Evaluation of the therapeutic effect of theta burst stimulation on drug-resistant auditory hallucinations in a schizophrenic patient and its impact on cognitive function and neuronal excitability: A case study

Sidhoumi, D.; Braha, S.; Bouaziz, Noomane; Benadhira, René; Januel, Dominique

doi:10.1016/j.clinph.2009.12.033

Cited by 27 publications

(14 citation statements)

References 8 publications

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“…In one study on eight treatment-refractory schizophrenia patients, intermittent TBS (iTBS) applied to the cerebellum resulted in an improvement in cognitive symptoms (Demirtas-Tatlidede et al, 2010), while another study showed that continuous TBS (cTBS) was not inferior to classic low-frequency TBS in reducing auditory hallucinations (Kindler et al, 2013). Moreover, single case studies indicate that cTBS applied to the temporal cortex might be a promising intervention for treatment-refractory auditory hallucinations (Eberle et al, 2010;Rachid et al, 2013;Sidhoumi et al, 2010). Investigations in healthy subjects have improved our understanding of TBS physiology and it has been suggested that the efficacy of TBS is dependent on the stimulation pattern, the activity of NMDA receptors (Huang et al, 2007;Wankerl et al, 2010), calcium homeostasis (Wankerl et al, 2010), the balance between inhibitory and facilitatory interneuronal networks (Huang et al, 2005), ongoing neural activity and metaplastic processes (Gentner et al, 2008;Hasan et al, 2011a), and on the recruitment of early and late cortical indirect waves (Hamada et al, 2013).…”

Section: Introductionmentioning

confidence: 97%

Investigations of motor-cortex cortical plasticity following facilitatory and inhibitory transcranial theta-burst stimulation in schizophrenia: A proof-of-concept study

Hasan

Brinkmann

Strube

et al. 2015

Journal of Psychiatric Research

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Section: Introductionmentioning

confidence: 97%

Investigations of motor-cortex cortical plasticity following facilitatory and inhibitory transcranial theta-burst stimulation in schizophrenia: A proof-of-concept study

Hasan

Brinkmann

Strube

et al. 2015

Journal of Psychiatric Research

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“…Theta burst stimulation (TBS) is a relatively new rTMS protocol that modulates activity in the underlying region in a shorter period of time, enabling more potent and longer-lasting post stimulation effects compared with standard rTMS (Huang et al, 2005; Stefan et al, 2008). Consecutive sessions of TBS have been employed safely and with promising clinical efficacy in schizophrenia (Bor et al, 2009; Sidhoumi et al, 2010), levodopa induced dyskinesias (Koch et al, 2009), spasticity (Mori et al, 2010) and depression (Chistyakov et al, 2010). Notably, ten sessions of standard TBS to lateral cerebellar hemispheres have led to improvement in levodopa-induced dyskinesias, highlighting the capability of TBS to augment long lasting plasticity via modulation of the cerebello-thalamo-cortical circuits (Koch et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Safety and proof of principle study of cerebellar vermal theta burst stimulation in refractory schizophrenia

Demirtaş-Tatlıdede¹,

Freitas²,

Cromer³

et al. 2010

Schizophrenia Research

157

110

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BACKGROUND Early invasive electrical stimulation studies suggested that enhancement of cerebellar vermal activity might prove valuable in symptomatic treatment of refractory neuropsychiatric diseases via modulation of emotion and affect. This proof of principle study aimed to test this hypothesis using noninvasive brain stimulation, and to explore the safety of this protocol in schizophrenia. METHODS Eight treatment-refractory patients with schizophrenia underwent ten sessions of intermittent theta burst stimulation (TBS) to the cerebellar vermis using MRI-guided transcranial magnetic stimulation (TMS). Assessments included side effect questionnaires, cardiovascular monitoring, psychiatric evaluations and comprehensive neuropsychological testing before and after TBS and at one-week follow-up. RESULTS Overall, TBS was tolerated well with mild side effects primarily comprising neck pain and headache. No serious adverse events occurred. Diastolic blood pressure (BP) showed mild decreases for five minutes post-TBS; no significant changes were detected for systolic BP or pulse. PANSS negative subscale showed significant improvements following TBS and during the follow-up. Calgary Depression Scale and self-report visual analog scales for Happiness and Sadness pointed to significant mood elevation. Neuropsychological testing revealed significantly fewer omissions in working memory and interference conditions of a Continuous Performance Test, a longer spatial span and better delay organization on the Rey-Osterrieth Complex Figure during follow-up. No significant worsening in psychiatric or neuropsychological measures was detected. CONCLUSIONS Theta burst stimulation of the cerebellar vermis is safe and well-tolerated, while offering the potential to modulate affect, emotion and cognition in schizophrenia. Future randomized, sham-stimulation controlled studies are warranted to support the clinical efficacy of this technique.

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“…The results of one case study indicate that iTBS, applied to the left prefrontal cortex, might be a promising avenue of treatment in schizophrenia, too [71]. LTD -inducing cTBS was used in two different case studies for the treatment of treatment resistant -auditory hallucinations [72,73]. One patient was treated for four weeks (five sessions per week) with cTBS applied over the left temporoparietal cortex and one patient received a bilateral cTBS stimulation over the right and left temporoparietal cortex for nine weeks (five sessions per week).…”

Section: Novel Stimulation Protocolsmentioning

confidence: 99%

Innovative Treatment Approaches in Schizophrenia Enhancing Neuroplasticity: Aerobic Exercise, Erythropoetin and Repetitive Transcranial Magnetic Stimulation

Wobrock¹,

Hasan²,

Falkai³

2012

CPB

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Schizophrenia is a brain disorder associated with subtle, but replicable cerebral volume loss mostly prevalent in frontal and temporal brain regions. Post-mortem studies of the hippocampus point to a reduction of the neuropil constituting mainly of synapses associated with changes of molecules mediating plastic responses of neurons during development and learning. Derived from animal studies interventions to enhance neuroplasticity by inducing adult neurogenesis, synaptogenesis, angiogenesis and long-term potentiation (LTP) were developed and the results translated into clinical studies in schizophrenia. Out of these interventions aerobic exercise has been shown to increase hippocampal volume, elevate N-acetyl-aspartate in the hippocampus as neuronal marker, and improve short-term memory in schizophrenia. The hematopoietic growth factor erythropoetin (EPO) is involved in brain development and associated with the production and differentiation of neuronal precursor cells. A first study demonstrated a positive effect of EPO application on cognition in schizophrenia patients. In randomised controlled studies with small sample size, the efficacy of repetitive transcranial magnetic stimulation (rTMS), a biological intervention focussing on the enhancement of LTP, has been shown for the improvement of positive and negative symptoms in schizophrenia,. The putative underlying neurobiological mechanisms of these interventions including the role of neurotrophic factors are outlined and implications for future research regarding neuroprotection strategies to improve schizophrenia are discussed.

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Evaluation of the therapeutic effect of theta burst stimulation on drug-resistant auditory hallucinations in a schizophrenic patient and its impact on cognitive function and neuronal excitability: A case study

Cited by 27 publications

References 8 publications

Investigations of motor-cortex cortical plasticity following facilitatory and inhibitory transcranial theta-burst stimulation in schizophrenia: A proof-of-concept study

Investigations of motor-cortex cortical plasticity following facilitatory and inhibitory transcranial theta-burst stimulation in schizophrenia: A proof-of-concept study

Safety and proof of principle study of cerebellar vermal theta burst stimulation in refractory schizophrenia

Innovative Treatment Approaches in Schizophrenia Enhancing Neuroplasticity: Aerobic Exercise, Erythropoetin and Repetitive Transcranial Magnetic Stimulation

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