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P0317 - Stereotactic neuronavigation of rTMS in the treatment of auditory hallucinations: A pilot study

Published online by Cambridge University Press:  16 April 2020

M. Klirova ,
J. Horacek ,
T. Novak ,
J. Cermak ,
M. Brunovsky  and
J. Tintera
M. Klirova
Affiliation:
Prague Psychiatric Centre, Prague, Czech Republic Centre of Neuropsychiatric Studies, Prague, Czech Republic 3rd Medical Faculty of Charles University, Prague, Czech Republic
J. Horacek
Affiliation:
Prague Psychiatric Centre, Prague, Czech Republic Centre of Neuropsychiatric Studies, Prague, Czech Republic 3rd Medical Faculty of Charles University, Prague, Czech Republic
T. Novak
Affiliation:
Prague Psychiatric Centre, Prague, Czech Republic Centre of Neuropsychiatric Studies, Prague, Czech Republic 3rd Medical Faculty of Charles University, Prague, Czech Republic
J. Cermak
Affiliation:
Prague Psychiatric Centre, Prague, Czech Republic Centre of Neuropsychiatric Studies, Prague, Czech Republic 3rd Medical Faculty of Charles University, Prague, Czech Republic
M. Brunovsky
Affiliation:
Prague Psychiatric Centre, Prague, Czech Republic Centre of Neuropsychiatric Studies, Prague, Czech Republic 3rd Medical Faculty of Charles University, Prague, Czech Republic
J. Tintera
Affiliation:
Centre of Neuropsychiatric Studies, Prague, Czech Republic

Abstract

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Objectives:

It was repeatedly reported that low frequency rTMS diminishes treatment-resistant auditory hallucinations. The main drawback to rTMS in general, so far has been the impossibility of precise targeting of the rTMS coil at the given cortical area. Stereotactic neuronavigation is a unique technology utilising the ability of aiming the coil with a high degree of anatomic accuracy based on an evaluation of the structural or functional neuroimaging of the brain.

Aim:

To prove the clinical effect of using rTMS neuronavigation in the therapy of treatment-resistant auditory hallucinations

Methods:

Seventeen schizophrenic patients with predominantly symptoms of treatment-resistant auditory hallucinations were treated.

Using double-blind sham-controlled parallel design, we evaluated the effect rTMS neuronavigation focused over the left temporo-parietal area, direct to the place with the highest metabolic activity (SPM II analysed PET contrast).

Parameter settings were: 0.9Hz, MT 100%, 1080 puses/session, 10 sessions, duration: 20 minutes per session.

Clinical effect was assessed using PANNS, AHRS and HCS.

Results:

We found a significant improvement in the total on scales of HCS and AHRS, representing more than 30% reduction of the symptoms after neuronavigated rTMS. Sham rTMS did not showed a trend for improvement over time. No side effects during rTMS were observed.

Conlusions:

Our study shows the acute effect of rTMS neuronavigation in the therapy of auditory hallucinations in schizophrenia. We believe that using neuronavigation and respecting an individual brain parameters and metabolic changes, we can evaluate higher efficiency of the rTMS method.

Supported by CNS, MZČR MZ0PCP2005 and MŠMT 1M0517

Type
Poster Session II: ECT/ TMS
Information
European Psychiatry , Volume 23 , Issue S2: 16th AEP Congress - Abstract book - 16th AEP Congress , April 2008 , pp. S285
Copyright
Copyright © European Psychiatric Association 2008
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