High-Frequency Neuronavigated rTMS in Auditory Verbal Hallucinations: A Pilot Double-Blind Controlled Study in Patients With Schizophrenia. (28th September 2017)

• Record Type: Journal Article
• Authors: Dollfus, Sonia; Jaafari, Nemat; Guillin, Olivier; Trojak, Benoit; Plaze, Marion; Saba, Ghassen; Nauczyciel, Cécilia; Montagne Larmurier, Aurélie; Chastan, Nathalie; Meille, Vincent; Krebs, Marie-Odile; Ayache, Samar S; Lefaucheur, Jean Pascal; Razafimandimby, Annick; Leroux, Elise; Morello, Rémy; Marie Batail, Jean; Brazo, Perrine; Lafay, Nicolas; Wassouf, Issa; Harika-Germaneau, Ghina; Guillevin, Remy; Guillevin, Carole; Gerardin, Emmanuel; Rotharmel, Maud; Crépon, Benoit; Gaillard, Raphael; Delmas, Christophe; Fouldrin, Gael; Laurent, Guillaume; Nathou, Clément; Etard, Olivier;
• Is Part Of: Schizophrenia bulletin. Volume 44:Number 3(2018:May)
• Page Start: 505
• Page End: 514
• Publication Date: 2017-09-28
• Subjects: Transcranial magnetic stimulation -- neuronavigation -- magnetic resonance imaging -- Auditory Hallucinations Rating Scale -- placebo -- trial -- 20 Hz; Schizophrenia -- Periodicals; Schizophrenia -- Research -- Periodicals; 616.898005
• DOI: 10.1093/schbul/sbx127
• Languages: English
• ISSNs: 0586-7614

Abstract

Abstract: Introduction: Despite extensive testing, the efficacy of low-frequency (1 Hz) repetitive transcranial magnetic stimulation (rTMS) of temporo-parietal targets for the treatment of auditory verbal hallucinations (AVH) in patients with schizophrenia is still controversial, but promising results have been reported with both high-frequency and neuronavigated rTMS. Here, we report a double-blind sham-controlled study to assess the efficacy of high-frequency (20 Hz) rTMS applied over a precise anatomical site in the left temporal region using neuronavigation. Methods: Fifty-nine of 74 randomized patients with schizophrenia or schizoaffective disorders (DSM-IV R) were treated with rTMS or sham treatment and fully evaluated over 4 weeks. The rTMS target was determined by morphological MRI at the crossing between the projection of the ascending branch of the left lateral sulcus and the superior temporal sulcus (STS). Results: The primary outcome was response to treatment, defined as a 30% decrease of the Auditory Hallucinations Rating Scale (AHRS) frequency item, observed at 2 successive evaluations. While there was no difference in primary outcome between the treatment groups, the percentages of patients showing a decrease of more than 30% of AHRS score (secondary outcome) did differ between the active (34.6%) and sham groups (9.1%) ( P = .016) at day 14. Discussion: This controlled study reports negative results on the primary outcome but demonstrates a transient effect of 20 Hz rTMS guided by neuronavigation and targeted on an accurate anatomical site for the treatment of AVHs in schizophrenia patients.