Twice daily low frequency rTMS for treatment-resistant auditory hallucinations - Archive ouverte HAL Access content directly
Journal Articles International Journal of Clinical and Health Psychology Year : 2023

Twice daily low frequency rTMS for treatment-resistant auditory hallucinations

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Abstract

Background: Repetitive transcranial magnetic stimulation (rTMS) has emerged as a therapeutic solution in patients with treatment-resistant auditory verbal hallucinations. However, the optimal stimulation parameters remain unclear, especially for patients with clozapine-resistant symptoms. Method: In an open label retrospective study, we investigated whether parameters of stimulation that were useful in patients with major depressive disorder would help schizophrenia patients with treatment-resistant auditory verbal hallucinations. Fourteen participants, including 9 under clozapine, received 30 sessions of 1 Hz rTMS over 3 weeks (360 pulses per sessions delivered with 60 s 'on' and 30 s 'off' at 110% of the resting motor threshold, 2 sessions per day). Stimulations were applied over the left temporoparietal junction (T3-P3 according to 10/20 system). Results: After rTMS, a significant decrease of auditory verbal hallucinations was observed (À38.7% § 31.8, p = 0.003) on the Auditory Hallucination Rating Scale. The beneficial effects were also significant in the 9 patients who were also receiving clozapine (À34.9% § 28.4, p = 0.01). Conclusions: Low frequency rTMS, 30 sessions over 3 weeks, appears to be a suitable approach to decrease treatment-resistant auditory verbal hallucinations, including in patients with clozapine-resistant symptoms. Results from the current retrospective study in the clinical settings need to be confirmed by large-scale randomized sham-controlled trials.
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Dates and versions

hal-03862836 , version 1 (21-11-2022)

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Jerome Brunelin, Filipe Galvao, Marine Mondino. Twice daily low frequency rTMS for treatment-resistant auditory hallucinations. International Journal of Clinical and Health Psychology, 2023, 23 (1), pp.100344. ⟨10.1016/j.ijchp.2022.100344⟩. ⟨hal-03862836⟩
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