A case of post-traumatic complex auditory hallucinosis treated with rTMS

Cosentino, Giuseppe; Giglia, Giuseppe; Palermo, Antonio; Panetta, Maristella; Baido, Rosa Lo; Brighina, Filippo; Fierro, Brigida

doi:10.1080/13554790903456191

Cited by 30 publications

(23 citation statements)

References 26 publications

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“…The MH disappeared after 2 weeks, only to reappear after 4 months; although by that time they were less intense, and only present in a quiet environment and before falling asleep (Cosentino et al, 2010). …”

Section: Resultsmentioning

confidence: 99%

“…It tends to consist of antiepileptics, antidepressants, antipsychotics or acetylcholinesterase inhibitors, but even when treated for a sufficient amount of time and at adequate plasma levels, MH can be refractory to most of these treatments (Sacks and Blom, 2012). Repetitive transcranial magnetic stimulation (rTMS) may perhaps be a viable option in the near future, but so far it only showed a favorable response in a single medication-resistant patient with post-traumatic damage to the right temporal lobe (Cosentino et al, 2010). …”

Section: Introductionmentioning

confidence: 99%

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Musical hallucinations: review of treatment effects

et al. 2015

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Background: Despite an increased scientific interest in musical hallucinations over the past 25 years, treatment protocols are still lacking. This may well be due to the fact that musical hallucinations have multiple causes, and that published cases are relatively rare.Objective: To review the effects of published treatment methods for musical hallucinations.Methods: A literature search yielded 175 articles discussing a total number of 516 cases, of which 147 articles discussed treatment in 276 individuals. We analyzed the treatment results in relation to the etiological factor considered responsible for the mediation of the musical hallucinations, i.e., idiopathic/hypoacusis, psychiatric disorder, brain lesion, and other pathology, epilepsy or intoxication/pharmacology.Results: Musical hallucinations can disappear without intervention. When hallucinations are bearable, patients can be reassured without any other treatment. However, in other patients musical hallucinations are so disturbing that treatment is indicated. Distinct etiological groups appear to respond differently to treatment. In the hypoacusis group, treating the hearing impairment can yield significant improvement and coping strategies (e.g., more acoustic stimulation) are frequently helpful. Pharmacological treatment methods can also be successful, with antidepressants being possibly more helpful than antiepileptics (which are still better than antipsychotics). The limited use of acetylcholinesterase inhibitors has looked promising. Musical hallucinations occurring as part of a psychiatric disorder tend to respond well to psychopharmacological treatments targeting the underlying disorder. Musical hallucinations experienced in the context of brain injuries and epilepsy tend to respond well to antiepileptics, but their natural course is often benign, irrespective of any pharmacological treatment. When intoxication/pharmacology is the main etiological factor, it is important to stop or switch the causative substance or medication.Conclusion: Treatments for musical hallucinations tend to yield favorable results when they target the main etiological factor of these phenomena. There is a need to establish the natural course of musical hallucinations, their response to non-pharmacological treatments, and their effects on the patient's quality of life. There is also a need to standardize the assessment of treatment responses, and document long-term follow up.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Musical hallucinations: review of treatment effects

et al. 2015

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“…Recently, García-Toro et al reported clinical benefit of transcranial magnetic stimulation (rTMS) for patients with auditory hallucinations and tinnitus 57 and Cosentino et al reported one case of post-traumatic complex auditory hallucination treated with rTMS 58 .…”

Section: Treatmentmentioning

confidence: 99%

Musical hallucination associated with hearing loss

Sánchez

Rocha

Knobel

et al. 2011

Arq. Neuro-Psiquiatr.

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In spite of the fact that musical hallucination have a significant impact on patients' lives, they have received very little attention of experts. Some researchers agree on a combination of peripheral and central dysfunctions as the mechanism that causes hallucination. The most accepted physiopathology of musical hallucination associated to hearing loss (caused by cochlear lesion, cochlear nerve lesion or by interruption of mesencephalon or pontine auditory information) is the disinhibition of auditory memory circuits due to sensory deprivation. Concerning the cortical area involved in musical hallucination, there is evidence that the excitatory mechanism of the superior temporal gyrus, as in epilepsies, is responsible for musical hallucination. In musical release hallucination there is also activation of the auditory association cortex. Finally, considering the laterality, functional studies with musical perception and imagery in normal individuals showed that songs with words cause bilateral temporal activation and melodies activate only the right lobe. The effect of hearing aids on the improvement of musical hallucination as a result of the hearing loss improvement is well documented. It happens because auditory hallucination may be influenced by the external acoustical environment. Neuroleptics, antidepressants and anticonvulsants have been used in the treatment of musical hallucination. Cases of improvement with the administration of carbamazepine, meclobemide and donepezil were reported, but the results obtained were not consistent. Key words: musical hallucination, auditory hallucination, hearning loss, deafness.Alucinações musicais associadas a perda auditiva RESUMO Apesar das alucinações musicais causarem grandes repercussões na vida dos pacientes, sempre foram pouco valorizadas e estudadas pelos profissionais. Alguns investigadores sugerem uma combinação de disfunções periféricas e centrais como o mecanismo causador das alucinações. A fisiopatologia mais aceita entre os pesquisadores de alucinação musical associada à hipoacusia ou anacusia (causada por lesão coclear, de nervo coclear ou interrupção de informação na ponte ou mesencéfalo) é a desibinição de circuitos de memória auditiva devido à deprivação sensorial. Em relação às áreas corticais envolvidas na alucinação musical, há evidência de que um mecanismo excitatório no córtex temporal superior, como nas epilepsias, seja responsável pela alucinação musical. Finalmente, considerando a lateralidade, estudos funcionais de percepção e imagética em indivíduos normais mostraram que canções com letras levam a ativação temporal bilateral e melodias ativam apenas o lobo temporal direito. É bem documentado o efeito de aparelhos auditivos na alucinação musical através de uma melhora da perda auditiva.

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“…15 Stimulation parameters in this case were 110% of MT using 20 Hz and train duration of 2 seconds. In contrast, 2 recent case reports reported good tolerability of rTMS in patients with depression 18 and auditory hallucinations 19 after TBI. A recent review pointed out the promising potential of rTMS as a diagnostic and therapeutic tool, which should further be evaluated in TBI patients.…”

Section: Tms and Seizure Risk In Tbi Patientsmentioning

confidence: 86%

“…Also in TBIassociated depression 18 and hallucinations, 19 relatively pronounced clinical effects have been reported. These promising results, however, may be confounded by reporting bias because all data arise from case reports.…”

Section: Efficacy Of Rtms In Tbi Patientsmentioning

confidence: 98%

Repetitive Transcranial Magnetic Stimulation for the Treatment of Chronic Tinnitus After Traumatic Brain Injury

Kreuzer

Landgrebe²,

Frank³

et al. 2013

Journal of Head Trauma Rehabilitation

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Tinnitus is a frequent symptom of traumatic brain injury, which is difficult to treat. Repetitive transcranial magnetic stimulation has shown beneficial effects in some forms of tinnitus. However, traumatic brain injury in the past has been considered as a relative contraindication for repetitive transcranial magnetic stimulation because of the increased risk of seizures. Here we present the case of a 53-year-old male patient suffering from severe tinnitus after traumatic brain injury with comorbid depression and alcohol abuse, who received 5 treatment series of repetitive transcranial magnetic stimulation (1 Hz stimulation protocol over left primary auditory cortex, 10 sessions of 2000 stimuli each, stimulation intensity 110% resting motor threshold). Repetitive transcranial magnetic stimulation was tolerated without any side effects and tinnitus complaints (measured by a validated tinnitus questionnaire and numeric rating scales) were improved in a replicable way throughout 5 courses of transcranial magnetic stimulation up to now.

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A case of post-traumatic complex auditory hallucinosis treated with rTMS

Cited by 30 publications

References 26 publications

Musical hallucinations: review of treatment effects

Musical hallucinations: review of treatment effects

Musical hallucination associated with hearing loss

Repetitive Transcranial Magnetic Stimulation for the Treatment of Chronic Tinnitus After Traumatic Brain Injury

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