A peer-reviewed, evidence-based journal for clinicians in the field of neuroscience
Issue link: https://innovationscns.epubxp.com/i/555782
Innovations in CLINICAL NEUROSCIENCE [ V O L U M E 1 2 , N U M B E R 7 – 8 , J U L Y – A U G U S T 2 0 1 5 ] 16 detected positive results in improving negative symptoms of schizophrenia. 32–42 The very first study of TMS for negative symptoms was carried out in 2000 by Rollnik et al. 32 In a double- blind, crossover study, 12 patients with schizophrenia were treated with two weeks of daily left prefrontal TMS versus two weeks of sham stimulation, yielding a significant decrease in the Brief Psychiatric Rating scale (BPRS) 33 with active TMS. Another study by Hajak et al in 2004 34 conducted a sham-controlled study of 20 patients with schizophrenia who received high frequency TMS over 10 days to the left dorsolateral prefrontal cortex. At the end of the study, functional neuroimaging was performed. There was a significant reduction in negative symptoms and depressive symptoms, while positive symptoms seemed to worsen. However, no changes were noted on the neuroimaging. Goyal et al 35 showed improvement of negative symptoms in their double-blind, sham- controlled study of 10 right-handed patients diagnosed with schizophrenia. Prikryl et al 36 also found improvement in negative symptoms in their randomized, sham-controlled study of 22 patients with schizophrenia who had prominent negative symptoms and were stabilized on antipsychotic medication. Schneider et al 37 used 10Hz TMS at 110 percent of the motor threshold over the left dorsolateral prefrontal cortex in 51 patients with schizophrenia, which showed significant benefit in reducing negative symptoms as well as neurocognitive deficits. Cordes et al 38 found mild to moderate benefit using 10Hz stimulation at 110- TABLE 1. TMS treatment for auditory hallucinations in schizophrenia AUTHOR/DATE N LOCATION % MT HERTZ TOTAL # OF PULSES RESULTS OF STUDY COIL TYPE Hoffman/2003 24 L T-P 90 1 unknown 52% of patients had improvement for at least 15 weeks Figure of Eight McIntosh/2004 16 L T-P 80 1 unknown N o difference between real and sham treatments F igure of Eight Poulet/2005 10 L T-P 90 1 10,000 AHRS improvement significantly m ore for active group Figure of E ight Chibbaro/2005 16 L T-P 90 1 3,600 SAPS showed significant improvement in active group Figure of eight Lee/2005 39 L&R; T-P 100 1 12,000 Both R and L treatments yielded better CGI scores Figure of Eight Brunelin/2006 24 L T-P 90 1 10,000 Significant improvement in AHRS compared to Sham Figure of Eight Jandl/2006 16 L&R; T-P 100 1 4,500 PSYRATS; mean hallucination scores did not differ group to group Figure of Eight Bagati/2009 40 L T-P 90 1 unknown Significant reduction in AHRS scores for active group Figure of Eight Vercammen/ 2009 38 R&L; T-P 90 1 14,400 AH significantly reduced in L T-P only Figure of Eight Saba/2006 18 L T-P 80 1 3,000 No group differences found Figure of Eight Rosa/2007 11 L T-P 90 1 9,600 No group differences found Figure of Eight Slotema/2011 62 L T-P 90 1 18,000 No group differences found Figure of Eight Abbreviations: MT: motor threshold; ND: no data; AHRS: Auditory Hallucination Rating Scale; PANSS: Positive and Negative Syndrome Scale; PSYRATS: Psychotic Symptoms Rating Scale; AH: auditory hallucinations; SAPS-NS: Scale for the Assessment of Positive Symptoms- Negative Symptoms; L T-P: left temporo-parietal cortex; L&R; T-P: left and right temporo-parietal cortex; L or R T-P: left or right temporo- parietal cortex