Pharmacopsychiatry 2011; 44(1): 39-41
DOI: 10.1055/s-0030-1265196
Letter

© Georg Thieme Verlag KG Stuttgart · New York

Bilateral Temporal 1 Hz rTMS (Repetitive Transcranial Magnetic Stimulation) Treatment in a Left-Handed Patient with Imperative Auditory Hallucinations

W. Sperling1 , J. Kornhuber1 , T. Biermann1
  • 1Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University, Erlangen-Nuremberg, Germany
Further Information

Publication History

received 07.06.2010 revised 03.08.2010

accepted 05.08.2010

Publication Date:
06 October 2010 (online)

This letter describes the case of a left-handed, 37-year-old patient with refractory auditory hallucinations. In spite of antipsychotic treatment with haloperidol, risperidone and clozapine, there was no resolution of symptoms during the entire course of his disease that started at the age of 25 years. The symptoms of auditory hallucinations measured with the SAPS (scale for the assessment of positive symptoms, SS 36–38) improved significantly only after 1-Hz repetitive transcranial magnetic (rTMS) stimulation on the right temporoparietal cortex. Therefore, 1-Hz rTMS of the temporoparietal cortex in patients with auditory hallucinations appears to be a promising approach in the treatment of refractory, and in particular extending disease pictures in schizophrenia. In these circumstances, the question of the localization of the speech centre for the choice of the stimulation site for 1-Hz repetitive TMS treatment seems to be important and should be addressed in future investigations.

References

  • 1 Kim DR, Pesiridou A, O’Reardon JP. Transcranial magnetic stimulation in the treatment of psychiatric disorders.  Curr Psychiatry Rep. 2009;  11 447-452
  • 2 Stanford AD, Sharif Z, Corcoran C. et al . rTMS strategies for the study and treatment of schizophrenia: a review.  Int J Neuropsychopharmacol. 2008;  11 563-576
  • 3 Andoh J, Martinot JL. Interhemispheric compensation: a hypothesis of TMS-induced effects on language-related areas.  Eur Psychiatry. 2008;  23 281-288
  • 4 Hugdahl K. “Hearing voices”: auditory hallucinations as failure of top-down control of bottom-up perceptual processes.  Scand J Psychol. 2009;  50 553-560
  • 5 Hugdahl K, Loberg EM, Nygard M. Left temporal lobe structural and functional abnormality underlying auditory hallucinations in schizophrenia.  Front Neurosci. 2009;  3 34-45
  • 6 Chibbaro G, Daniele M, Alagona G. et al . Repetitive transcranial magnetic stimulation in schizophrenic patients reporting auditory hallucinations.  Neurosci Lett. 2005;  383 54-57
  • 7 Driesen NR, Leung HC, Calhoun VD. et al . Impairment of working memory maintenance and response in schizophrenia: functional magnetic resonance imaging evidence.  Biol Psychiatry. 2008;  64 1026-1034
  • 8 Hoffman RE, Gueorguieva R, Hawkins KA. et al . Temporoparietal transcranial magnetic stimulation for auditory hallucinations: safety, efficacy and moderators in a fifty patient sample.  Biol Psychiatry. 2005;  58 97-104
  • 9 Fitzgerald PB, Benitez J, Daskalakis JZ. et al . A double-blind sham-controlled trial of repetitive transcranial magnetic stimulation in the treatment of refractory auditory hallucinations.  J Clin Psychopharmacol. 2005;  25 358-362
  • 10 Coulson S, Lovett C. Handedness, hemispheric asymmetries, and joke comprehension.  Brain Res Cogn Brain Res. 2004;  19 275-288
  • 11 Shimizu A, Endo M, Yamaguchi N. et al . Hand preference in schizophrenics and handedness conversion in their childhood.  Acta Psychiatr Scand. 1985;  72 259-265
  • 12 Rossi S, Hallett M, Rossini PM. et al . Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research.  Clin Neurophysiol. 2009;  120 2008-2039
  • 13 Kay SR, Opler LA, Lindenmayer JP. The positive and negative syndrome scale (PANSS): rationale and standardisation.  Br J Psychiatry Suppl. 1989;  59-67

Correspondence

Prof. Dr. med. W. Sperling

Department of Psychiatry and Psychotherapy

Friedrich-Alexander-University of Erlangen-Nuremberg

Schwabachanlage 6–10

91054 Erlangen

Germany

Phone: +49/9131/85 46194

Fax: +49/9131/853 4105

Email: wolfgang.sperling@uk-erlangen.de