Examining transcranial direct-current stimulation (tDCS) as a treatment for hallucinations in schizophrenia
Abstract
OBJECTIVE: Some 25%–30% of patients with schizophrenia have auditory verbal hallucinations that are refractory to antipsychotic drugs. Outcomes in studies of repetitive transcranial magnetic stimulation suggest the possibility that application of transcranial direct-current stimulation (tDCS) with inhibitory stimulation over the left temporo-parietal cortex and excitatory stimulation over the left dorsolateral prefrontal cortex could affect hallucinations and negative symptoms, respectively. The authors investigated the efficacy of tDCS in reducing the severity of auditory verbal hallucinations as well as negative symptoms. METHOD: Thirty patients with schizophrenia and medication-refractory auditory verbal hallucinations were randomly allocated to receive 20 minutes of active 2-mA tDCS or sham stimulation twice a day on 5 consecutive weekdays. The anode was placed over the left dorsolateral prefrontal cortex and the cathode over the left temporo-parietal cortex. RESULTS: Auditory verbal hallucinations were robustly reduced by tDCS relative to sham stimulation, with a mean diminution of 31% (SD=14; d=1.58, 95% CI=0.76–2.40). The beneficial effect on hallucinations lasted for up to 3 months. The authors also observed an amelioration with tDCS of other symptoms as measured by the Positive and Negative Syndrome Scale (d=0.98, 95% CI=0.22–1.73), especially for the negative and positive dimensions. No effect was observed on the dimensions of disorganization or grandiosity/excitement. CONCLUSIONS: Although this study is limited by the small sample size, the results show promise for treating refractory auditory verbal hallucinations and other selected manifestations of schizophrenia.
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This effect was still present 3 months later, with 6 of 15 participants in the experimental condition showing a reduction in hallucination frequency of more than 50%.
“This effect was still present 3 months later, with 6 of 15 participants in the experimental condition showing a reduction in hallucination frequency of more than 50%.”
From Auditory verbal hallucinations as atypical inner speech monitoring, and the potential of neurostimulation as a treatment option (2013) · cites this paper as Brunelin et al., 2012
Active cathodal tDCS over temporoparietal cortex produced a 31% reduction in hallucination severity compared to an 8% reduction in the sham condition.
“Results showed that those who received active cathodal stimulation over temporoparietal cortex experienced a 31% reduction in hallucination severity, as measured by the Auditory Hallucination Rating Scale (which takes into account variables such as hallucination frequency, loudness, and salience of the AVH), compared to an 8% reported reduction in the sham condition.”
From Auditory verbal hallucinations as atypical inner speech monitoring, and the potential of neurostimulation as a treatment option (2013) · cites this paper as Brunelin et al., 2012
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- Authors
- Brunelin, J., Mondino, M., Gassab, L., Haesebaert, F., Gaha, L., Suaud-Chagny, M.-F., Saoud, M., Mechri, A., & Poulet, E.
- Affiliations
- From University of Lyon, Lyon, France; Centre Hospitalier Le Vinatier, Bron, France; and Research Laboratory “Vulnérabilité aux psychoses” and Centre Hospitalo-Unversitaire Fattouma Bourguiba, Monastir, Tunisia.
- University of Monastir (TN)
- Venue
- American Journal of Psychiatry
- Published
- 2012-07
- Volume
- 169
- Issue
- 7
- Pages
- 719-724
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2158026972
- Cited by
- 520
- References
- 39
- Citations by year
- 2026: 6 · 2025: 33 · 2024: 27 · 2023: 23 · 2022: 38 · 2021: 40 · 2020: 33 · 2019: 44 · 2018: 52 · 2017: 49 · 2016: 50 · 2015: 45 · 2014: 46 · 2013: 26 · 2012: 8
- FWCI
- 20.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- 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
- transcranial direct current stimulation, auditory verbal hallucinations, schizophrenia, negative symptoms, dorsolateral prefrontal cortex, temporoparietal cortex, anodal stimulation, cathodal stimulation, non-pharmacological treatment
- MeSH terms
- Adult, Cerebral Cortex, Electric Stimulation Therapy, Hallucinations, Humans, Psychiatric Status Rating Scales, Schizophrenia
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