Aleman, A., Sommer, I. E. & Kahn, R. S. Efficacy of slow repetitive transcranial magnetic stimulation in the treatment of resistant auditory hallucinations in schizophrenia: a meta-analysis. J. Clin. Psychiatry 63, 416-421
BCN Neuroimaging Center, University Medical Center Groningen, University of Groningen, the Netherlands. The Journal of Clinical Psychiatry
(Impact Factor: 5.5).
04/2007; 68(3):416-21. DOI: 10.4088/JCP.v68n0310
Slow repetitive transcranial magnetic stimulation (rTMS), at a frequency of 1 Hz, has been proposed as a treatment for auditory hallucinations. Several studies have now been reported regarding the efficacy of TMS treatment, but results were inconsistent. Therefore, meta-analytic integration of the published trials is needed to evaluate the prospects of this new treatment.
A literature search was conducted using PubMed and Web of Science for the years 1966 until February 2006. We used the search terms transcranial magnetic stimulation, TMS, rTMS, and hallucination*.
From 15 treatment studies published since 1999, ten were sham-controlled trials and provided sufficient valid information to be included. All studies targeted the left tem-poroparietal cortex using 1 Hz rTMS.
Standardized mean gain effect sizes of real rTMS versus sham rTMS were computed based on pretreatment-posttreatment comparisons (computed from mean and SD values or t or F statistics).
After calculation of treatment gain on hallucination ratings using standardized mean differences (sham vs. active rTMS), a mean weighted effect size was computed in the random effects model. We observed a significant mean weighted effect size for rTMS versus sham across the 10 studies, involving 212 patients, d = 0.76 (95% CI = 0.36 to 1.17). When only studies were included that used continuous stimulation (9 studies), the mean effect size increased to d = 0.88 and heterogeneity disappeared. There was no significant effect of rTMS on a composite index of general psychotic symptoms.
The results of this meta-analysis provide evidence for the efficacy of rTMS as an intervention that selectively alters neurobiologic factors underlying auditory hallucinations.
Available from: PubMed Central
- "tions yet ) that this is indeed a promising strategy . Three meta - analyses—one on the effects of TMS in diminishing auditory hallucinations and two on the TMS use for treating negative symptoms—support that TMS is a valuable intervention for treating schizophrenia symptoms ( Aleman et al . , 2007 ; Freitas et al . , 2009 ; Shi et al . , 2014 ) . Aleman et al . ( 2007 ) have found substantial evidence for the applicability of TMS for the treatment of auditory hallucinations in schizophrenia but no significant effect on a general index of psychotic symptoms after reviewing 10 studies . Nonetheless , Freitas et al . ( 2009 ) and Shi et al . ( 2014 ) have found significant effects of TMS on decreasing n"
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ABSTRACT: Being socially connected directly impacts our basic needs and survival. People with deficits in social cognition might exhibit abnormal behaviors and face many challenges in our highly social-dependent world. These challenges and limitations are associated with a substantial economical and subjective impact. As many conditions where social cognition is affected are highly prevalent, more treatments have to be developed. Based on recent research, we review studies where non-invasive neuromodulatory techniques have been used to promote Social Plasticity in developmental disorders. We focused on three populations where non-invasive brain stimulation seems to be a promising approach in inducing social plasticity: Schizophrenia, Autism Spectrum Disorder (ASD) and Williams Syndrome (WS). There are still very few studies directly evaluating the effects of transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS) in the social cognition of these populations. However, when considering the promising preliminary evidences presented in this review and the limited amount of clinical interventions available for treating social cognition deficits in these populations today, it is clear that the social neuroscientist arsenal may profit from non-invasive brain stimulation techniques for rehabilitation and promotion of social plasticity.
Frontiers in Neuroscience 09/2015; 9. DOI:10.3389/fnins.2015.00294 · 3.66 Impact Factor
- "A meta-analysis of 15 studies from 1999 to 2006 of yet another method for unilateral activation employs slow repetitive regional transcranial magnetic stimulation (rTMS) over the left temporoparietal cortex. When compared to sham treatment for resistant auditory hallucinations in schizophrenics, the data " provides evidence for the efficacy of rTMS as an intervention that selectively alters neurobiologic factors underlying auditory hallucinations " (Aleman et al., 2007). Here we report on one schizophrenic female (Ms. "
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ABSTRACT: Nasal dominance, at the onset of hallucinations, was studied as a marker of both the lateralized ultradian rhythm of the autonomic nervous system and the tightly coupled ultradian rhythm of alternating cerebral hemispheric dominance in a single case study of a schizophrenic female. Over 1086 days, 145 hallucination episodes occurred with left nostril dominance significantly greater than the right nostril dominant phase of the nasal cycle. A right nostril breathing exercise, that primarily stimulates the left hemisphere, reduces symptoms more quickly for hallucinations.
Psychiatry Research 01/2015; 226(1). DOI:10.1016/j.psychres.2014.12.065 · 2.47 Impact Factor
Available from: V. J. Carr
- "Social skills training improves social interactions (Pfammatter et al. 2006; Kurtz & Mueser, 2008) Medium effect sizes a Symptoms and relapse Antipsychotics improve overall symptoms and reduce relapse rates more than placebo (Mota et al. 2002; Duggan et al. 2005; Irving et al. 2006; Adams et al. 2007; Nussbaum & Stroup, 2008; Rattehalli et al. 2010; Belgamwar & El-Sayeh, 2011; Leucht et al. 2012a, b) Second-generation antipsychotics (particularly risperidone or olanzapine in various doses) have less extrapyramidal side effects than first-generation antipsychotics (particularly haloperidol in various doses) in patients with first-episode psychosis (Crossley et al. 2010) Adjunctive rTMS applied at low frequency (1 Hz) via continuous stimulation to the left temporoparietal cortex reduces auditory hallucinations in the short term (Aleman et al. 2007; Demeulemeester et al. 2012; Slotema et al. 2012), adjusting for inadequate sham conditions and possible publication bias (Demeulemeester et al. 2012). Adjunctive rTMS given at high frequency (10 to 20 Hz) applied to the left dorsolateral prefrontal cortex reduces negative symptoms in the short term compared with sham (Dlabac-de Lange et al. 2010) Adjunctive oestrogen improves positive and negative symptoms in female patients compared with placebo (Begemann et al. 2012) Adjunctive Ginkgo biloba reduces positive symptoms, particularly in patients taking first-generation antipsychotics (Singh et al. 2010a) Cognitive behavioural therapy reduces symptoms, particularly positive symptoms over the long term compared with standard care (Pfammatter et al. 2006; Bird et al. 2010) and may be more effective over the long term than other psychosocial treatments (Sarin et al. 2011; Jones et al. 2012) Adjunctive antidepressants improve negative symptoms (Singh et al. 2010b) Psychoeducation reduces relapse rates (Pfammatter et al. 2006) Other outcomes Intensive case management increases treatment adherence and independent living (Dieterich et al. 2010) Cognitive remediation improves attention, memory, executive functioning, cognitive flexibility, processing speed, social cognition, social functioning and problem solving (McGurk et al. 2007) Integrated psychological therapy improves cognitive and global functioning (Roder et al. 2011) Vocational rehabilitation improves competitive employment (Crowther et al. 2001) Psychoeducation reduces levels of familial expressed emotion, and improves treatment adherence (Pfammatter et al. 2006; Xia et al. 2011) Small effect sizes a Symptoms and relapse Symptoms are reduced with adjunctive lithium (Leucht et al. 2007a), NMDA receptor modulators (when not adjunctive to clozapine) (Singh & Singh, 2011) and electroconvulsive therapy (Tharyan & Adams, 2005) "
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ABSTRACT: Background. True findings about schizophrenia remain elusive; many findings are not replicated and conflicting results are common. Well-conducted systematic reviews have the ability to make robust, generalizable conclusions, with good meta-analyses potentially providing the closest estimate of the true effect size. In this paper, we undertake a systematic approach to synthesising the available evidence from well-conducted systematic reviews on schizophrenia.
Method. Reviews were identified by searching Medline, EMBASE, CINAHL, Current Contents and PsycINFO. The decision to include or exclude reviews, data extraction and quality assessments were conducted in duplicate. Evidence was graded as high quality if reviews contained large samples and robust results; and as moderate quality if reviews contained imprecision, inconsistency, smaller samples or study designs that may be prone to bias.
Results. High- and moderate-quality evidence shows that numerous psychosocial and biomedical treatments are effective. Patients have relatively poor cognitive functioning, and subtle, but diverse, structural brain alterations, altered electrophysiological functioning and sleep patterns, minor physical anomalies, neurological soft signs, and sensory alterations. There are markers of infection, inflammation or altered immunological parameters; and there is increased mortality from a range of causes. Risk for schizophrenia is increased with cannabis use, pregnancy and birth complications, prenatal exposure to Toxoplasma gondii, childhood central nervous system viral infections, childhood adversities, urbanicity and immigration (first and second generation), particularly in certain ethnic groups. Developmental motor delays and lower intelligence quotient in childhood and adolescence are apparent.
Conclusions. We conclude that while our knowledge of schizophrenia is very substantial, our understanding of it remains limited.
Psychological Medicine 02/2014; 44(16). DOI:10.1017/S0033291714000166 · 5.94 Impact Factor
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