Advertisement

Treatment of Auditory Hallucinations With Bilateral Theta Burst Stimulation: A Randomized Controlled Pilot Trial

Published:January 10, 2014DOI:https://doi.org/10.1016/j.brs.2014.01.001
      Auditory hallucinations (AH) are a core symptom of schizophrenia, often leading to distress [
      • Oorschot M.
      • Lataster T.
      • Thewissen V.
      • Bentall R.
      • Delespaul P.
      • Myin-Germeys I.
      Temporal dynamics of visual and auditory hallucinations in psychosis.
      ]. Repetitive transcranial magnetic stimulation (TMS) applied to the left temporoparietal cortex has been shown to ameliorate AH in patients with schizophrenia [
      • Hoffman R.E.
      • Gueorguieva R.
      • Hawkins K.A.
      • et al.
      Temporoparietal transcranial magnetic stimulation for auditory hallucinations: safety, efficacy and moderators in a fifty patient sample.
      ]. However, the effect sizes are moderate and an optimization of stimulation parameters would be desirable [
      • Slotema C.W.
      • Aleman A.
      • Daskalakis Z.J.
      • Sommer I.E.
      Meta-analysis of repetitive transcranial magnetic stimulation in the treatment of auditory verbal hallucinations: update and effects after one month.
      ]. Continuous theta burst stimulation (cTBS), a patterned form of rTMS with brief stimulation sessions [
      • Huang Y.Z.
      • Edwards M.J.
      • Rounis E.
      • Bhatia K.P.
      • Rothwell J.C.
      Theta burst stimulation of the human motor cortex.
      ] has recently been put forward as a new option to induce a more effective and quicker modulation of cortical hyperactivity and associated auditory hallucinations [
      • Eberle M.C.
      • Wildgruber D.
      • Wasserka B.
      • Fallgatter A.J.
      • Plewnia C.
      Relief from chronic intractable auditory hallucinations after long-term bilateral theta burst stimulation.
      ,
      • Sidhoumi D.
      • Braha S.
      • Bouaziz N.
      • Brunelin J.
      • Benadhira R.
      • Januel D.
      Evaluation of the therapeutic effect of theta burst stimulation on drug-resistant auditory hallucinations in a schizophrenic patient and its impact on cognitive function and neuronal excitability: a case study.
      ,
      • Rachid F.
      • Vianin P.
      • Besse C.
      Safety and efficacy of continuous theta burst stimulation at 30 Hz in a patient with chronic auditory hallucinations: a case study in a private practice setting.
      ,
      • Kindler J.
      • Homan P.
      • Flury R.
      • Strik W.
      • Dierks T.
      • Hubl D.
      Theta burst transcranial magnetic stimulation for the treatment of auditory verbal hallucinations: results of a randomized controlled study.
      ]. Moreover, recent studies indicate an additional critical involvement of the right temporoparietal cortex in the generation of AH [
      • Hoffman R.E.
      • Wu K.
      • Pittman B.
      • et al.
      Transcranial magnetic stimulation of Wernicke's and Right homologous sites to curtail “voices”: a randomized trial.
      ]. With this sham-controlled two-armed pilot trial, we aimed to provide a first estimate of efficacy as a basis for further larger clinical studies with bilateral cTBS to treat AH.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      References

        • Oorschot M.
        • Lataster T.
        • Thewissen V.
        • Bentall R.
        • Delespaul P.
        • Myin-Germeys I.
        Temporal dynamics of visual and auditory hallucinations in psychosis.
        Schizophr Res. 2012; 140: 77-82
        • Hoffman R.E.
        • Gueorguieva R.
        • Hawkins K.A.
        • et al.
        Temporoparietal transcranial magnetic stimulation for auditory hallucinations: safety, efficacy and moderators in a fifty patient sample.
        Biol Psychiatry. 2005; 58: 97-104
        • Slotema C.W.
        • Aleman A.
        • Daskalakis Z.J.
        • Sommer I.E.
        Meta-analysis of repetitive transcranial magnetic stimulation in the treatment of auditory verbal hallucinations: update and effects after one month.
        Schizophr Res. 2012; 142: 40-45
        • Huang Y.Z.
        • Edwards M.J.
        • Rounis E.
        • Bhatia K.P.
        • Rothwell J.C.
        Theta burst stimulation of the human motor cortex.
        Neuron. 2005; 45: 201-206
        • Eberle M.C.
        • Wildgruber D.
        • Wasserka B.
        • Fallgatter A.J.
        • Plewnia C.
        Relief from chronic intractable auditory hallucinations after long-term bilateral theta burst stimulation.
        Am J Psychiatry. 2010 Nov; 167: 1410
        • Sidhoumi D.
        • Braha S.
        • Bouaziz N.
        • Brunelin J.
        • Benadhira R.
        • Januel D.
        Evaluation of the therapeutic effect of theta burst stimulation on drug-resistant auditory hallucinations in a schizophrenic patient and its impact on cognitive function and neuronal excitability: a case study.
        Clin Neurophysiol. 2010; 121: 802
        • Rachid F.
        • Vianin P.
        • Besse C.
        Safety and efficacy of continuous theta burst stimulation at 30 Hz in a patient with chronic auditory hallucinations: a case study in a private practice setting.
        Brain Stimul. 2013; 6: 707-708
        • Kindler J.
        • Homan P.
        • Flury R.
        • Strik W.
        • Dierks T.
        • Hubl D.
        Theta burst transcranial magnetic stimulation for the treatment of auditory verbal hallucinations: results of a randomized controlled study.
        Psychiatry Res. 2013; 209: 114-117
        • Hoffman R.E.
        • Wu K.
        • Pittman B.
        • et al.
        Transcranial magnetic stimulation of Wernicke's and Right homologous sites to curtail “voices”: a randomized trial.
        Biol Psychiatry. 2013; 73: 1008-1014
        • Haddock G.
        • McCarron J.
        • Tarrier N.
        • Faragher E.B.
        Scales to measure dimensions of hallucinations and delusions: the psychotic symptom rating scales (PSYRATS).
        Psychol Med. 1999; 29: 879-889