to pharmacotherapy in about 25% of adults with schizophrenia. Treatment with noninvasive brain stimulation would provide a welcomed additional tool for the clinical management of auditory hallucinations. A recent study found a significant reduction in auditory hallucinations in people with schizophrenia after five days of twice-daily transcranial direct current stimulation (tDCS) that simultaneously targeted left dorsolateral prefrontal cortex and left temporo-parietal cortex.

Hypothesis

We hypothesized that once-daily tDCS with stimulation electrodes over left frontal and temporo-parietal areas reduces auditory hallucinations in patients with schizophrenia.

Methods

We performed a randomized, double-blind, sham-controlled study that evaluated five days of daily tDCS of the same cortical targets in 26 outpatients with schizophrenia and schizoaffective disorder with auditory hallucinations.

Results

We found a significant reduction in auditory hallucinations measured by the Auditory Hallucination Rating Scale (F2,50 = 12.22, P < 0.0001) that was not specific to the treatment group (F2,48 = 0.43, P = 0.65). No significant change of overall schizophrenia symptom severity measured by the Positive and Negative Syndrome Scale was observed.

Conclusions

The lack of efficacy of tDCS for treatment of auditory hallucinations and the pronounced response in the sham-treated group in this study contrasts with the previous finding and demonstrates the need for further optimization and evaluation of noninvasive brain stimulation strategies. In particular, higher cumulative doses and higher treatment frequencies of tDCS together with strategies to reduce placebo responses should be investigated. Additionally, consideration of more targeted stimulation to engage specific deficits in temporal organization of brain activity in patients with auditory hallucinations may be warranted.

Keywords

tDCSAuditory hallucinationsBrain stimulationPANSSAHRSPlacebo response
Type
Original article
Information
European Psychiatry , Volume 33 , Issue 1 , March 2016 , pp. 54 - 60
Copyright
Copyright © European Psychiatric Association 2016

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References

Shergill, S.S.Murray, R.M.McGuire, P.K.Auditory hallucinations: a review of psychological treatments. Schizophr Res 1998; 32(3): 137–150CrossRefGoogle ScholarPubMed
Aleman, A.Sommer, I.E.Kahn, R.S.Efficacy of slow repetitive transcranial magnetic stimulation in the treatment of resistant auditory hallucinations in schizophrenia: a meta-analysis. J Clin Psychiatry 2007; 68(3): 416–421CrossRefGoogle ScholarPubMed
de Jesus, D.R., et al.A pilot double-blind sham-controlled trial of repetitive transcranial magnetic stimulation for patients with refractory schizophrenia treated with clozapine Psychiatry Res 2011; 188(2): 203–207CrossRefGoogle ScholarPubMed
Slotema, C.W., et al.Can low-frequency repetitive transcranial magnetic stimulation really relieve medication-resistant auditory verbal hallucinations? Negative results from a large randomized controlled trial Biol Psychiatry 2011; 69(5): 450–456CrossRefGoogle ScholarPubMed
Nitsche, M.A.Paulus, W.Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation. J Physiol 2000; 527(Pt 3): 633–639CrossRefGoogle ScholarPubMed
Nitsche, M.A.Paulus, W.Transcranial direct current stimulation – update 2011. Restor Neurol Neurosci 2011; 29(6): 463–492Google ScholarPubMed
Brunelin, J., et al.Examining transcranial direct current stimulation (tDCS) as a treatment for hallucinations in schizophrenia Am J Psychiatry 2012; 169(7): 719–724CrossRefGoogle Scholar
Dierks, T., et al.Activation of Heschl's gyrus during auditory hallucinations Neuron 1999; 22(3): 615–621CrossRefGoogle ScholarPubMed
Jardri, R., et al.Cortical activations during auditory verbal hallucinations in schizophrenia: a coordinate-based meta-analysis Am J Psychiatry 2011; 168(1): 73–81CrossRefGoogle ScholarPubMed
Ropohl, A., et al.Cortical activity associated with auditory hallucinations Neuroreport 2004; 15(3): 523–526CrossRefGoogle ScholarPubMed
Sritharan, A., et al.EEG coherence measures during auditory hallucinations in schizophrenia. Psychiatry Res 2005; 136(2–3):189–200CrossRefGoogle Scholar
Ishii, R., et al.Theta rhythm increases in left superior temporal cortex during auditory hallucinations in schizophrenia: a case report Neuroreport 2000; 11(14): 3283–3287CrossRefGoogle ScholarPubMed
Reulbach, U., et al.Specific and unspecific auditory hallucinations in patients with schizophrenia: a magnetoencephalographic study Neuropsychobiology 2007; 55(2): 89–95CrossRefGoogle ScholarPubMed
Angelopoulos, E., et al.Cortical interactions during the experience of auditory verbal hallucinations J Neuropsychiatry Clin Neurosci 2011; 23(3): 287–293CrossRefGoogle ScholarPubMed
Lawrie, S.M., et al.Reduced frontotemporal functional connectivity in schizophrenia associated with auditory hallucinations Biol Psychiatry 2002; 51(12): 1008–1011CrossRefGoogle ScholarPubMed
Fitzgerald, P.B., et al.A negative pilot study of daily bimodal transcranial direct current stimulation in schizophrenia Brain Stimul 2014; 7(6): 813–816CrossRefGoogle Scholar
Oldfield, R.C.The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia 1971; 9(1): 97–113CrossRefGoogle ScholarPubMed
Bates, D., et al.lme4: linear mixed-effects models using Eigen and S4. R package version 1.1-6 2014Google Scholar
Halekoh, U.Hojsgaard, S.A Kenward-Roger approximation and parametric bootstrap methods for tests in linear mixed models – the R package pbkrtest. J Stat Software 2014; 59: 1–32CrossRefGoogle Scholar
Bose, A., et al.Insight facilitation with add-on tDCS in schizophrenia. Schizophr Res 2014; 156(1): 63–65CrossRefGoogle Scholar
Brunoni, A.R., et al.Understanding tDCS effects in schizophrenia: a systematic review of clinical data and an integrated computation modeling analysis. Expert Rev Med Devices 2014; 11(4): 383–394CrossRefGoogle Scholar
Monte-Silva, K., et al.Shaping the optimal repetition interval for cathodal transcranial direct current stimulation (tDCS). J Neurophysiol 2010; 103(4): 1735–1740CrossRefGoogle Scholar
Daskalakis, Z.J.Levinson, A.J.Fitzgerald, P.B.Repetitive transcranial magnetic stimulation for major depressive disorder: a review. Can J Psychiatry 2008; 53(9): 555–566CrossRefGoogle ScholarPubMed
Carpenter, L.L., et al.Transcranial magnetic stimulation (TMS) for major depression: a multisite, naturalistic, observational study of acute treatment outcomes in clinical practice. Depress Anxiety 2012; 29(7): 587–596CrossRefGoogle ScholarPubMed
Rutherford, B.R., et al.Placebo response in antipsychotic clinical trials: a meta-analysis. JAMA Psychiatry 2014; 71(12): 1409–1421CrossRefGoogle ScholarPubMed
Fitzgerald, P.B., et al.A study of the effects of lorazepam and dextromethorphan on the response to cortical 1 Hz repetitive transcranial magnetic stimulation. Neuroreport 2005; 16(13): 1525–1528CrossRefGoogle ScholarPubMed
Nitsche, M.A., et al.Pharmacological modulation of cortical excitability shifts induced by transcranial direct current stimulation in humans. J Physiol 2003; 553(Pt 1):293–301CrossRefGoogle ScholarPubMed
Nitsche, M.A., et al.GABAergic modulation of DC stimulation-induced motor cortex excitability shifts in humans. Eur J Neurosci 2004; 19(10): 2720–2726CrossRefGoogle ScholarPubMed
Nitsche, M.A., et al.Dopaminergic modulation of long-lasting direct current-induced cortical excitability changes in the human motor cortex. Eur J Neurosci 2006; 23(6): 1651–1657CrossRefGoogle ScholarPubMed
Mondino, M.Jardri, R.Suaud-Chagny, M.F.Saoud, M.Poulet, E.Brunelin, J.Effects of fronto-temporal transcranial direct current stimulation on auditory verbal hallucinations and resting-state functional connectivity of the left temporo-parietal junction in patients with schizophrenia. Schizophr Bull 2015CrossRefGoogle ScholarPubMed
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