Transcranial stimulation technique reduces hallucinations

By Mark Cowen

Transcranial direct-current stimulation (tDCS) is effective for the treatment of auditory hallucinations in patients with schizophrenia, study results show.

Jerome Brunelin (University of Lyon, France) and team also found that tDCS was associated with a reduction in positive and negative symptoms in patients with the mental health disorder.

The researchers studied 30 schizophrenia patients who were still experiencing auditory hallucinations despite treatment with antipsychotic medications for at least 3 months.

The participants were randomly assigned to receive active (n=15) or sham tDCS (n=15) in 20-minute sessions, twice a day over 5 consecutive days.

There were no significant differences between the groups at baseline regarding age, gender, education levels, or medication use. There were also no significant between-group differences at baseline regarding scores on the Auditory Hallucination Rating Scale (AHRS) and the Positive and Negative Syndrome Scale (PANSS).

All of the participants continued to take their prescribed antipsychotic medications during the study period.

The researchers found that patients assigned to active tDCS had a 31% improvement in AHRS scores at 5 weeks compared with baseline, with mean scores falling from 28.3 to 19.9. By contrast, patients assigned to sham tDCS showed only an 8% improvement, with mean AHRS scores falling from 27.2 to 25.1.

Furthermore, compared with baseline, patients assigned to active tDCS showed improvements in AHRS scores of 36% at 1 month and 38% at 3 months. By contrast, respective improvements of just 3% and 5% were observed in those assigned to sham tDCS.

Patients assigned to active tDCS also showed a greater improvement in positive and negative symptoms over the study period than those assigned to sham treatment, with mean PANSS scores falling from 76.9 to 66.9 compared with from 82.8 to 80.5, respectively.

Brunelin and team conclude in the American Journal of Psychiatry: "Our results suggest that tDCS, an easy-to-use, low-cost stimulation tool with few side effects, by acting antagonistically on two distinct brain areas involved in the pathophysiology of schizophrenia, could constitute a new tool in the treatment of refractory symptoms."

They add: "Further studies with larger samples and additional evaluations, such as functional evaluations (eg, quality of life, social autonomy of patients) and imaging, are needed to confirm these promising results."

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