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Haslam SA, Fong P, Haslam C, Cruwys T. Connecting to Community: A Social Identity Approach to Neighborhood Mental Health. PERSONALITY AND SOCIAL PSYCHOLOGY REVIEW 2024; 28:251-275. [PMID: 38146705 PMCID: PMC11193917 DOI: 10.1177/10888683231216136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
ACADEMIC ABSTRACT Integrative theorizing is needed to advance our understanding of the relationship between where a person lives and their mental health. To this end, we introduce a social identity model that provides an integrated explanation of the ways in which social-psychological processes mediate and moderate the links between neighborhood and mental health. In developing this model, we first review existing models that are derived primarily from a resource-availability perspective informed by research in social epidemiology, health geography, and urban sociology. Building on these, the social identity model implicates neighborhood identification in four key pathways between residents' local environment and their mental health. We review a wealth of recent research that supports this model and which speaks to its capacity to integrate and extend insights from established models. We also explore the implications of the social identity approach for policy and intervention. PUBLIC ABSTRACT We need to understand the connection between where people live and their mental health better than we do. This article helps us do this by presenting an integrated model of the way that social and psychological factors affect the relationship between someone's neighborhood and their mental health. This model builds on insights from social epidemiology, health geography, and urban sociology. Its distinct and novel contribution is to point to the importance of four pathways through which neighborhood identification shapes residents' mental health. A large body of recent research supports this model and highlights its potential to integrate and expand upon existing theories. We also discuss how our model can inform policies and interventions that seek to improve mental health outcomes in communities.
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Affiliation(s)
| | - Polly Fong
- The University of Queensland, Brisbane, Australia
| | | | - Tegan Cruwys
- The Australian National University, Canberra, Australian Capital Territory, Australia
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Mehta DD, Siddiqui S, Ward HB, Steele VR, Pearlson GD, George TP. Functional and structural effects of repetitive transcranial magnetic stimulation (rTMS) for the treatment of auditory verbal hallucinations in schizophrenia: A systematic review. Schizophr Res 2024; 267:86-98. [PMID: 38531161 DOI: 10.1016/j.schres.2024.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 02/26/2024] [Accepted: 03/15/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Auditory verbal hallucinations (AVH) are a disabling symptom for people with schizophrenia (SCZ), and do not always respond to antipsychotics. Repetitive transcranial magnetic stimulation (rTMS) has shown efficacy for medication-refractory AVH, though the underlying neural mechanisms by which rTMS produces these effects remain unclear. This systematic review evaluated the structural and functional impact of rTMS for AVH in SCZ, and its association with clinical outcomes. METHODS A systematic search was conducted in Medline, PsychINFO, and PubMed using terms for four key concepts: AVH, SCZ, rTMS, neuroimaging. Using PRISMA guidelines, 18 studies were identified that collected neuroimaging data of an rTMS intervention for AVH in SCZ. Risk of bias assessments was conducted. RESULTS Low frequency (<5 Hz) rTMS targeting left hemispheric language processing regions may normalize brain abnormalities in AVH patients at structural, functional, electrophysiological, and topological levels, with concurrent symptom improvement. Amelioration of aberrant neural activity in frontotemporal networks associated with speech and auditory processing was commonly observed, as well as in cerebellar and emotion regulation regions. Neuroimaging analyses identified neural substrates with direct correlations to post-rTMS AVH severity, propounding their use as therapeutic targets. DISCUSSION Combined rTMS-neuroimaging highlights the multidimensional alterations of rTMS on brain activity and structure in treatment-resistant AVH, which may be used to develop more efficacious therapies. Larger randomized, sham-controlled studies are needed. Future studies should explore alternate stimulation targets, investigate the neural effects of high-frequency rTMS and evaluate long-term neuroimaging outcomes.
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Affiliation(s)
- Dhvani D Mehta
- Institute of Medical Sciences, Temerty Faculty of Medicine, University of Toronto, Canada; Department of Psychiatry, Vanderbilt University, Nashville, TN, USA; Hartford Hospital and Department of Psychiatry and Behavioural Sciences, Yale University, New Haven, CT, USA; Department of Psychiatry, University of Toronto, Canada; Addictions Division and Institute for Mental Health Policy and Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.
| | - Salsabil Siddiqui
- Institute of Medical Sciences, Temerty Faculty of Medicine, University of Toronto, Canada; Department of Psychiatry, Vanderbilt University, Nashville, TN, USA; Hartford Hospital and Department of Psychiatry and Behavioural Sciences, Yale University, New Haven, CT, USA; Department of Psychiatry, University of Toronto, Canada; Addictions Division and Institute for Mental Health Policy and Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Heather B Ward
- Institute of Medical Sciences, Temerty Faculty of Medicine, University of Toronto, Canada; Department of Psychiatry, Vanderbilt University, Nashville, TN, USA; Hartford Hospital and Department of Psychiatry and Behavioural Sciences, Yale University, New Haven, CT, USA; Department of Psychiatry, University of Toronto, Canada; Addictions Division and Institute for Mental Health Policy and Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Vaughn R Steele
- Institute of Medical Sciences, Temerty Faculty of Medicine, University of Toronto, Canada; Department of Psychiatry, Vanderbilt University, Nashville, TN, USA; Hartford Hospital and Department of Psychiatry and Behavioural Sciences, Yale University, New Haven, CT, USA; Department of Psychiatry, University of Toronto, Canada; Addictions Division and Institute for Mental Health Policy and Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Godfrey D Pearlson
- Institute of Medical Sciences, Temerty Faculty of Medicine, University of Toronto, Canada; Department of Psychiatry, Vanderbilt University, Nashville, TN, USA; Hartford Hospital and Department of Psychiatry and Behavioural Sciences, Yale University, New Haven, CT, USA; Department of Psychiatry, University of Toronto, Canada; Addictions Division and Institute for Mental Health Policy and Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Tony P George
- Institute of Medical Sciences, Temerty Faculty of Medicine, University of Toronto, Canada; Department of Psychiatry, Vanderbilt University, Nashville, TN, USA; Hartford Hospital and Department of Psychiatry and Behavioural Sciences, Yale University, New Haven, CT, USA; Department of Psychiatry, University of Toronto, Canada; Addictions Division and Institute for Mental Health Policy and Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.
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Dollfus S, Letourneur F, Métivier L, Moulier V, Rothärmel M. Self-assessment scale of auditory verbal hallucinations (SAVH): A novel tool for patients with schizophrenia. Schizophr Res 2024; 267:19-23. [PMID: 38513330 DOI: 10.1016/j.schres.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/18/2024] [Accepted: 03/14/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND A scale for self-assessment of auditory verbal hallucinations (SAVH) was developed for patients, and this study aimed to validate the scale by investigating its psychometric properties. METHODS Forty one patients with schizophrenia or schizoaffective disorders (DSM-5) self-assessed their hallucinations using nine SAVH questions. Each question was scored from 0 to 5, indicating the severity of the symptoms. Patients were also evaluated with the Brief Psychiatric Rating Scale (BPRS), Auditory Hallucination Rating Scale (AHRS), and Birchwood Insight Scale (BIS). The psychometric properties of the SAVH were assessed by the face, internal consistency, construct, convergent and discriminant validities. RESULTS SAVH scores were used to examine the psychometric properties. Cronbach's α and Guttman's Lambda-6 were 0.67 and 0.73 respectively. Significant correlations were observed between SAVH and AHRS total scores, as well as BPRS hallucinatory behavior subscores. No significant correlations were found between total SAVH scores and (i) levels of insight or (ii) negative BPRS subscores. Factor analysis on SAVH revealed three factors accounting for 59.3 % of the variance. Most patients found the questions clear, appropriate, and of adequate length. CONCLUSIONS SAVH demonstrated good psychometric properties, suggesting its utility in assessing auditory verbal hallucinations (AVH). This self-assessment could be valuable in evaluating AVH treatment efficacy, monitoring AVH, and empowering patients.
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Affiliation(s)
- Sonia Dollfus
- Inserm UMR-S 1237 PhIND, Presage team, GIP Cyceron, 14000 Caen, France; Normandie Univ, UNICAEN, UFR de Médecine, 14000 Caen, France; CHU de Caen, Service de Psychiatrie, 14000 Caen, France; Fédération Hospitalo-Universitaire (FHU) A2M2P- CHU, Caen 14000, France.
| | - Florian Letourneur
- Normandie Univ, UNICAEN, UFR de Médecine, 14000 Caen, France; CHU de Caen, Service de Psychiatrie, 14000 Caen, France; Fédération Hospitalo-Universitaire (FHU) A2M2P- CHU, Caen 14000, France
| | - Lucie Métivier
- Inserm UMR-S 1237 PhIND, Presage team, GIP Cyceron, 14000 Caen, France; Normandie Univ, UNICAEN, UFR de Médecine, 14000 Caen, France; Fédération Hospitalo-Universitaire (FHU) A2M2P- CHU, Caen 14000, France
| | - Virginie Moulier
- Centre Hospitalier du Rouvray, Service Hospitalo-Universitaire de Psychiatrie, Centre Thérapeutique d'Excellence, 76300 Sotteville-lès-Rouen, France; Unité de Recherche Clinique (URC), EPS Ville Evrard, Neuilly-sur-Marne, France
| | - Maud Rothärmel
- Inserm UMR-S 1237 PhIND, Presage team, GIP Cyceron, 14000 Caen, France; Centre Hospitalier du Rouvray, Service Hospitalo-Universitaire de Psychiatrie, Centre Thérapeutique d'Excellence, 76300 Sotteville-lès-Rouen, France; Fédération Hospitalo-Universitaire (FHU) A2M2P- CHU, Caen 14000, France
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Dollfus S, Letourneur F, Metivier L, Moulier V, Rothärmel M. A digital tool for self-assessment of auditory verbal hallucinations in schizophrenia. Schizophr Res 2024; 264:188-190. [PMID: 38154361 DOI: 10.1016/j.schres.2023.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 11/15/2023] [Accepted: 12/16/2023] [Indexed: 12/30/2023]
Abstract
Auditory verbal hallucinations (AVH) are experienced by approximately 70 % of patients with schizophrenia and are frequently associated with high levels of distress. Therefore, alleviating hallucinations is an important therapeutic challenge. However, for prescribing a personalized treatment adapted to the patient, an accurate and detailed assessment of AVH is necessary. Until now, there have been no self-evaluations; instead, only scales based on observer ratings have been used to assess AVH. Nevertheless, self-assessments may enhance patient symptom awareness and increase their insight and involvement in the treatment, promoting empowerment (Eisen et al., 2000). In this context, a mobile app called MIMO was devised in order to monitor AVHs assessed by the patients themselves. This app, including the Self-assessment of Auditory verbal Hallucinations (SAVH-https://sns-dollfus.com/), was devised as an ecological momentary assessment tool. The present study aimed to demonstrate the feasibility and acceptability of this app.
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Affiliation(s)
- Sonia Dollfus
- Normandie Univ, UNICAEN, Inserm U1237, PhIND, Neuropresage team, GIP Cyceron, 14000 Caen, France; Normandie Univ, UNICAEN, UFR de Médecine, 14000 Caen, France; CHU de Caen, Service de Psychiatrie, 14000 Caen, France; Fédération Hospitalo-Universitaire A2M2P-CHU, Caen 14000, France.
| | | | - Lucie Metivier
- Normandie Univ, UNICAEN, Inserm U1237, PhIND, Neuropresage team, GIP Cyceron, 14000 Caen, France; Normandie Univ, UNICAEN, UFR de Médecine, 14000 Caen, France; Fédération Hospitalo-Universitaire A2M2P-CHU, Caen 14000, France
| | - Virginie Moulier
- Centre Hospitalier du Rouvray, Service Hospitalo-Universitaire de Psychiatrie, Centre Thérapeutique d'Excellence, 76300 Sotteville-lès-Rouen, France; Unité de Recherche Clinique (URC), EPS Ville Evrard, Neuilly-sur-Marne, France
| | - Maud Rothärmel
- Normandie Univ, UNICAEN, Inserm U1237, PhIND, Neuropresage team, GIP Cyceron, 14000 Caen, France; Centre Hospitalier du Rouvray, Service Hospitalo-Universitaire de Psychiatrie, Centre Thérapeutique d'Excellence, 76300 Sotteville-lès-Rouen, France; Fédération Hospitalo-Universitaire A2M2P-CHU, Caen 14000, France
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Tuppurainen H, Määttä S, Könönen M, Julkunen P, Kautiainen H, Hyvärinen S, Vaurio O, Joensuu M, Vanhanen M, Aho-Mustonen K, Mervaala E, Tiihonen J. Navigated and individual α-peak-frequency-guided transcranial magnetic stimulation in male patients with treatment-refractory schizophrenia. J Psychiatry Neurosci 2024; 49:E87-E95. [PMID: 38428970 PMCID: PMC10914400 DOI: 10.1503/jpn.230063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/25/2023] [Accepted: 12/07/2023] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Previous electroencephalography (EEG) studies have indicated altered brain oscillatory α-band activity in schizophrenia, and treatment with repetitive transcranial magnetic stimulation (rTMS) using individualized α-frequency has shown therapeutic effects. Magnetic resonance imaging-based neuronavigation methods allow stimulation of a specific cortical region and improve targeting of rTMS; therefore, we sought to study the efficacy of navigated, individual α-peak-frequency-guided rTMS (αTMS) on treatment-refractory schizophrenia. METHODS We recruited medication-refractory male patients with schizophrenia or schizoaffective disorder in this doubleblind, sham-controlled study. We randomized patients to a 3-week course of either active αTMS or sham stimulation applied to the left dorsolateral prefrontal cortex (DLPFC). We assessed participants with the Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impression Scale (CGI) at baseline and after treatment. We conducted a follow-up assessment with the PANSS 3 months after intervention. RESULTS We included 44 patients. After treatment, we observed a significantly higher PANSS total score (p = 0.029), PANSS general psychopathology score (p = 0.027) and PANSS 5-factor model cognitive-disorganized factor score (p = 0.011) in the αTMS group than the sham group. In addition, the CGI-Improvement score was significantly higher among those who received αTMS compared with sham stimulation (p = 0.048). LIMITATIONS The limited number of study participants included only male patients. Depression was not formally evaluated. CONCLUSION Navigated αTMS to the left DLPFC reduced total, general psychopathological, and cognitive-disorganized symptoms of schizophrenia. These results provide evidence for the therapeutic efficacy of individual α-peak-frequency-guided rTMS in treatment-refractory schizophrenia. CLINICAL TRIAL REGISTRATION NCT01941251; ClinicalTrials.gov.
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Affiliation(s)
- Heli Tuppurainen
- From the Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland (Tuppurainen, Hyvärinen, Vaurio, Joensuu, Vanhanen, Aho-Mustonen, Tiihonen); the Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland (Määttä, Könönen, Julkunen, Mervaala); the Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland (Könönen); the Department of Technical Physics, University of Eastern Finland, Kuopio, Finland (Julkunen); the Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland (Kautiainen); the Folkhälsan Research Center, Helsinki, Finland (Kautiainen); Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland (Mervaala); the Department of Clinical Neuroscience, Karolinska Institutet, and Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden (Tiihonen)
| | - Sara Määttä
- From the Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland (Tuppurainen, Hyvärinen, Vaurio, Joensuu, Vanhanen, Aho-Mustonen, Tiihonen); the Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland (Määttä, Könönen, Julkunen, Mervaala); the Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland (Könönen); the Department of Technical Physics, University of Eastern Finland, Kuopio, Finland (Julkunen); the Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland (Kautiainen); the Folkhälsan Research Center, Helsinki, Finland (Kautiainen); Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland (Mervaala); the Department of Clinical Neuroscience, Karolinska Institutet, and Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden (Tiihonen)
| | - Mervi Könönen
- From the Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland (Tuppurainen, Hyvärinen, Vaurio, Joensuu, Vanhanen, Aho-Mustonen, Tiihonen); the Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland (Määttä, Könönen, Julkunen, Mervaala); the Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland (Könönen); the Department of Technical Physics, University of Eastern Finland, Kuopio, Finland (Julkunen); the Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland (Kautiainen); the Folkhälsan Research Center, Helsinki, Finland (Kautiainen); Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland (Mervaala); the Department of Clinical Neuroscience, Karolinska Institutet, and Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden (Tiihonen)
| | - Petro Julkunen
- From the Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland (Tuppurainen, Hyvärinen, Vaurio, Joensuu, Vanhanen, Aho-Mustonen, Tiihonen); the Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland (Määttä, Könönen, Julkunen, Mervaala); the Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland (Könönen); the Department of Technical Physics, University of Eastern Finland, Kuopio, Finland (Julkunen); the Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland (Kautiainen); the Folkhälsan Research Center, Helsinki, Finland (Kautiainen); Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland (Mervaala); the Department of Clinical Neuroscience, Karolinska Institutet, and Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden (Tiihonen)
| | - Hannu Kautiainen
- From the Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland (Tuppurainen, Hyvärinen, Vaurio, Joensuu, Vanhanen, Aho-Mustonen, Tiihonen); the Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland (Määttä, Könönen, Julkunen, Mervaala); the Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland (Könönen); the Department of Technical Physics, University of Eastern Finland, Kuopio, Finland (Julkunen); the Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland (Kautiainen); the Folkhälsan Research Center, Helsinki, Finland (Kautiainen); Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland (Mervaala); the Department of Clinical Neuroscience, Karolinska Institutet, and Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden (Tiihonen)
| | - Soile Hyvärinen
- From the Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland (Tuppurainen, Hyvärinen, Vaurio, Joensuu, Vanhanen, Aho-Mustonen, Tiihonen); the Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland (Määttä, Könönen, Julkunen, Mervaala); the Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland (Könönen); the Department of Technical Physics, University of Eastern Finland, Kuopio, Finland (Julkunen); the Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland (Kautiainen); the Folkhälsan Research Center, Helsinki, Finland (Kautiainen); Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland (Mervaala); the Department of Clinical Neuroscience, Karolinska Institutet, and Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden (Tiihonen)
| | - Olli Vaurio
- From the Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland (Tuppurainen, Hyvärinen, Vaurio, Joensuu, Vanhanen, Aho-Mustonen, Tiihonen); the Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland (Määttä, Könönen, Julkunen, Mervaala); the Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland (Könönen); the Department of Technical Physics, University of Eastern Finland, Kuopio, Finland (Julkunen); the Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland (Kautiainen); the Folkhälsan Research Center, Helsinki, Finland (Kautiainen); Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland (Mervaala); the Department of Clinical Neuroscience, Karolinska Institutet, and Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden (Tiihonen)
| | - Mikko Joensuu
- From the Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland (Tuppurainen, Hyvärinen, Vaurio, Joensuu, Vanhanen, Aho-Mustonen, Tiihonen); the Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland (Määttä, Könönen, Julkunen, Mervaala); the Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland (Könönen); the Department of Technical Physics, University of Eastern Finland, Kuopio, Finland (Julkunen); the Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland (Kautiainen); the Folkhälsan Research Center, Helsinki, Finland (Kautiainen); Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland (Mervaala); the Department of Clinical Neuroscience, Karolinska Institutet, and Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden (Tiihonen)
| | - Matti Vanhanen
- From the Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland (Tuppurainen, Hyvärinen, Vaurio, Joensuu, Vanhanen, Aho-Mustonen, Tiihonen); the Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland (Määttä, Könönen, Julkunen, Mervaala); the Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland (Könönen); the Department of Technical Physics, University of Eastern Finland, Kuopio, Finland (Julkunen); the Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland (Kautiainen); the Folkhälsan Research Center, Helsinki, Finland (Kautiainen); Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland (Mervaala); the Department of Clinical Neuroscience, Karolinska Institutet, and Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden (Tiihonen)
| | - Kati Aho-Mustonen
- From the Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland (Tuppurainen, Hyvärinen, Vaurio, Joensuu, Vanhanen, Aho-Mustonen, Tiihonen); the Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland (Määttä, Könönen, Julkunen, Mervaala); the Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland (Könönen); the Department of Technical Physics, University of Eastern Finland, Kuopio, Finland (Julkunen); the Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland (Kautiainen); the Folkhälsan Research Center, Helsinki, Finland (Kautiainen); Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland (Mervaala); the Department of Clinical Neuroscience, Karolinska Institutet, and Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden (Tiihonen)
| | - Esa Mervaala
- From the Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland (Tuppurainen, Hyvärinen, Vaurio, Joensuu, Vanhanen, Aho-Mustonen, Tiihonen); the Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland (Määttä, Könönen, Julkunen, Mervaala); the Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland (Könönen); the Department of Technical Physics, University of Eastern Finland, Kuopio, Finland (Julkunen); the Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland (Kautiainen); the Folkhälsan Research Center, Helsinki, Finland (Kautiainen); Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland (Mervaala); the Department of Clinical Neuroscience, Karolinska Institutet, and Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden (Tiihonen)
| | - Jari Tiihonen
- From the Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland (Tuppurainen, Hyvärinen, Vaurio, Joensuu, Vanhanen, Aho-Mustonen, Tiihonen); the Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland (Määttä, Könönen, Julkunen, Mervaala); the Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland (Könönen); the Department of Technical Physics, University of Eastern Finland, Kuopio, Finland (Julkunen); the Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland (Kautiainen); the Folkhälsan Research Center, Helsinki, Finland (Kautiainen); Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland (Mervaala); the Department of Clinical Neuroscience, Karolinska Institutet, and Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden (Tiihonen)
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Li R, Fu R, Cui ZQ, Guo L, Chen YH, Bai J, Yang JB, Tan QR, Peng ZW. Effects of low-frequency rTMS combined with risperidone on the gut microbiome in hospitalized patients with chronic schizophrenia. Brain Res 2023; 1819:148539. [PMID: 37598899 DOI: 10.1016/j.brainres.2023.148539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/23/2023] [Accepted: 08/17/2023] [Indexed: 08/22/2023]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) has been widely used in treating schizophrenia (SCH). However, the effects of the low frequency of rTMS combined with antipsychotics on the gut microbiome in chronic SCH have been poorly investigated. In the present study, psychiatric symptoms were assessed and the stool samples obtained from 33 adult patients with chronic SCH (at baselinephase), 27 after 2 weeks of treatment (rTMS combined with risperidone, SCH-2W), and 37 healthy controls (HC) were analyzed by 16S rRNA gene sequencing. We found that the reduction of phylum Proteobacteria, family Enterobacteriaceae and genera Escherichia-Shigella as well as the increase of genera norank_f_Lachnospiraceae might be related to the antipsychotic effect of rTMS combined with risperidone. These findings indicate that the brain-gut-microbiota axis might be involved in the therapeutic effect of rTMS combined with antipsychotic drugs.
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Affiliation(s)
- Rui Li
- Department of Psychiatry, Chang'an Hospital, Xi'an 710000, China
| | - Rui Fu
- Department of Psychiatry, Chang'an Hospital, Xi'an 710000, China
| | - Zhi-Quan Cui
- Department of Psychiatry, Chang'an Hospital, Xi'an 710000, China
| | - Lin Guo
- Department of Psychiatry, Chang'an Hospital, Xi'an 710000, China
| | - Yi-Huan Chen
- Department of Psychiatry, Xijing Hospital, Air Force Medical University, Xi'an 710032, China
| | - Jie Bai
- Department of Psychiatry, Gaoxin Hospital, Xi'an 710077, China
| | - Jia-Bin Yang
- Department of Psychiatry, Chang'an Hospital, Xi'an 710000, China
| | - Qing-Rong Tan
- Department of Psychiatry, Chang'an Hospital, Xi'an 710000, China.
| | - Zheng-Wu Peng
- Department of Psychiatry, Chang'an Hospital, Xi'an 710000, China; Department of Psychiatry, Xijing Hospital, Air Force Medical University, Xi'an 710032, China.
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7
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Mao J, Fan K, Zhang Y, Wen N, Fang X, Ye X, Chen Y. 10 Hz repetitive transcranial magnetic stimulation (rTMS) may improve cognitive function: An exploratory study of schizophrenia patients with auditory hallucinations. Heliyon 2023; 9:e19912. [PMID: 37809845 PMCID: PMC10559318 DOI: 10.1016/j.heliyon.2023.e19912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/18/2023] [Accepted: 09/05/2023] [Indexed: 10/10/2023] Open
Abstract
Objectives Cognitive impairment in schizophrenia patients with auditory hallucinations is more prominent compared to those without. Our study aimed to investigate the cognitive improvement effects of 10 Hz repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) in schizophrenia with auditory hallucinations. Methods A total of 60 schizophrenic patients with auditory hallucinations in this study were randomly assigned to sham or active group. Both groups received 10 Hz or sham rTMS targeted in left DLPFC for 20 sessions. The Positive and Negative Syndrome Scale (PANSS), the Auditory Hallucination Rating Scale (AHRS), the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and the Udvalg for Kliniske Under-sogelser (UKU) side effect scale were used to measure psychiatric symptoms, auditory hallucinations, cognition, and side reaction, respectively. Results Our results indicated that the active group experienced greater improvements in RBANS-total score (P = 0.043) and immediate memory subscale score (P = 0.001). Additionally, the PANSS-total score, negative and positive subscale score were obviously lower in the active group compared to the sham group (all P < 0.050). Furthermore, our study found that the improvement of RBANS-total score was positively associated with the decline of positive factor score, and the improvement of language score in RBANS was positively associated with the reduction in PANSS-total scale, negative and positive subscale score in the real stimulation group (all P < 0.050). Conclusion Our results demonstrated that a four-week intervention of 10 Hz rTMS over the left DLPFC can improve cognition (particularly immediate memory) among schizophrenia patients with auditory hallucinations. Future studies with larger sample size are needful to verify our preliminary findings.
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Affiliation(s)
- Jiankai Mao
- Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, PR China
| | - Kaili Fan
- Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, PR China
| | - Yaoyao Zhang
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, Zhejiang, PR China
| | - Na Wen
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, Zhejiang, PR China
| | - Xinyu Fang
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, PR China
| | - Xiangming Ye
- Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, PR China
| | - Yi Chen
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, Zhejiang, PR China
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8
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Brunelin J, Bouaziz N, Dollfus S, Kallel L, Jardri R, Rachid F, Mondino M. Letter to the editor: Safety of "accelerated" rTMS protocols with twice-daily sessions in patients with schizophrenia - A comment on Caulfield et al. J Psychiatr Res 2022; 156:754-757. [PMID: 36088124 DOI: 10.1016/j.jpsychires.2022.08.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 08/25/2022] [Indexed: 01/20/2023]
Affiliation(s)
- Jerome Brunelin
- Centre Hospitalier Le Vinatier, F-69500, Bron, France; Inserm U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Université Claude Bernard Lyon 1, Université Jean Monnet, F-69000, Lyon, France.
| | - Noomane Bouaziz
- Unité de Recherche Clinique, Pôle 93G03, EPS de Ville Evrard, Neuilly sur Marne, France
| | - Sonia Dollfus
- UNICAEN, Inserm UMR-S 1237, GIP Cyceron, Caen, F-14000, France; CHU Caen, Centre Esquirol, Caen, F-14000, France
| | | | - Renaud Jardri
- Laboratoire de Neurosciences Cognitives & Computationnelles (LNC(2)), ENS, INSERM U-960, PSL Research University, Paris, France; Univ Lille, INSERM U-1172, Lille Neurosciences & Cognition Centre, Plasticity and Subjectivity Team, & CHU Lille, Fontan Hospital, CURE Platform, Lille, France
| | - Fady Rachid
- Private Practice 7, Place de la Fusterie, 1204, Geneva, Switzerland
| | - Marine Mondino
- Centre Hospitalier Le Vinatier, F-69500, Bron, France; Inserm U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Université Claude Bernard Lyon 1, Université Jean Monnet, F-69000, Lyon, France
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9
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Caulfield KA, Fleischmann HH, George MS, McTeague LM. Reply to "Letter to the editor: Safety of "accelerated" rTMS protocols with twice-daily sessions in patients with schizophrenia - A comment on Caulfield et al.". J Psychiatr Res 2022; 156:758-760. [PMID: 36123170 DOI: 10.1016/j.jpsychires.2022.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 08/19/2022] [Indexed: 01/20/2023]
Affiliation(s)
- Kevin A Caulfield
- Brain Stimulation Division, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA.
| | - Holly H Fleischmann
- Brain Stimulation Division, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA; Department of Psychology, University of Georgia, Athens, GA, USA
| | - Mark S George
- Brain Stimulation Division, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - Lisa M McTeague
- Brain Stimulation Division, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA
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10
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Chang X, Zhao W, Kang J, Xiang S, Xie C, Corona-Hernández H, Palaniyappan L, Feng J. Language abnormalities in schizophrenia: binding core symptoms through contemporary empirical evidence. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2022; 8:95. [PMID: 36371445 PMCID: PMC9653408 DOI: 10.1038/s41537-022-00308-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Both the ability to speak and to infer complex linguistic messages from sounds have been claimed as uniquely human phenomena. In schizophrenia, formal thought disorder (FTD) and auditory verbal hallucinations (AVHs) are manifestations respectively relating to concrete disruptions of those abilities. From an evolutionary perspective, Crow (1997) proposed that "schizophrenia is the price that Homo sapiens pays for the faculty of language". Epidemiological and experimental evidence points to an overlap between FTD and AVHs, yet a thorough investigation examining their shared neural mechanism in schizophrenia is lacking. In this review, we synthesize observations from three key domains. First, neuroanatomical evidence indicates substantial shared abnormalities in language-processing regions between FTD and AVHs, even in the early phases of schizophrenia. Second, neurochemical studies point to a glutamate-related dysfunction in these language-processing brain regions, contributing to verbal production deficits. Third, genetic findings further show how genes that overlap between schizophrenia and language disorders influence neurodevelopment and neurotransmission. We argue that these observations converge into the possibility that a glutamatergic dysfunction in language-processing brain regions might be a shared neural basis of both FTD and AVHs. Investigations of language pathology in schizophrenia could facilitate the development of diagnostic tools and treatments, so we call for multilevel confirmatory analyses focused on modulations of the language network as a therapeutic goal in schizophrenia.
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Affiliation(s)
- Xiao Chang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
- MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
- Zhangjiang Fudan International Innovation Center, Shanghai, China
| | - Wei Zhao
- MOE-LCSM, School of Mathematics and Statistics, Hunan Normal University, Changsha, PR China
| | - Jujiao Kang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
- Shanghai Center for Mathematical Sciences, Shanghai, China
| | - Shitong Xiang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
| | - Chao Xie
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
| | - Hugo Corona-Hernández
- Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lena Palaniyappan
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
- Robarts Research Institute, University of Western Ontario, London, Ontario, Canada.
- Lawson Health Research Institute, London, Ontario, Canada.
| | - Jianfeng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China.
- MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China.
- Zhangjiang Fudan International Innovation Center, Shanghai, China.
- Shanghai Center for Mathematical Sciences, Shanghai, China.
- Department of Computer Science, University of Warwick, Coventry, UK.
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11
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Chithra U, Samantaray S, Kumar V, K R, Maity K, E N, Akhtar KJ, Parlikar R, Bagali KB, Sreeraj VS, Shreekantiah U, Purohith AN, Shenoy S, Praharaj SK, Goyal N, Mehta UM, Venkatasubramanian G, Thirthalli J. Add-on accelerated continuous theta burst stimulation (a-cTBS) over the left temporoparietal junction for the management of persistent auditory hallucinations in schizophrenia: A case series. Brain Stimul 2022; 15:1511-1512. [PMID: 36410627 DOI: 10.1016/j.brs.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/04/2022] [Accepted: 11/15/2022] [Indexed: 11/21/2022] Open
Affiliation(s)
- Uppinkudru Chithra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, 560029, Karnataka State, India
| | - Subham Samantaray
- Central Institute of Psychiatry (CIP), Ranchi, 834006, Jharkhand State, India
| | - Vikas Kumar
- Central Institute of Psychiatry (CIP), Ranchi, 834006, Jharkhand State, India
| | - Rajkumar K
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, 560029, Karnataka State, India
| | - Ketaki Maity
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, 560029, Karnataka State, India
| | - Nathiya E
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, 560029, Karnataka State, India
| | - Khalid Jiya Akhtar
- Central Institute of Psychiatry (CIP), Ranchi, 834006, Jharkhand State, India
| | - Rujuta Parlikar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, 560029, Karnataka State, India
| | - Kiran Basawaraj Bagali
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, 560029, Karnataka State, India
| | - Vanteemar S Sreeraj
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, 560029, Karnataka State, India.
| | - Umesh Shreekantiah
- Central Institute of Psychiatry (CIP), Ranchi, 834006, Jharkhand State, India
| | - Abhiram Narasimhan Purohith
- Department of Psychiatry, Kasturba Medical College (KMC), Manipal, Manipal Academy of Higher Education (MAHE), Manipal, Udupi, 576104, Karnataka, India
| | - Sonia Shenoy
- Department of Psychiatry, Kasturba Medical College (KMC), Manipal, Manipal Academy of Higher Education (MAHE), Manipal, Udupi, 576104, Karnataka, India
| | - Samir Kumar Praharaj
- Department of Psychiatry, Kasturba Medical College (KMC), Manipal, Manipal Academy of Higher Education (MAHE), Manipal, Udupi, 576104, Karnataka, India
| | - Nishant Goyal
- Central Institute of Psychiatry (CIP), Ranchi, 834006, Jharkhand State, India
| | - Urvakhsh Meherwan Mehta
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, 560029, Karnataka State, India
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, 560029, Karnataka State, India
| | - Jagadisha Thirthalli
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, 560029, Karnataka State, India
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12
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Lorentzen R, Nguyen TD, McGirr A, Hieronymus F, Østergaard SD. The efficacy of transcranial magnetic stimulation (TMS) for negative symptoms in schizophrenia: a systematic review and meta-analysis. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2022; 8:35. [PMID: 35853882 PMCID: PMC9261093 DOI: 10.1038/s41537-022-00248-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 03/21/2022] [Indexed: 04/20/2023]
Abstract
Several trials have shown preliminary evidence for the efficacy of transcranial magnetic stimulation (TMS) as a treatment for negative symptoms in schizophrenia. Here, we synthesize this literature in a systematic review and quantitative meta-analysis of double-blind randomized controlled trials of TMS in patients with schizophrenia. Specifically, MEDLINE, EMBASE, Web of Science, and PsycINFO were searched for sham-controlled, randomized trials of TMS among patients with schizophrenia. The effect of TMS vs. sham on negative symptoms in each study was quantified by the standardized mean difference (SMD, Cohen's d) with 95% confidence intervals (95%CI) and pooled across studies using an inverse variance random effects model. We identified 57 studies with a total of 2633 participants that were included in the meta-analysis. The pooled analysis showed statistically significant superiority of TMS (SMD = 0.41, 95%CI: 0.26; 0.56, p-value < 0.001), corresponding to a number needed to treat of 5. Furthermore, stratified analyses suggested that TMS targeting the left dorsolateral prefrontal cortex and using a stimulation frequency >1 Hz was most efficacious. There was, however, substantial heterogeneity and high risk of bias among the included studies. In conclusion, TMS appears to be an efficacious treatment option for patients with schizophrenia suffering from negative symptoms, but the optimal TMS parameters are yet to be established.
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Affiliation(s)
- Rasmus Lorentzen
- Department of Affective Disorders, Aarhus University Hospital - Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Tuan D Nguyen
- Department of Affective Disorders, Aarhus University Hospital - Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Alexander McGirr
- Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Canada
| | - Fredrik Hieronymus
- Department of Affective Disorders, Aarhus University Hospital - Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Pharmacology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Søren D Østergaard
- Department of Affective Disorders, Aarhus University Hospital - Psychiatry, Aarhus, Denmark.
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
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13
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Brunelin J, Mondino M, Haesebaert J, Attal J, Benoit M, Chupin M, Dollfus S, El-Hage W, Galvao F, Jardri R, Llorca PM, Magaud L, Plaze M, Schott-Pethelaz AM, Suaud-Chagny MF, Szekely D, Fakra E, Poulet E. Examining transcranial random noise stimulation as an add-on treatment for persistent symptoms in schizophrenia (STIM'Zo): a study protocol for a multicentre, double-blind, randomized sham-controlled clinical trial. Trials 2021; 22:964. [PMID: 34963486 PMCID: PMC8715588 DOI: 10.1186/s13063-021-05928-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 12/08/2021] [Indexed: 12/26/2022] Open
Abstract
Background One out of three patients with schizophrenia failed to respond adequately to antipsychotics and continue to experience debilitating symptoms such as auditory hallucinations and negative symptoms. The development of additional therapeutic approaches for these persistent symptoms constitutes a major goal for patients. Here, we develop a randomized-controlled trial testing the efficacy of high-frequency transcranial random noise stimulation (hf-tRNS) for the treatment of resistant/persistent symptoms of schizophrenia in patients with various profiles of symptoms, cognitive deficits and illness duration. We also aim to investigate the biological and cognitive effects of hf-tRNS and to identify the predictors of clinical response. Methods In a randomized, double-blind, 2-arm parallel-group, controlled, multicentre study, 144 patients with schizophrenia and persistent symptoms despite the prescription of at least one antipsychotic treatment will be randomly allocated to receive either active (n = 72) or sham (n = 72) hf-tRNS. hf-tRNS (100–500 Hz) will be delivered for 20 min with a current intensity of 2 mA and a 1-mA offset twice a day on 5 consecutive weekdays. The anode will be placed over the left dorsolateral prefrontal cortex and the cathode over the left temporoparietal junction. Patients’ symptoms will be assessed prior to hf-tRNS (baseline), after the 10 sessions, and at 1-, 3- and 6-month follow-up. The primary outcome will be the number of responders defined as a reduction of at least 25% from the baseline scores on the Positive and Negative Syndrome Scale (PANSS) after the 10 sessions. Secondary outcomes will include brain activity and connectivity, source monitoring performances, social cognition, other clinical (including auditory hallucinations) and biological variables, and attitude toward treatment. Discussion The results of this trial will constitute a first step toward establishing the usefulness of hf-tRNS in schizophrenia whatever the stage of the illness and the level of treatment resistance. We hypothesize a long-lasting effect of active hf-tRNS on the severity of schizophrenia symptoms as compared to sham. This trial will also have implications for the use of hf-tRNS as a preventive intervention of relapse in patients with schizophrenia. Trial registration ClinicalTrials.gov NCT02744989. Prospectively registered on 20 April 2016
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Affiliation(s)
- Jerome Brunelin
- Centre Hospitalier Le Vinatier, PSYR2 team, Bat 416 - 1st floor; 95 boulevard Pinel, 69678, F-69500, Bron cedex, France. .,INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, PSYR2 Team, F-69000, Lyon, France. .,Lyon 1 University, F-69000, Villeurbanne, France. .,Université Jean Monnet Saint Etienne, F-42000, Saint Etienne, France.
| | - Marine Mondino
- Centre Hospitalier Le Vinatier, PSYR2 team, Bat 416 - 1st floor; 95 boulevard Pinel, 69678, F-69500, Bron cedex, France.,INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, PSYR2 Team, F-69000, Lyon, France.,Lyon 1 University, F-69000, Villeurbanne, France.,Université Jean Monnet Saint Etienne, F-42000, Saint Etienne, France
| | - Julie Haesebaert
- Hospices Civils de Lyon, Pôle Santé Publique, Service Recherche et Epidémiologie Cliniques, F-69003, Lyon, France.,Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Villeurbanne, France
| | | | | | - Marie Chupin
- Paris Brain Institute - Institut du Cerveau (ICM), Inserm U 1127, CNRS UMR 7225, Sorbonne Université, F-75013, Paris, France.,CATI Multicenter Neuroimaging Platform, F-75000, Paris, France
| | | | - Wissam El-Hage
- CHRU de Tours, CIC 1415, INSERM, Tours; UMR 1253, iBrain, Université de Tours, INSERM, F-37044, Tours, France
| | - Filipe Galvao
- Centre Hospitalier Le Vinatier, PSYR2 team, Bat 416 - 1st floor; 95 boulevard Pinel, 69678, F-69500, Bron cedex, France
| | - Renaud Jardri
- University in Lille, INSERM U1172, CHU Lille, Lille Neuroscience & Cognition Research Centre, Plasticity & SubjectivitY (PSY) team, CURE Platform, Lille, France
| | | | - Laurent Magaud
- Hospices Civils de Lyon, Pôle Santé Publique, Service Recherche et Epidémiologie Cliniques, F-69003, Lyon, France
| | - Marion Plaze
- GHU PARIS Psychiatrie & Neurosciences, site Sainte-Anne, Service Hospitalo-Universitaire, F-75014, Paris, France.,Université de Paris, F-75005, Paris, France
| | - Anne Marie Schott-Pethelaz
- Hospices Civils de Lyon, Pôle Santé Publique, Service Recherche et Epidémiologie Cliniques, F-69003, Lyon, France.,Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Marie-Françoise Suaud-Chagny
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, PSYR2 Team, F-69000, Lyon, France.,Lyon 1 University, F-69000, Villeurbanne, France.,Université Jean Monnet Saint Etienne, F-42000, Saint Etienne, France
| | | | - Eric Fakra
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, PSYR2 Team, F-69000, Lyon, France.,Lyon 1 University, F-69000, Villeurbanne, France.,Université Jean Monnet Saint Etienne, F-42000, Saint Etienne, France.,CHU de Saint Etienne, F-42000, Saint Etienne, France
| | - Emmanuel Poulet
- Centre Hospitalier Le Vinatier, PSYR2 team, Bat 416 - 1st floor; 95 boulevard Pinel, 69678, F-69500, Bron cedex, France.,INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, PSYR2 Team, F-69000, Lyon, France.,Lyon 1 University, F-69000, Villeurbanne, France.,Université Jean Monnet Saint Etienne, F-42000, Saint Etienne, France.,Psychiatric emergency service, Hospices civils de Lyon, F-69005, Lyon, France
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14
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Guttesen LL, Albert N, Nordentoft M, Hjorthøj C. Repetitive transcranial magnetic stimulation and transcranial direct current stimulation for auditory hallucinations in schizophrenia: Systematic review and meta-analysis. J Psychiatr Res 2021; 143:163-175. [PMID: 34500345 DOI: 10.1016/j.jpsychires.2021.09.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/25/2021] [Accepted: 09/01/2021] [Indexed: 11/16/2022]
Abstract
Through imaging studies, a significant increase in cerebral activity has been detected in fronto-temporal areas in patients experiencing auditory verbal hallucinations. Therefore, non-invasive neuromodulation, in particular transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS), has been considered as a therapeutic intervention for medication-resistant auditory verbal hallucinations in schizophrenia. We aimed to synthesize results from randomized trials on either rTMS or tDCS versus placebo in patients with schizophrenia by including five recently published trials in the field. A systematic review and meta-analysis of relevant literature was conducted. Studies were included on the basis of pre-defined selection criteria. The quality of the studies was assessed by the Cochrane Risk of Bias Tool for Randomized Controlled Trials. RevMan 5.3 was used to conduct the statistical analysis. Including 465 and 960 patients, respectively, 12 tDCS and 27 rTMS studies were included. Regarding treatment of medication refractory auditory verbal hallucinations, no significant effect of tDCS (-0.23 [-0.49, 0.02], p = 0.08) or rTMS (-0.19 [-0.50, 0,11], p = 0.21) was found compared to sham in this meta-analysis. The current study found that it cannot be concluded that rTMS and tDCS are efficacious in treating medication-resistant auditory verbal hallucinations. Larger randomized controlled tDCS trials of a higher quality should be conducted in the future to establish substantial evidence of tDCS. The interventions appear safe and may have beneficial effects on other outcomes.
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Affiliation(s)
- Liv Liebach Guttesen
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Denmark; Psychiatric Center of Ballerup, Copenhagen University Hospital, Denmark
| | - Nikolai Albert
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Denmark; Psychiatry Region Zealand East, Roskilde, Denmark
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Denmark
| | - Carsten Hjorthøj
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Denmark; University of Copenhagen, Department of Public Health, Section of Epidemiology, Denmark.
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15
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Zhuo C, Cheng L, Li G, Xu Y, Jing R, Li S, Zhang L, Lin X, Zhou C. COMT-Val158Met polymorphism modulates antipsychotic effects on auditory verbal hallucinations and temporal lobe gray matter volumes in healthy individuals-symptom relief accompanied by worrisome volume reductions. Brain Imaging Behav 2021; 14:1373-1381. [PMID: 30712251 PMCID: PMC7572342 DOI: 10.1007/s11682-019-00043-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Investigation of auditory verbal hallucinations (AVHs) in schizophrenics is complicated by psychiatric symptoms. Investigating healthy individuals with AVHs (H-AVHs) can obviate such confounding factors. The objective of this study was to explore the effects of antipsychotic treatment on AVHs and gray matter volumes (GMVs) in H-AVH subjects and whether such are effects are influenced by COMT-Val158Met genotype. Magnetic resonance imaging (MRI) and genotyping studies were completed for 42 H-AVH subjects and 42 well-matched healthy controls (HCs). COMT-Met/Met homozygotes (158th codon) were identified as COMT-Met genotype; COMT-Met/Val heterozygotes and COMT-Val/Val homozygotes were identified as COMT-Val genotype. Data were compared across groups (H-AVH vs. HC, and between genotypes) with two-sample t-tests. The H-AVH COMT-Met group showed a stronger response to antipsychotic treatment than the H-AVH COMT-Val group (p < 0.001). Both H-AVH genotype groups exhibited temporal lobe GMV reductions after treatment, and relative to their respective genotype-matched HC groups. Antipsychotic treatment effects in H-AVH subjects were influenced by COMT-Val158Met genotype and associated with widespread GMV reductions. These findings provide clues for further exploration of treatment targets for AVHs. Treatment associated GMV reductions, however, raise concerns about use of antipsychotics in H-AVH subjects.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Psychiatric-Neuroimaging-Genetics and Morbidity Laboratory (PNGC-Lab), Tianjin Mental Health Center, Mental Health Teaching Hospital, Nankai University Affiliated Anding Hospital, Tianjin Medical University, Tianjin, 300222, China. .,Department of Psychiatry, Institute of Mental Healthy, Genetic Lab, Jining Medical University, Jining, 272191, China. .,Department of Psychiatry, College of Basic Medical Research, Tianjin Medical University, Tianjin, 300000, China. .,Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, 030001, China. .,Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, 325000, China. .,Department of Psychiatry, Shanxi Medical University, Taiyuan, 030000, China.
| | - Langlang Cheng
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, 325000, China
| | - Gongying Li
- Department of Psychiatry, Institute of Mental Healthy, Genetic Lab, Jining Medical University, Jining, 272191, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, 030001, China.,Department of Psychiatry, Shanxi Medical University, Taiyuan, 030000, China
| | - Rixing Jing
- Department of Pattern Recognition, China National Key Laboratory, Institute of Automation, Chinese Academy of Sciences, Beijing, 100191, China.,Department of Pattern Recognition, University of Chinese Academy of Sciences, Beijing, 100191, China
| | - Shen Li
- Department of Psychiatry, College of Basic Medical Research, Tianjin Medical University, Tianjin, 300000, China
| | - Li Zhang
- GHM Institute of CNS Regeneration, Jinan University, Guangzhou, 510632, Guangdong Province, China
| | - Xiaodong Lin
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, 325000, China.
| | - Chunhua Zhou
- Department of Pharmacy, The First Hospital of Hebei Medical University, Shijiazhuang, 050000, China.
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16
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Brandt SJ, Oral HY, Arellano-Bravo C, Plawecki MH, Hummer TA, Francis MM. Repetitive Transcranial Magnetic Stimulation as a Therapeutic and Probe in Schizophrenia: Examining the Role of Neuroimaging and Future Directions. Neurotherapeutics 2021; 18:827-844. [PMID: 33844154 PMCID: PMC8423934 DOI: 10.1007/s13311-021-01046-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2021] [Indexed: 12/31/2022] Open
Abstract
Schizophrenia is a complex condition associated with perceptual disturbances, decreased motivation and affect, and disrupted cognition. Individuals living with schizophrenia may experience myriad poor outcomes, including impairment in independent living and function as well as decreased life expectancy. Though existing treatments may offer benefit, many individuals still experience treatment resistant and disabling symptoms. In light of the negative outcomes associated with schizophrenia and the limitations in currently available treatments, there is a significant need for novel therapeutic interventions. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technique that can modulate the activity of discrete cortical regions, allowing direct manipulation of local brain activation and indirect manipulation of the target's associated neural networks. rTMS has been studied in schizophrenia for the treatment of auditory hallucinations, negative symptoms, and cognitive deficits, with mixed results. The field's inability to arrive at a consensus on the use rTMS in schizophrenia has stemmed from a variety of issues, perhaps most notably the significant heterogeneity amongst existing trials. In addition, it is likely that factors specific to schizophrenia, rather than the rTMS itself, have presented barriers to the interpretation of existing results. However, advances in approaches to rTMS as a biologic probe and therapeutic, many of which include the integration of neuroimaging with rTMS, offer hope that this technology may still play a role in improving the understanding and treatment of schizophrenia.
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Affiliation(s)
- Stephen J Brandt
- Indiana University School of Medicine, Department of Psychiatry, 355W 16 St., Indianapolis, IN, USA
| | - Halimah Y Oral
- Indiana University School of Medicine, Department of Psychiatry, 355W 16 St., Indianapolis, IN, USA
| | - Carla Arellano-Bravo
- Indiana University School of Medicine, Department of Psychiatry, 355W 16 St., Indianapolis, IN, USA
| | - Martin H Plawecki
- Indiana University School of Medicine, Department of Psychiatry, 355W 16 St., Indianapolis, IN, USA
| | - Tom A Hummer
- Indiana University School of Medicine, Department of Psychiatry, 355W 16 St., Indianapolis, IN, USA
| | - Michael M Francis
- Indiana University School of Medicine, Department of Psychiatry, 355W 16 St., Indianapolis, IN, USA.
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17
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Briend F, Leroux E, Nathou C, Delcroix N, Dollfus S, Etard O. GeodesicSlicer: a Slicer Toolbox for Targeting Brain Stimulation. Neuroinformatics 2020; 18:509-516. [PMID: 32125609 DOI: 10.1007/s12021-020-09457-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
NonInvasive Brain Stimulation (NIBS) is a potential therapeutic tool with growing interest, but neuronavigation-guided software and tools available for the target determination are mostly either expensive or closed proprietary applications. To address these limitations, we propose GeodesicSlicer, a customizable, free, and open-source NIBS therapy research toolkit. GeodesicSlicer is implemented as an extension for the widely used 3D Slicer medical image visualization and analysis application platform. GeodesicSlicer uses cortical stimulation target from either functional or anatomical images to provide functionality specifically designed for NIBS therapy research. The provided algorithms are tested and they are accessible through a convenient graphical user interface. Modules have been created for NIBS target determination according to the position of the electrodes in the 10-20 system electroencephalogram and calculating correction factors to adjust the repetitive Transcranial Magnetic Stimulation (rTMS) dose for the treatment. Two illustrative examples are processing with the module. This new open-source software has been developed for NIBS therapy: GeodesicSlicer is an alternative for laboratories that do not have access to neuronavigation system. The triangulation-based MRI-guided method presented here provides a reproducible and inexpensive way to position the TMS coil that may be used without the use of a neuronavigation system.
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Affiliation(s)
- F Briend
- Normandie Univ, UNICAEN, ISTS EA 7466, GIP CYCERON, F-14000, Caen, France.
| | - E Leroux
- Normandie Univ, UNICAEN, ISTS EA 7466, GIP CYCERON, F-14000, Caen, France
| | - C Nathou
- Normandie Univ, UNICAEN, ISTS EA 7466, GIP CYCERON, F-14000, Caen, France.,CHU de Caen, Service de Psychiatrie adulte, Centre Esquirol, 14000, Caen, France
| | - N Delcroix
- Normandie Univ, UNICAEN, CNRS, CHU de Caen, UMS 3408, GIP Cyceron, 14000, Caen, France
| | - S Dollfus
- Normandie Univ, UNICAEN, ISTS EA 7466, GIP CYCERON, F-14000, Caen, France.,CHU de Caen, Service de Psychiatrie adulte, Centre Esquirol, 14000, Caen, France
| | - O Etard
- Normandie Univ, UNICAEN, ISTS EA 7466, GIP CYCERON, F-14000, Caen, France.,Service d'Explorations Fonctionnelles du Système Nerveux, CHU de Caen, 14000, Caen, France
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18
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Briend F, Nathou C, Delcroix N, Dollfus S, Etard O. A new toolbox to compare target localizations for non-invasive brain stimulation: An application of rTMS treatment for auditory hallucinations in schizophrenia. Schizophr Res 2020; 223:305-310. [PMID: 32933813 DOI: 10.1016/j.schres.2020.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 06/24/2020] [Accepted: 09/07/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Most repetitive transcranial magnetic stimulation (rTMS) studies aiming to reduce auditory verbal hallucinations (AVH) in schizophrenia target the left temporo-parietal junction (TPJ), but the efficacy of this approach remains controversial. The observed differences in efficacy could be attributed to inaccurate target localization. Here, to precisely quantify anatomical bias induced by localization method, we developed a free open-source software (GeodesicSlicer) that computes shortest curved path (i.e. geodesic) between rTMS targets. Here we compare a personalized target with accurate anatomical criteria with a standardized target based on the 10-20 EEG system (the middle between T3 and P3 electrodes: T3P3). METHODS We compare in 69 patients with schizophrenia the geodesic distances of two approaches for rTMS target localization within the left TPJ. In addition, we characterize the personalized target according to the 10-20 EEG system. RESULTS A differential of 3 cm in term of geodesic distance between rTMS localization approaches was observed. Moreover, this personalized target to treat AVH is located at 25% in the T3-P3 axis. CONCLUSIONS This software for rTMS localization comparison demonstrates the difference between standardized and personalized rTMS target. This difference has the potential to explain a part of the dissonant clinical results found in previous rTMS studies.
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Affiliation(s)
- F Briend
- Normandie Univ, UNICAEN, ISTS, EA 7466, GIP Cyceron, 14000 Caen, France.
| | - C Nathou
- Normandie Univ, UNICAEN, ISTS, EA 7466, GIP Cyceron, 14000 Caen, France; CHU de Caen, Service de Psychiatrie adulte, Centre Esquirol, 14000 Caen, France
| | - N Delcroix
- Normandie Univ, UNICAEN, CNRS, CHU de Caen, UMS 3408, GIP Cyceron, 14000 Caen, France
| | - S Dollfus
- Normandie Univ, UNICAEN, ISTS, EA 7466, GIP Cyceron, 14000 Caen, France; CHU de Caen, Service de Psychiatrie adulte, Centre Esquirol, 14000 Caen, France
| | - O Etard
- Normandie Univ, UNICAEN, ISTS, EA 7466, GIP Cyceron, 14000 Caen, France; CHU de Caen, Service d'Explorations Fonctionnelles du Système Nerveux, 14000 Caen, France
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19
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Pouget P, Frey S, Ahnine H, Attali D, Claron J, Constans C, Aubry JF, Arcizet F. Neuronavigated Repetitive Transcranial Ultrasound Stimulation Induces Long-Lasting and Reversible Effects on Oculomotor Performance in Non-human Primates. Front Physiol 2020; 11:1042. [PMID: 32973560 PMCID: PMC7466663 DOI: 10.3389/fphys.2020.01042] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 07/29/2020] [Indexed: 12/17/2022] Open
Abstract
Since the late 2010s, Transcranial Ultrasound Stimulation (TUS) has been used experimentally to carryout safe, non-invasive stimulation of the brain with better spatial resolution than Transcranial Magnetic Stimulation (TMS). This innovative stimulation method has emerged as a novel and valuable device for studying brain function in humans and animals. In particular, single pulses of TUS directed to oculomotor regions have been shown to modulate visuomotor behavior of non-human primates during 100 ms ultrasound pulses. In the present study, a sustained effect was induced by applying 20-s trains of neuronavigated repetitive Transcranial Ultrasound Stimulation (rTUS) to oculomotor regions of the frontal cortex in three non-human primates performing an antisaccade task. With the help of MRI imaging and a frame-less stereotactic neuronavigation system (SNS), we were able to demonstrate that neuronavigated TUS (outside of the MRI scanner) is an efficient tool to carry out neuromodulation procedures in non-human primates. We found that, following neuronavigated rTUS, saccades were significantly modified, resulting in shorter latencies compared to no-rTUS trials. This behavioral modulation was maintained for up to 20 min. Oculomotor behavior returned to baseline after 18-31 min and could not be significantly distinguished from the no-rTUS condition. This study is the first to show that neuronavigated rTUS can have a persistent effect on monkey behavior with a quantified return-time to baseline. The specificity of the effects could not be explained by auditory confounds.
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Affiliation(s)
- Pierre Pouget
- Institute of Brain and Spinal Cord, UMRS 975 Inserm, CNRS 7225, UMPC, Paris, France
| | | | - Harry Ahnine
- Institute of Brain and Spinal Cord, UMRS 975 Inserm, CNRS 7225, UMPC, Paris, France
| | - David Attali
- Physics for Medicine Paris, Inserm, ESPCI Paris, CNRS, PSL Research University, Univ Paris Diderot, Sorbonne Paris Cite, Paris, France.,Université de Paris, Institute of Psychiatry and Neuroscience of Paris (IPNP), Inserm U1266, Team Pathophysiology of Psychiatric Disorders, Paris, France.,GHU Paris Psychiatrie et Neurosciences, Site Sainte-Anne, Service Hospitalo-Universitaire, Paris, France
| | - Julien Claron
- Physics for Medicine Paris, Inserm, ESPCI Paris, CNRS, PSL Research University, Univ Paris Diderot, Sorbonne Paris Cite, Paris, France
| | - Charlotte Constans
- Physics for Medicine Paris, Inserm, ESPCI Paris, CNRS, PSL Research University, Univ Paris Diderot, Sorbonne Paris Cite, Paris, France
| | - Jean-Francois Aubry
- Physics for Medicine Paris, Inserm, ESPCI Paris, CNRS, PSL Research University, Univ Paris Diderot, Sorbonne Paris Cite, Paris, France
| | - Fabrice Arcizet
- Institut de la Vision CNRS, Inserm, Sorbonne Université, Paris, France
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20
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Li X, Yuan X, Kang Y, Pang L, Liu Y, Zhu Q, Lv L, Huang XF, Song X. A synergistic effect between family intervention and rTMS improves cognitive and negative symptoms in schizophrenia: A randomized controlled trial. J Psychiatr Res 2020; 126:81-91. [PMID: 32428747 DOI: 10.1016/j.jpsychires.2020.04.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 04/19/2020] [Accepted: 04/23/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The present study explored an efficient new therapy that combined repetitive transcranial magnetic stimulation (rTMS) and family intervention in addition to risperidone to improve schizophrenia. METHODS A randomized controlled trial (January 2016-September 2017) involving 200 patients, of which 188 patients completed the 12-week study, and 50 controls were conducted in the research. The patients were randomly assigned to 12 weeks of treatment with risperidone alone (risperidone group), rTMS and risperidone (rTMS group), family intervention and risperidone (family intervention group), rTMS and risperidone plus family intervention (combined group). MATRICS Consensus Cognitive Battery (MCCB) and the Positive and Negative Symptoms Scale (PANSS) were used to evaluate treatment efficacy. Repeated measures analysis of variance (RMANOVA) were performed to evaluate different treatment efficacy between four groups after 12 weeks of treatment. RESULTS (1) There were no significant differences in sex, age, education, cognitive function, or PANSS scores between the four groups at baseline (p's > 0.05). (2) There was a significant decrease in the PANSS scores and an increase in the MCCB scores after 12 weeks of treatment in all groups (time effect p's < 0.001). (3) The improvements in positive symptoms and negative symptoms were more obvious in the combined group than in other groups (p's < 0.05). (4) The combined group showed the superior effect in cognition function after 12 weeks. (5) And, interestingly, a remarkable synergistic effect between rTMS and family intervention therapy was observed. CONCLUSION There was a synergistic effect between rTMS and the family intervention as an effective combined therapy in improving schizophrenia. This study is registered with Chictr.org, number ChiCTR1900024422 (http://www.chictr.org.cn/edit.aspx?pid=34285&htm=4).
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Affiliation(s)
- Xue Li
- The First Affiliated Hospital/Zhengzhou University, Zhengzhou, China; Biological Psychiatry International Joint Laboratory of Henan, Zhengzhou University, Zhengzhou, China; Henan Psychiatric Transformation Research Key Laboratory, Zhengzhou University, Zhengzhou, China
| | - Xiuxia Yuan
- The First Affiliated Hospital/Zhengzhou University, Zhengzhou, China; Biological Psychiatry International Joint Laboratory of Henan, Zhengzhou University, Zhengzhou, China; Henan Psychiatric Transformation Research Key Laboratory, Zhengzhou University, Zhengzhou, China
| | - Yulin Kang
- Department of Biomedical Engineering, College of Engineering, Peking University, Beijing, China
| | - Lijuan Pang
- The First Affiliated Hospital/Zhengzhou University, Zhengzhou, China; Biological Psychiatry International Joint Laboratory of Henan, Zhengzhou University, Zhengzhou, China; Henan Psychiatric Transformation Research Key Laboratory, Zhengzhou University, Zhengzhou, China
| | - Yafei Liu
- The Supervision Bureau of the Health and Family Planning Commission, Wancheng District, Nanyang City, China
| | - Qiyue Zhu
- The First Affiliated Hospital/Zhengzhou University, Zhengzhou, China; Biological Psychiatry International Joint Laboratory of Henan, Zhengzhou University, Zhengzhou, China; Henan Psychiatric Transformation Research Key Laboratory, Zhengzhou University, Zhengzhou, China
| | - Luxian Lv
- Henan Province Mental Hospital, The Second Affiliated Hospital, Xinxiang Medical University, Xinxiang, China
| | - Xu-Feng Huang
- Illawarra Health and Medical Research Institute and School of Medicine, University of Wollongong, NSW2522, Australia.
| | - Xueqin Song
- The First Affiliated Hospital/Zhengzhou University, Zhengzhou, China; Biological Psychiatry International Joint Laboratory of Henan, Zhengzhou University, Zhengzhou, China; Henan Psychiatric Transformation Research Key Laboratory, Zhengzhou University, Zhengzhou, China.
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21
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Zhuo C, Wang C, Song X, Xu X, Li G, Lin X, Xu Y, Tian H, Jiang D, Wang W, Zhou C. A unified model of shared brain structural alterations in patients with different mental disorders who experience own-thought auditory verbal hallucinations-A pilot study. Brain Behav 2020; 10:e01614. [PMID: 32304354 PMCID: PMC7303372 DOI: 10.1002/brb3.1614] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 02/10/2020] [Accepted: 03/15/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To explore shared brain structural alterations in patients diagnosed with mental disorders who experience own-thought auditory verbal hallucinations (OTAVHs). METHODS A cohort of 143 first-diagnosis, nonmedicated patients with OTAVHs was enrolled: 25 with schizophrenia (FUSCH-OTAVH), 20 with major depression disorder (FUMDD-OTAVH), 28 with bipolar disorder (FUBD-OTAVH), 22 patients with posttraumatic stress disorder (FUPTSD-OTAVH), 21 with anxiety disorder (FUAD-OTAVH), and 27 with borderline personality disorder (FUBPD-OTAVH); 25 healthy controls (HCs) participated. The Auditory Hallucinations Rating Scale (AHRS), multiple psychometric scales, voxel-based morphometry (VBM), tract-based spatial statistics (TBSS), and multiple regression were used. RESULTS Compared with HCs, patients had increased occipital cortex, dorsal prefrontal cortex (PFC), and striatum gray matter volumes (GMVs), a reduced insular cortex (IC) GMV, and an impaired frontooccipital fasciculus. The following differences were found versus HCs: FUSCH-OTAVH, reduced PFC and occipital GMVs, increased striatum and thalamus GMVs, impaired arcuate fasciculus, u-shaped bundle, optic tract, and upper longitudinal fasciculus (LF); FUMDD-OTAVH, increased posterior frontotemporal junction and hippocampus GMVs; FUMN-OTAVH, increased posterior frontotemporal junction and parietal cortex GMVs, reduced hippocampus GMV, impaired upper LF; FUPTSD-OTAVH, increased temporal, hippocampus, and nucleus accumbens GMVs; FUBPD-OTAVH, increased frontotemporal junction and hippocampus GMVs, impaired upper/lower LF; and FUAD-OTAVH, increased frontal and temporal cortex, hippocampus GMVs. CONCLUSIONS The present findings provide evidence consistent with a bottom-up and top-down reciprocal action dysfunction hypothesis of AVHs and with the dopamine hypothesis of AVHs. We observed specific features related to OTAVHs in patients with different mental disorders. The findings, though complex, provide clues for further studies of specific mental disorders.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Biological Psychiatry, School of Mental Health, Jining Medical University, Jining, China.,The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China.,Biological Psychiatry International Joint Laboratory of Henan, Zhengzhou University, Zhengzhou, China.,Henan Psychiatric Transformation Research Key Laboratory, Zhengzhou University, Zhengzhou, China.,Department of Psychiatry and Neuroimaging Centre, Wenzhou Seventh People's Hospital, Wenzhou, China.,Department of Psychiatry, First Hospital, First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, China.,Department of Psychiatric-Neuroimging-Genetics and Comorbidity Labotorary (PNGC_Lab), Tianjin Anding Hospital, Tianjin, China.,Canada and China Joint Laboratory of Biological Psychiatry, Xiamen Xianye Hospital, Xiamen, China
| | - Chunxiang Wang
- Department of Radiology, MRI Center, Tianjin Children Hospital, Tianjin Medical University Affiliated Tianjin Children Hospital, Tianjin, China
| | - Xueqin Song
- The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China.,Biological Psychiatry International Joint Laboratory of Henan, Zhengzhou University, Zhengzhou, China.,Henan Psychiatric Transformation Research Key Laboratory, Zhengzhou University, Zhengzhou, China
| | - Xuexin Xu
- Department of Radiology, MRI Center, Tianjin Children Hospital, Tianjin Medical University Affiliated Tianjin Children Hospital, Tianjin, China
| | - Gongying Li
- Department of Biological Psychiatry, School of Mental Health, Jining Medical University, Jining, China
| | - Xiaodong Lin
- Department of Psychiatry and Neuroimaging Centre, Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Yong Xu
- Department of Psychiatry, First Hospital, First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Hongjun Tian
- Department of Psychiatric-Neuroimging-Genetics and Comorbidity Labotorary (PNGC_Lab), Tianjin Anding Hospital, Tianjin, China
| | - Deguo Jiang
- Department of Psychiatry and Neuroimaging Centre, Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Wenqiang Wang
- Canada and China Joint Laboratory of Biological Psychiatry, Xiamen Xianye Hospital, Xiamen, China
| | - Chunhua Zhou
- Department of Pharmacology, The First Affiliated Hospital of Hebei Medical University, Shijiazhuang, China
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22
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Zhuo C, Xu X, Lin X, Chen M, Ji F, Jiang D, Xu Y, Wang L, Li Y, Tian H, Wang W, Zhou C. Depressive symptoms combined with auditory hallucinations are accompanied with severe gray matter brain impairments in patients with first-episode untreated schizophrenia - A pilot study in China. Neurosci Lett 2020; 730:135033. [PMID: 32417389 DOI: 10.1016/j.neulet.2020.135033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 04/07/2020] [Accepted: 05/03/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Depressive symptoms and auditory hallucinations (AHs) are often accompanied by gray matter volume (GMV) alterations in schizophrenia. However, little is known about the effects of concurrent depressive symptoms and AHs on the GMV of patients with schizophrenia. AIM To investigate the pathological features of gray brain matter in patients with first-episode untreated schizophrenia (FUSCH) who have concurrent moderate-to-severe depressive symptoms and AHs (FUSCH-DAH). METHODS The Calgary Depression Scale for Schizophrenia (CDSS) and Auditory Hallucinations Rating Scale (AHRS) were adopted. Voxel-based morphometry (VBM)-based GMV analyses were used to measure cortical alterations. FUSCH-DAH patients were compared to FUSCH patients with depressive symptoms but without AHs, denoted as FUSCH-D, along with healthy controls. RESULTS GMV reductions were more substantial in the FUSCH-DAH patients than FUSCH-D patients or healthy controls. Both FUSCH-DAH and FUSCH-D groups showed GMV reductions of the parietal, frontal, and temporal lobes, which were not apparent in the healthy controls. Compared to FUSCH-D patients, FUSCH-DAH patients demonstrated more substantial GMV reductions in the Broca area, Wernicke region, insular lobe, and prefrontal lobe. The GMV reductions were 1.06% and 0.58% in FUSCH-DAH and FUSCH-D patients, respectively, as compared with the healthy controls. CONCLUSIONS This is the first report showing that concurrent depressive symptoms and AHs leads to severe GMV deterioration in FUSCH-DAH patients. Hence, there is a reciprocal relationship between AHs and depressive symptoms in FUSCH-DAH patients. However, the potential additive effects of concurrent AHs and depressive symptoms require further investigation in order to identify future targeted therapies for schizophrenia.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Biological Psychiatry, School of Mental Health, Jining Medical University, Jining 272191, Shandong Province, China; Department of Psychiatry and Neuroimaging Center, Wenzhou Seventh People's Hospital, Wenzhou, 325000, Zhejiang Province, China; Psychiatric-Neuroimaging-Genetics and Comorbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, 300300 Tianjin, China.
| | - Xuexin Xu
- Department of Radiology, MRI Center, Tianjin Children Hospital, Tianjin Medical University Affiliated Tianjin Children Hospital, Tianjin 300444, China
| | - Xiaodong Lin
- Department of Psychiatry and Neuroimaging Center, Wenzhou Seventh People's Hospital, Wenzhou, 325000, Zhejiang Province, China
| | - Min Chen
- Department of Biological Psychiatry, School of Mental Health, Jining Medical University, Jining 272191, Shandong Province, China
| | - Feng Ji
- Department of Biological Psychiatry, School of Mental Health, Jining Medical University, Jining 272191, Shandong Province, China
| | - Deguo Jiang
- Department of Psychiatry and Neuroimaging Center, Wenzhou Seventh People's Hospital, Wenzhou, 325000, Zhejiang Province, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China; MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan 030001, China
| | - Lina Wang
- Psychiatric-Neuroimaging-Genetics and Comorbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, 300300 Tianjin, China
| | - Yancheng Li
- Psychiatric-Neuroimaging-Genetics and Comorbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, 300300 Tianjin, China
| | - Hongjun Tian
- Psychiatric-Neuroimaging-Genetics and Comorbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, 300300 Tianjin, China
| | - Wenqiang Wang
- Canada and China Joint Laboratory of Biological Psychiatry, Xiamen Xianye Hospital, Xiamen 361000, Fujian Province, China
| | - Chunhua Zhou
- Department of Pharmacology, The First Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
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23
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Zhuo C, Lin X, Wang C, Song X, Xu X, Li G, Xu Y, Tian H, Zhang Y, Wang W, Zhou C. Unified and disease specific alterations to brain structure in patients across six categories of mental disorders who experience own-thought auditory verbal hallucinations: A pilot study. Brain Res Bull 2020; 160:33-39. [PMID: 32298780 DOI: 10.1016/j.brainresbull.2020.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 02/28/2020] [Accepted: 04/04/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To explore the unified and disease specific structural features of the brain in patients spanning six mental disorders who experience own-thought auditory verbal hallucinations (OTAVH). METHODS A pilot study was conducted on 25 patients with schizophrenia (FUSCH-OTAVH), 20 patients with major depression disorder (FUMDD-OTAVH), 28 patients with bipolar disorder (FUBD-OTAVH), 22 patients with posttraumatic stress disorder (FUPTSD-OTAVH), 21 patients with anxiety disorder (FUAD-OTAVH), and 27 patients with borderline personality disorder (FUBPD-OTAVH). Twenty-five healthy controls (HCs) were also recruited. Auditory Hallucinations Rating Scale (AHRS) multiple psychometric scales were adopted to assess the clinical features of voxel-based morphometry (VBM), tract-based spatial statistics (TBSS), and multiple regression in all patients. Common and specific brain features of OTAVH among these mental disorders were investigated. RESULTS Compared to HCs, GMV aberrant pattern across all the six categories patients with OTAVH decreased in the occipital cortex, left parietal lobe, prefrontal cortex (PFC), and insular cortex (IC). Aberrant patterns in white matter (WM) were detected in the corpus callosum and impairment of the fronto-occipital fasciculus. Structural differences in the brain were observed for each mental disorder versus HCs. CONCLUSIONS The unified brain aberrant features of OTAVH across six mental disorders were characterized by decreased GMV and WM impairments in some regions and the specific brain features of each disease were also characterized. In conclusion, this study provides evidence for the structural basis of OTAVH and potential avenues for investigating disease specific brain features of OTAVH.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Biological Psychiatry, School of Mental Health, Jining Medical University, 272191, Jining, Shandong Province, China; The First Affiliated Hospital/Zhengzhou University, Zhengzhou, China; Biological Psychiatry International Joint Laboratory of Henan, Zhengzhou University, Zhengzhou, China; Henan Psychiatric Transformation Research Key Laboratory, Zhengzhou University, Zhengzhou, 450000, China; Department of Psychiatry and Neuroimaging Centre, Wenzhou Seventh People's Hospital, Wenzhou, 325000, Zhejiang Province, China; Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China; MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, 030001, China; Department of Psychiatric-Neuroimging-Genetics and Comorbidity Labotorary (PNGC_Lab), Tianjin Anding Hospital, 300300, Tianjin, China; Canada and China Joint Laboratory of Biological Psychiatry, Xiamen Xianye Hospital, Xiamen, 361000, Fujian Province, China.
| | - Xiaodong Lin
- Department of Psychiatry and Neuroimaging Centre, Wenzhou Seventh People's Hospital, Wenzhou, 325000, Zhejiang Province, China
| | - Chunxiang Wang
- Department of Radiology, MRI Center, Tianjin Children Hospital, Tianjin Medical University Affiliated Tianjin Children Hospital, Tianjin, 300444, China
| | - Xueqin Song
- The First Affiliated Hospital/Zhengzhou University, Zhengzhou, China; Biological Psychiatry International Joint Laboratory of Henan, Zhengzhou University, Zhengzhou, China; Henan Psychiatric Transformation Research Key Laboratory, Zhengzhou University, Zhengzhou, 450000, China
| | - Xuexin Xu
- Department of Radiology, MRI Center, Tianjin Children Hospital, Tianjin Medical University Affiliated Tianjin Children Hospital, Tianjin, 300444, China
| | - Gongying Li
- Department of Biological Psychiatry, School of Mental Health, Jining Medical University, 272191, Jining, Shandong Province, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Hongjun Tian
- Department of Psychiatric-Neuroimging-Genetics and Comorbidity Labotorary (PNGC_Lab), Tianjin Anding Hospital, 300300, Tianjin, China
| | - Yonghui Zhang
- Department of Psychiatric-Neuroimging-Genetics and Comorbidity Labotorary (PNGC_Lab), Tianjin Anding Hospital, 300300, Tianjin, China
| | - Wenqiang Wang
- Canada and China Joint Laboratory of Biological Psychiatry, Xiamen Xianye Hospital, Xiamen, 361000, Fujian Province, China
| | - Chunhua Zhou
- Department of Pharmacology, The First Hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei Province, China
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Dondé C, Haesebaert F, Poulet E, Mondino M, Brunelin J. [Not Available]. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2020; 65:237-244. [PMID: 31835905 PMCID: PMC7385421 DOI: 10.1177/0706743719895641] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: The aim of this study was to validate the French version of the 7-item
Auditory Hallucination Rating Scale (AHRS) so as to facilitate fine-grained
assessment of auditory hallucinations (AH) in native French-speaking
patients with schizophrenia (SZ) in clinical settings and studies. Method: Patients (N = 66) were diagnosed with SZ according to the
Diagnostic and Statistical Manual of Mental Disorders.
The French version of the AHRS was developed using a forward–backward
translation procedure. Psychometric properties of the French version of the
AHRS were tested including (i) construct validity with a confirmatory
one-factor analysis, (ii) internal validity with Pearson correlations and
Cronbach α coefficients, and (iii) external validity by correlations with
the Scale for Assessment of Positive Symptoms (SAPS-H1), the Positive and
Negative Syndrome Scale (PANSS-P3; concurrent), the PANSS-Negative subscale
and age of subjects (divergent), and inter-rater intraclass correlation
coefficients (ICCs). Results: (i) The confirmatory one-factor analysis found a root mean square error of
approximation (RMSEA) = 0.00, 90% confidence interval = [0.000 to 0.011],
and a comparative fit index = 0.994. (ii) Correlations between AHRS total
score and individual items were mostly ≥0.4. Cronbach α coefficient was
0.61. (iii) Correlations with PANSS-P3 and SAPS-H1 were 0.42 and 0.53,
respectively. In a subset of participants (N = 16), ICC
values were extremely high and significant for AHRS total and individual
item scores (ICCs range 0.899 to 0.996) Conclusion: The French version of the AHRS is a psychometrically acceptable instrument
for the evaluation of AH severity in French-speaking patients with SZ.
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Affiliation(s)
- Clément Dondé
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France
| | - Frédéric Haesebaert
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France
| | - Emmanuel Poulet
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Department of Emergency Psychiatry, University Hospital Edouard Herriot, Hospices civils de Lyon, France
| | - Marine Mondino
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France
| | - Jérôme Brunelin
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France
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High-frequency neuronavigated rTMS effect on clinical symptoms and cognitive dysfunction: a pilot double-blind, randomized controlled study in Veterans with schizophrenia. Transl Psychiatry 2020; 10:79. [PMID: 32098946 PMCID: PMC7042343 DOI: 10.1038/s41398-020-0745-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 11/05/2019] [Accepted: 11/08/2019] [Indexed: 12/17/2022] Open
Abstract
Cognitive impairment is a central aspect of schizophrenia (SCZ) that occurs at the onset of the disease and is related to poor social function and outcome in patients with SCZ. Recent literatures have revealed repetitive transcranial magnetic stimulation (rTMS) to be one of the efficient medical interventions for cognitive impairments. However, no study has been conducted to investigate the treatment effectiveness of 20 Hz rTMS with neuronavigation system administered to the left dorsolateral prefrontal cortex (DLPFC) in patients with schizophrenia. In this randomized, double-blind and sham-controlled study, 56 patients were enrolled in 20 Hz rTMS (n = 28) or sham stimulation (n = 28) over left DLPFC for 8 weeks. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was performed to measure the cognitive function at baseline and after 8 weeks of rTMS treatment. The positive and negative syndrome scales (PANSS) was performed to assess the clinical symptoms at baseline, after 2-week treatment, 4-week treatment, 6-week treatment, and 8-week treatment. Totally, 15 subjects (seven in active group and eight in sham group) dropped out during the trial and the main findings were from completed 41 patients. At 2 weeks, 4 weeks, and 6 weeks, there were no significant differences in PANSS total score and subscores between the sham and treatment groups. At 8 weeks, the 20 Hz rTMS significantly increased the immediate memory score compared with the sham. Furthermore, the improvement in the immediate memory score was correlated with the decrease in the excitement factor score of the patients with SCZ. Our results suggest that 20 Hz rTMS appears to be an effective treatment for improving the cognitive performance and reducing the clinical symptoms of patients with SCZ.
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26
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Zöllner R, Hübener AF, Dannlowski U, Kircher T, Sommer J, Zavorotnyy M. Theta-Burst Stimulation for Auditory-Verbal Hallucination in Very-Late-Onset Schizophrenia-Like Psychosis-A Functional Magnetic Resonance Imaging Case Study. Front Psychiatry 2020; 11:294. [PMID: 32425822 PMCID: PMC7212466 DOI: 10.3389/fpsyt.2020.00294] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 03/25/2020] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Treating very-late-onset (>60 years) schizophrenia-like psychosis (VLOSLP) is challenging. Age-related factors in elderly individuals (e.g., metabolism, medication side effects, drug-interaction, somatic morbidity) may adversely affect treatment. Novel therapeutic approaches are needed to ensure the favorable therapeutic outcome in geriatric patients. Previously, theta-burst stimulation (TBS), a novel form of repetitive transcranial magnetic stimulation, was reported being beneficial in the treatment for auditory-verbal hallucination (AVH) in young and middle-aged schizophrenia (SZ) patients. CASE PRESENTATION Here we present a case of a male patient aged 73. His first psychotic episode manifested with paranoid delusions, auditory-verbal and tactile hallucinations at the age of 66, and first remitted following a second-generation antipsychotics (SGA). Years later, after a relapse the AVH did not respond to previously effective olanzapine, whereas its augmentation with an inhibitory TBS over the left temporal lobe led to a stable remission. During his second relapse, TBS was again capable of facilitating therapeutic action of SGA in the same patient. Extending to our clinical observation, a series of functional MRI scans employing a tonal activation paradigm depicted altered auditory processing during AVH as well as brain activation change during remission. CONCLUSIONS The current case might indicate to favorable effects of combining conventional medicament therapy and non-invasive brain stimulation techniques for elderly patients. Also, we speculate that despite obviously distinct etiologies, the present functional imaging and clinical observation may also demonstrate a possible common pathophysiological pathway underlying AVH in VLOSLP and SZ.
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Affiliation(s)
- Rebecca Zöllner
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany.,Marburg Center for Mind, Brain and Behavior - MCMBB, University of Marburg, Marburg, Germany.,Health Protection Authority, Frankfurt am Main, Germany
| | - Anne-Friederike Hübener
- Department of Social Psychiatry, University of Applied Science Niederrhein, Krefeld, Germany
| | - Udo Dannlowski
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany.,Department of Psychiatry and Psychotherapy, University of Muenster, Muenster, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Jens Sommer
- Marburg Center for Mind, Brain and Behavior - MCMBB, University of Marburg, Marburg, Germany.,Core-Unit Brainimaging, Faculty of Medicine, University of Marburg, Marburg, Germany
| | - Maxim Zavorotnyy
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany.,Marburg Center for Mind, Brain and Behavior - MCMBB, University of Marburg, Marburg, Germany.,Department of Psychiatry and Psychotherapy, Psychiatric Services Aargau, Academic Hospital of the University of Zurich, Brugg, Switzerland
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27
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Lefaucheur JP, Aleman A, Baeken C, Benninger DH, Brunelin J, Di Lazzaro V, Filipović SR, Grefkes C, Hasan A, Hummel FC, Jääskeläinen SK, Langguth B, Leocani L, Londero A, Nardone R, Nguyen JP, Nyffeler T, Oliveira-Maia AJ, Oliviero A, Padberg F, Palm U, Paulus W, Poulet E, Quartarone A, Rachid F, Rektorová I, Rossi S, Sahlsten H, Schecklmann M, Szekely D, Ziemann U. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): An update (2014-2018). Clin Neurophysiol 2020; 131:474-528. [PMID: 31901449 DOI: 10.1016/j.clinph.2019.11.002] [Citation(s) in RCA: 946] [Impact Index Per Article: 236.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 10/21/2019] [Accepted: 11/02/2019] [Indexed: 02/08/2023]
Abstract
A group of European experts reappraised the guidelines on the therapeutic efficacy of repetitive transcranial magnetic stimulation (rTMS) previously published in 2014 [Lefaucheur et al., Clin Neurophysiol 2014;125:2150-206]. These updated recommendations take into account all rTMS publications, including data prior to 2014, as well as currently reviewed literature until the end of 2018. Level A evidence (definite efficacy) was reached for: high-frequency (HF) rTMS of the primary motor cortex (M1) contralateral to the painful side for neuropathic pain; HF-rTMS of the left dorsolateral prefrontal cortex (DLPFC) using a figure-of-8 or a H1-coil for depression; low-frequency (LF) rTMS of contralesional M1 for hand motor recovery in the post-acute stage of stroke. Level B evidence (probable efficacy) was reached for: HF-rTMS of the left M1 or DLPFC for improving quality of life or pain, respectively, in fibromyalgia; HF-rTMS of bilateral M1 regions or the left DLPFC for improving motor impairment or depression, respectively, in Parkinson's disease; HF-rTMS of ipsilesional M1 for promoting motor recovery at the post-acute stage of stroke; intermittent theta burst stimulation targeted to the leg motor cortex for lower limb spasticity in multiple sclerosis; HF-rTMS of the right DLPFC in posttraumatic stress disorder; LF-rTMS of the right inferior frontal gyrus in chronic post-stroke non-fluent aphasia; LF-rTMS of the right DLPFC in depression; and bihemispheric stimulation of the DLPFC combining right-sided LF-rTMS (or continuous theta burst stimulation) and left-sided HF-rTMS (or intermittent theta burst stimulation) in depression. Level A/B evidence is not reached concerning efficacy of rTMS in any other condition. The current recommendations are based on the differences reached in therapeutic efficacy of real vs. sham rTMS protocols, replicated in a sufficient number of independent studies. This does not mean that the benefit produced by rTMS inevitably reaches a level of clinical relevance.
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Affiliation(s)
- Jean-Pascal Lefaucheur
- ENT Team, EA4391, Faculty of Medicine, Paris Est Créteil University, Créteil, France; Clinical Neurophysiology Unit, Department of Physiology, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris, Créteil, France.
| | - André Aleman
- Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Chris Baeken
- Department of Psychiatry and Medical Psychology, Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium; Department of Psychiatry, University Hospital (UZBrussel), Brussels, Belgium; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - David H Benninger
- Neurology Service, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Jérôme Brunelin
- PsyR2 Team, U1028, INSERM and UMR5292, CNRS, Center for Neuroscience Research of Lyon (CRNL), Centre Hospitalier Le Vinatier, Lyon-1 University, Bron, France
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Saša R Filipović
- Department of Human Neuroscience, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
| | - Christian Grefkes
- Department of Neurology, Cologne University Hospital, Cologne, Germany; Institute of Neurosciences and Medicine (INM3), Jülich Research Centre, Jülich, Germany
| | - Alkomiet Hasan
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Friedhelm C Hummel
- Defitech Chair in Clinical Neuroengineering, Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland; Defitech Chair in Clinical Neuroengineering, Swiss Federal Institute of Technology (EPFL) Valais and Clinique Romande de Réadaptation, Sion, Switzerland; Clinical Neuroscience, University of Geneva Medical School, Geneva, Switzerland
| | - Satu K Jääskeläinen
- Department of Clinical Neurophysiology, Turku University Hospital and University of Turku, Turku, Finland
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Letizia Leocani
- Department of Neurorehabilitation and Experimental Neurophysiology Unit, Institute of Experimental Neurology (INSPE), IRCCS San Raffaele, University Vita-Salute San Raffaele, Milan, Italy
| | - Alain Londero
- Department of Otorhinolaryngology - Head and Neck Surgery, Université Paris Descartes Sorbonne Paris Cité, Hôpital Européen Georges Pompidou, Paris, France
| | - Raffaele Nardone
- Department of Neurology, Franz Tappeiner Hospital, Merano, Italy; Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria; Karl Landsteiner Institut für Neurorehabilitation und Raumfahrtneurologie, Salzburg, Austria
| | - Jean-Paul Nguyen
- Multidisciplinary Pain Center, Clinique Bretéché, ELSAN, Nantes, France; Multidisciplinary Pain, Palliative and Supportive Care Center, UIC22-CAT2-EA3826, University Hospital, CHU Nord-Laënnec, Nantes, France
| | - Thomas Nyffeler
- Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland; Perception and Eye Movement Laboratory, Department of Neurology, University of Bern, Bern, Switzerland; Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Albino J Oliveira-Maia
- Champalimaud Research & Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal; Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal; NOVA Medical School
- Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Antonio Oliviero
- FENNSI Group, Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Ulrich Palm
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany; Medical Park Chiemseeblick, Bernau, Germany
| | - Walter Paulus
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany
| | - Emmanuel Poulet
- PsyR2 Team, U1028, INSERM and UMR5292, CNRS, Center for Neuroscience Research of Lyon (CRNL), Centre Hospitalier Le Vinatier, Lyon-1 University, Bron, France; Department of Emergency Psychiatry, Edouard Herriot Hospital, Groupement Hospitalier Centre, Hospices Civils de Lyon, Lyon, France
| | - Angelo Quartarone
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | | | - Irena Rektorová
- Applied Neuroscience Research Group, Central European Institute of Technology, CEITEC MU, Masaryk University, Brno, Czech Republic; First Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Simone Rossi
- Department of Medicine, Surgery and Neuroscience, Si-BIN Lab Human Physiology Section, Neurology and Clinical Neurophysiology Unit, University of Siena, Siena, Italy
| | - Hanna Sahlsten
- ENT Clinic, Mehiläinen and University of Turku, Turku, Finland
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - David Szekely
- Department of Psychiatry, Princess Grace Hospital, Monaco
| | - Ulf Ziemann
- Department of Neurology and Stroke, and Hertie Institute for Clinical Brain Research, Eberhard Karls University, Tübingen, Germany
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Translating preclinical findings in clinically relevant new antipsychotic targets: focus on the glutamatergic postsynaptic density. Implications for treatment resistant schizophrenia. Neurosci Biobehav Rev 2019; 107:795-827. [DOI: 10.1016/j.neubiorev.2019.08.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 07/20/2019] [Accepted: 08/22/2019] [Indexed: 02/07/2023]
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Abstract
PURPOSE OF REVIEW This current review summarizes the investigational and therapeutic applications of transcranial magnetic stimulation (TMS) in schizophrenia. RECENT FINDINGS Fairly consistent findings of an impaired cortical excitation-inhibition balance, cortical plasticity, and motor resonance have been reported in schizophrenia. Cortical connectivity impairments have also been demonstrated in motor and prefrontal brain regions. In terms of treatment, the best support is for 1-Hz TMS to the left temporoparietal cortex for the short-term treatment of persistent auditory hallucinations. High-frequency TMS to the left prefrontal cortex improves negative and cognitive symptoms, but with inconsistent and small effects. TMS combined with diverse brain mapping techniques and clinical evaluation can unravel critical brain-behavior relationships relevant to schizophrenia. These provide critical support to the conceptualization of schizophrenia as a connectopathy with anomalous cortical plasticity. Adaptive modulation of these aberrant brain networks in a neuroscience-informed manner drives short-term therapeutic gains in difficult-to-treat symptoms of schizophrenia.
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Schwippel T, Schroeder PA, Fallgatter AJ, Plewnia C. Clinical review: The therapeutic use of theta-burst stimulation in mental disorders and tinnitus. Prog Neuropsychopharmacol Biol Psychiatry 2019; 92:285-300. [PMID: 30707989 DOI: 10.1016/j.pnpbp.2019.01.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 01/10/2019] [Accepted: 01/28/2019] [Indexed: 12/30/2022]
Abstract
Repetitive Transcranial Magnetic Stimulation (rTMS) is a neuromodulatory treatment intervention, which can be used to alleviate symptoms of mental disorders. Theta-burst stimulation (TBS), an advanced, patterned form of TMS, features several advantages regarding applicability, treatment duration and neuroplastic effects. This clinical review summarizes TBS studies in mental disorders and tinnitus and discusses effectivity and future directions of clinical TBS research. Following the PRISMA guidelines, the authors included 47 studies published until July 2018. Particularly in depression, evidence for the effectiveness of TBS and non-inferiority to conventional rTMS exists. Evidence for therapeutic efficacy of TBS in other mental disorders remains weak due to a large heterogeneity between studies. Rigorous reporting standards and adequately powered controlled trials are indispensable to foster validity and translation into clinical use. Nevertheless, TBS remains a promising instrument to target maladaptive brain networks and to ameliorate psychiatric symptoms.
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Affiliation(s)
- Tobias Schwippel
- Department of Psychiatry and Psychotherapy, Neurophysiology & Interventional Neuropsychiatry, University of Tübingen, Calwerstr. 14, 72076 Tübingen, Germany
| | - Philipp A Schroeder
- Department of Psychology, Clinical Psychology & Psychotherapy, University of Tübingen, Schleichstr. 4, 72076 Tübingen, Germany
| | - Andreas J Fallgatter
- Department of Psychiatry and Psychotherapy, Neurophysiology & Interventional Neuropsychiatry, University of Tübingen, Calwerstr. 14, 72076 Tübingen, Germany; LEAD Graduate School & Research Network, University of Tübingen, 72074 Tübingen, Germany
| | - Christian Plewnia
- Department of Psychiatry and Psychotherapy, Neurophysiology & Interventional Neuropsychiatry, University of Tübingen, Calwerstr. 14, 72076 Tübingen, Germany.
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31
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Zhuo C, Xu Y, Zhang L, Jing R, Zhou C. The Effect of Dopamine Antagonist Treatment on Auditory Verbal Hallucinations in Healthy Individuals Is Clearly Influenced by COMT Genotype and Accompanied by Corresponding Brain Structural and Functional Alterations: An Artificially Controlled Pilot Study. Front Genet 2019; 10:92. [PMID: 30894870 PMCID: PMC6414462 DOI: 10.3389/fgene.2019.00092] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 01/29/2019] [Indexed: 11/29/2022] Open
Abstract
Few studies have been conducted to explore the influence of the catechol-o-methyltransferase (COMT) genotype on the severity of and treatment efficacy on auditory verbal hallucination (AVH) symptoms in healthy individuals with AVHs (Hi-AVHs). We hypothesized that the efficacy of dopamine antagonist treatment on AVHs in Hi-AVHs may be influenced by their COMT genotype and may be accompanied by corresponding brain alterations. To preliminarily investigate and test our hypothesis in an artificially controlled pilot study, we enrolled 42 Hi-AVHs as subjects and used magnetic resonance imaging and genetic methods to explore the basis brain features to investigate whether the efficacy of dopamine antagonist treatment on AVHs in Hi-AVH subjects was influenced by their COMT genotype or not. We found that COMT-met genotype subjects’ treatment response was better than that of COMT-val subjects. Although COMT-met genotype subjects demonstrated an increase in global functional connectivity density (gFCD) but no difference on gray matter volume (GMV) compared to COMT-val genotype subjects at baseline, notably, we found that both groups demonstrated gFCD and GMV reduction after treatment, but the reduction was more widespread in COMT-met genotype subjects than in COMT-val genotype subjects. This is the first study to report that Hi-AVH subjects’ baseline brain functional features are influenced by their COMT genotypes and that the COMT-met genotype subjects exhibit better responses to dopamine antagonists but have more widespread GMV and gFCD reduction than subjects with the COMT-val genotype. Despite several limitations, these findings may provide auxiliary information to further explain the mechanisms of AVHs and provide a clue for scholars to further explore specific treatment targets for AVHs in Hi-AVH subjects or in schizophrenia patients.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Psychiatric-Neuroimaging-Genetics and Comorbidity Laboratory (PNGC-Lab), Tianjin Mental Health Centre, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin Anding Hospital, Tianjin, China.,Department of Psychiatry, College of Basic Medical Science, Tianjin Medical University, Tianjin, China.,Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, China.,Department of Psychiatry, Institute of Mental Health, Jining Medical University, Jining, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Li Zhang
- GHM Institute of CNS Regeneration, Jinan University, Guangzhou, China
| | - Rixing Jing
- Department of Pattern Recognition, China National Key Laboratory, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,Department of Pattern Recognition, University of Chinese Academy of Sciences, Beijing, China
| | - Chunhua Zhou
- Department of Pharmacy, The First Hospital of Hebei Medical University, Shijiazhuang, China
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32
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Nathou C, Etard O, Dollfus S. Auditory verbal hallucinations in schizophrenia: current perspectives in brain stimulation treatments. Neuropsychiatr Dis Treat 2019; 15:2105-2117. [PMID: 31413576 PMCID: PMC6662171 DOI: 10.2147/ndt.s168801] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 05/24/2019] [Indexed: 12/16/2022] Open
Abstract
PURPOSE This review reports the current perspectives of brain stimulation techniques in the treatment of auditory verbal hallucinations (AVH) in schizophrenia. METHODS A systematic search of the literature in the PubMed database revealed that the most studied techniques are noninvasive techniques (NIBS), including electroconvulsive therapy (ECT), transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS). RESULTS The results showed that ECT could have great clinical efficacy but is currently underused in practice perhaps due to the costs associated with its limited implementation and potential associated risks. tDCS is still poorly studied and does not demonstrate sufficiently homogeneous or conclusive results yet to prove its efficacy in the treatment of AVH. However, its safe and simple implementation allows us to recommend it to patients who are refractory to other stimulation techniques. Finally, rTMS seems to be the most efficacious NIBS to offer patients with persistent AVH as an add-on therapeutic strategy. Its implementation has a non negligible cost but can be performed by a single practitioner. Great evolution in these techniques with technological progress, robotics and computer science are currently being tested and will undoubtedly improve the clinical efficacy of these procedures, particularly towards more personalized treatments such as individual rTMS targets and intensities. There are also new techniques for deep brain stimulation based on focused ultrasound that could provide much insight into the treatment of AVH in schizophrenia. CONCLUSION This review suggests that add-on brain stimulation treatments could play a key role among the therapeutic strategies for auditory hallucinations reduction in schizophrenia.
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Affiliation(s)
- Clément Nathou
- Normandie Univ, UNICAEN, CHU de Caen, Service de Psychiatrie Adulte , Caen, F-14000, France.,Normandie Univ, UNICAEN, ISTS, EA 7466 , GIP Cyceron, Caen 14000, France
| | - Olivier Etard
- Normandie Univ, UNICAEN, ISTS, EA 7466 , GIP Cyceron, Caen 14000, France.,Normandie Univ, UNICAEN, CHU de Caen, Service des Explorations Fonctionnelles du Système Nerveux, CHU de Caen, Caen, F-14000, France
| | - Sonia Dollfus
- Normandie Univ, UNICAEN, CHU de Caen, Service de Psychiatrie Adulte , Caen, F-14000, France.,Normandie Univ, UNICAEN, ISTS, EA 7466 , GIP Cyceron, Caen 14000, France
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Nathou C, Duprey E, Simon G, Razafimandimby A, Leroux E, Dollfus S, Etard O. Effects of low- and high-frequency repetitive transcranial magnetic stimulation on long-latency auditory evoked potentials. Neurosci Lett 2018; 686:198-204. [PMID: 30219485 DOI: 10.1016/j.neulet.2018.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 08/03/2018] [Accepted: 09/01/2018] [Indexed: 10/28/2022]
Abstract
Long-latency auditory event potentials (LLAEPs) involving local and global auditory processes have been investigated to examine the impact of low-frequency (LF) and high-frequency (HF) repetitive transcranial magnetic stimulation (rTMS) on the cortical excitability of the temporal cortex. We hypothesized that both stimulation frequencies have the same modulation effect, in accordance with clinical data showing a reduction in auditory verbal hallucinations (AVHs) after LF and HF temporal rTMS in patients with schizophrenia. With 30 right-handed healthy volunteer participants enrolled in a crossover trial, we analyzed LLAEPs before and after LF- and HF-rTMS of the left temporal cortex. While we observed no changes in latencies, we did observe a similar inhibitory action of both rTMS frequencies on LLAEP amplitudes. Analysis of surface potential maps and cortical generators revealed some differences regarding auditory processes: HF-rTMS produced earlier, more diffuse, and more right-lateralized effects than LF-rTMS. Beyond a local impact, rTMS exerted a remote modulation influence on the frontal cortex that might be involved in attentional processes. This association could explain the therapeutic effect of temporal HF-rTMS on AVH.
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Affiliation(s)
- Clément Nathou
- CHU de Caen, Service de Psychiatrie adulte, Centre Esquirol, Caen, F-14000, France; Normandie Univ, UNICAEN, ISTS, EA 7466, GIP Cyceron, 14000, Caen, France.
| | - Emmanuelle Duprey
- CHU de Caen, Service de Psychiatrie adulte, Centre Esquirol, Caen, F-14000, France; Normandie Univ, UNICAEN, ISTS, EA 7466, GIP Cyceron, 14000, Caen, France
| | - Gregory Simon
- Université Paris-Descartes, Normandie Univ, UNICAEN, UMR CNRS 8240 LAPSYDE, 14000, Caen, France
| | | | - Elise Leroux
- Normandie Univ, UNICAEN, ISTS, EA 7466, GIP Cyceron, 14000, Caen, France
| | - Sonia Dollfus
- CHU de Caen, Service de Psychiatrie adulte, Centre Esquirol, Caen, F-14000, France; Normandie Univ, UNICAEN, ISTS, EA 7466, GIP Cyceron, 14000, Caen, France
| | - Olivier Etard
- Normandie Univ, UNICAEN, ISTS, EA 7466, GIP Cyceron, 14000, Caen, France; CHU de Caen, Service des explorations fonctionnelles du système nerveux, Caen, F-14000, France
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