Temporoparietal transcranial magnetic stimulation for auditory hallucinations: safety, efficacy and moderators in a fifty patient sample
Abstract
Background Auditory hallucinations are often resistant to treatment and can produce significant distress and behavioral difficulties. A preliminary report based on 24 patients with schizophrenia or schizoaffective disorder indicated greater improvement in auditory hallucinations following 1-hertz left temporoparietal repetitive transcranial magnetic stimulation (rTMS) compared to sham stimulation. Data from the full 50-subject sample incorporating 26 new patients are now presented to more comprehensively assess safety/tolerability, efficacy and moderators of this intervention.Methods Right-handed patients experiencing auditory hallucinations at least 5 times per day were randomly allocated to receive either rTMS or sham stimulation. A total of 132 minutes of rTMS was administered over 9 days at 90% motor threshold using a double-masked, sham-controlled, parallel design.Results Hallucination Change Score was more improved for rTMS relative to sham stimulation (p = .008) as was the Clinical Global Impressions Scale (p = .0004). Hallucination frequency was significantly decreased during rTMS relative to sham stimulation (p = .0014) and was a moderator of rTMS effects (p = .008). There was no evidence of neurocognitive impairment associated with rTMS.Conclusions Left temporoparietal 1-hertz rTMS warrants further study as an intervention for auditory hallucinations. Data suggest that this intervention selectively alters neurobiological factors determining frequency of these hallucinations.
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Initial studies indicated that rTMS may be effective as a treatment to reduce AVHs, with a large effect size of .94 in a 50 patient sample reducing frequency of AVHs.
“These initial studies indicated that rTMS may be effective as a treatment to reduce AVHs, as measured by the Auditory Hallucinations Rating Scale, a 7-item scale which assesses hallucination frequency, number of voices, volume, vividness, salience, length and distress caused. A large effect size of .94 was found in the 50 patient sample, reducing the frequency of AVHs.”
From Auditory verbal hallucinations as atypical inner speech monitoring, and the potential of neurostimulation as a treatment option (2013) · cites this paper as Hoffman et al., 2005
Hoffman et al. (2005) reported that many patients correctly guessed which condition they had been in.
“Hoffman et al. (2005), using this sham technique, reported that many patients correctly guessed which condition they had been in”
From Auditory verbal hallucinations as atypical inner speech monitoring, and the potential of neurostimulation as a treatment option (2013) · cites this paper as Hoffman et al., 2005
The other two adequately powered studies (Hoffman et al., 2005, 2013) originate from the same institution.
“Of the three studies discussed here that have achieved adequate power, one finds no effect of neurostimulation (Slotema et al., 2011), and the other two originate from the same institution (Hoffman et al., 2005, 2013).”
From Auditory verbal hallucinations as atypical inner speech monitoring, and the potential of neurostimulation as a treatment option (2013) · cites this paper as Hoffman et al., 2005
Currently, evidence suggests no negative effects of neurostimulation on short-term verbal memory or hearing function (pure-tone audiometry).
“Currently, evidence suggests that there are no negative effects on neuropsychological measures such a short-term verbal memory (Hoffman et al., 2005) or measures of hearing function such as pure-tone audiometry (Schonfeldt-Lecuona et al., 2012)”
From Auditory verbal hallucinations as atypical inner speech monitoring, and the potential of neurostimulation as a treatment option (2013) · cites this paper as Hoffman et al., 2005
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- Authors
- Hoffman, R. E., Gueorguieva, R., Hawkins, K. A., Varanko, M., Boutros, N. N., Wu, Y.-T., Carroll, K., & Krystal, J. H.
- Affiliations
- Yale University (US)
- Corresponding author
- Hoffman, Ralph E.
- ORCID
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2005-07
- Volume
- 58
- Issue
- 2
- Pages
- 97-104
- ISSN
- 0006-3223 (ISSN-L)
- OpenAlex
- W2042532524
- Cited by
- 272
- References
- 54
- Citations by year
- 2026: 5 · 2025: 11 · 2024: 9 · 2023: 12 · 2022: 6 · 2021: 10 · 2020: 9 · 2019: 9 · 2018: 7 · 2017: 9 · 2016: 10 · 2015: 13 · 2014: 17 · 2013: 12 · 2012: 20
- FWCI
- 10.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5k02aa000261-04)
- National Institute on Alcohol Abuse and Alcoholism (KO2 AA 00261-01)
- National Institute of Mental Health (R21MH063326, R01MH067073, R21 MH 63326)
- National Institute on Drug Abuse (P50DA009241, P50-DA-0-9241)
- National Center for Research Resources (M01RR000125, RR00125)
- Topics
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Keywords
- auditory hallucinations, repetitive transcranial magnetic stimulation, temporoparietal cortex, low-frequency rTMS, schizophrenia, schizoaffective disorder, treatment moderators
- MeSH terms
- Adult, Double-Blind Method, Electromagnetic Fields, Electric Stimulation Therapy, Female, Hallucinations, Humans, Functional Laterality, Male, Middle Aged, Parietal Lobe, Psychotic Disorders, Schizophrenic Psychology, Temporal Lobe, Treatment Outcome, Statistics, Nonparametric, Transcranial Magnetic Stimulation
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