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Exploratory study of once-daily transcranial direct current stimulation (tDCS) as a treatment for auditory hallucinations in schizophrenia

Published online by Cambridge University Press:  23 March 2020

F. Fröhlich ,
T.N. Burrello ,
J.M. Mellin ,
A.L. Cordle ,
C.M. Lustenberger ,
J.H. Gilmore  and
L.F. Jarskog
F. Fröhlich*
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel HillNC27599USA Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel HillNC27599USA Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel HillNC27599USA Neuroscience Center, University of North Carolina at Chapel Hill, Chapel HillNC27599USA Department of Neurology, University of North Carolina at Chapel Hill, Chapel HillNC27599USA
T.N. Burrello
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel HillNC27599USA
J.M. Mellin
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel HillNC27599USA
A.L. Cordle
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel HillNC27599USA
C.M. Lustenberger
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel HillNC27599USA
J.H. Gilmore
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel HillNC27599USA
L.F. Jarskog
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel HillNC27599USA
*
⁎ Corresponding author. Tel.: +39 3 213 758 27; fax: +39 3 213 758 21. E-mail address:flavio_frohlich@med.unc.edu
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Abstract

Background

Auditory hallucinations are resistant to pharmacotherapy in about 25% of adults with schizophrenia. Treatment with noninvasive brain stimulation would provide a welcomed additional tool for the clinical management of auditory hallucinations. A recent study found a significant reduction in auditory hallucinations in people with schizophrenia after five days of twice-daily transcranial direct current stimulation (tDCS) that simultaneously targeted left dorsolateral prefrontal cortex and left temporo-parietal cortex.

Hypothesis

We hypothesized that once-daily tDCS with stimulation electrodes over left frontal and temporo-parietal areas reduces auditory hallucinations in patients with schizophrenia.

Methods

We performed a randomized, double-blind, sham-controlled study that evaluated five days of daily tDCS of the same cortical targets in 26 outpatients with schizophrenia and schizoaffective disorder with auditory hallucinations.

Results

We found a significant reduction in auditory hallucinations measured by the Auditory Hallucination Rating Scale (F2,50 = 12.22, P < 0.0001) that was not specific to the treatment group (F2,48 = 0.43, P = 0.65). No significant change of overall schizophrenia symptom severity measured by the Positive and Negative Syndrome Scale was observed.

Conclusions

The lack of efficacy of tDCS for treatment of auditory hallucinations and the pronounced response in the sham-treated group in this study contrasts with the previous finding and demonstrates the need for further optimization and evaluation of noninvasive brain stimulation strategies. In particular, higher cumulative doses and higher treatment frequencies of tDCS together with strategies to reduce placebo responses should be investigated. Additionally, consideration of more targeted stimulation to engage specific deficits in temporal organization of brain activity in patients with auditory hallucinations may be warranted.

Keywords

tDCSAuditory hallucinationsBrain stimulationPANSSAHRSPlacebo response
Type
Original article
Information
European Psychiatry , Volume 33 , Issue 1 , March 2016 , pp. 54 - 60
Copyright
Copyright © European Psychiatric Association 2016

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