Auditory hallucinations are found most often in patients with schizophrenia, with a prevalence of 75% in that population (2). These are the most common forms of hallucinations (1). Secondly, we have shown that treatment with high frequency TMS makes a difference to at least some sufferers, although there is a long way to go before we will know if TMS is the best route to treat these patients in the long-term”.According to DSM-IV-TR, a hallucination is “a sensory perception that has a compelling sense of reality of a true perception, but occurs without external stimulation of the relevant sensory organ.” Thus, an auditory hallucination is a false perception of sound. This means two things firstly it seems that we now can say with some certainty that we have found a specific anatomical area of the brain associated with auditory verbal hallucinations in schizophrenia.
This is the first controlled trial to show an improvement in these patients by targeting a specific area of the brain and using high frequency TMS. Professor Sonia Dollfus said: “Auditory Verbal Hallucinations, or “hearing voices” can be a disturbing symptom of schizophrenia, both for patients and for those close to sufferers. However, there is a lack of controlled trials to show that TMS works effectively with AVH sufferers. TMS uses magnetic pulses to the brain, and has been shown to be effective in several psychiatric conditions. Transcranial Magnetic Stimulation (TMS) has been suggested as a possible way of treating the hearing of voices in schizophrenia. The researchers found that 34.6% of the patients being treated by TMS showed a significant response, whereas only 9.1% of patients in the sham group responded (‘significant response’ was defined as a more than 30% decrease in the Total Auditory Hallucinations Rating Scale score). Using magnetic resonance imaging (MRI), the pulses were targeted at a specific brain area in the temporal lobe, which is associated with language (the exact area is the crossing of the projection of the ascending branch of the left lateral sulcus and the left superior temporal sulcus)Īfter 2 weeks, the patients were re-evaluated.
The treated patients received a series of 20 Hz high-frequency magnetic pulses over 2 sessions a day for 2 days. The researchers interviewed the patients using a standard protocol – the Auditory Hallucinations Rating Scale – which revealed most of the characteristic features of the voices which they were hearing. The French research team worked with 26 patients who received active TMS treatment, and 33 as a control group, who received sham (placebo) treatment.
These voices, may be ‘heard’ as having a variety of different characteristics, for example as internal or external, friendly or threatening, they may be continuously present or present only occasionally, and so on. One of the best-known is hearing voices, also known as Auditory Verbal Hallucination (AVH), which around 70% of people with schizophrenia experience at some point. People with schizophrenia experience a range of symptoms, which may include delusions, muddled thoughts and hallucinations. Schizophrenia is a serious long-term mental health problem. “This is the first controlled trial to precisely determine an anatomically defined brain area where high frequency magnetic pulses can improve the hearing of voices”, said lead researcher, Professor Sonia Dollfus (University of Caen, CHU, France). This early clinical work was presented at the ECNP conference in Paris on Tuesday 5th September, with later publication in Schizophrenia Bulletin. They have been able to show in a controlled trial that targeting this area with magnetic pulses can improve the condition in some patients. Source: European College of Neuropsychopharmacology.įor the first time, scientists have precisely identified and targeted an area of the brain which is involved in “hearing voices”, experienced by many patients with schizophrenia. The researchers were able to control the hallucinations with the help of transcranial magnetic stimulation. Summary: Researchers have identified a specific area of the brain responsible for auditory verbal hallucinations in people with schizophrenia.