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Randomized Controlled Trial
. 2018 Jun:51:25-33.
doi: 10.1016/j.eurpsy.2018.01.004. Epub 2018 Mar 11.

Randomized trial of transcranial alternating current stimulation for treatment of auditory hallucinations in schizophrenia

Juliann M Mellin  1 , Sankaraleengam Alagapan  1 , Caroline Lustenberger  1 , Courtney E Lugo  1 , Morgan L Alexander  1 , John H Gilmore  1 , L Fredrik Jarskog  1 , Flavio Fröhlich  2
Affiliations
Randomized Controlled Trial

Randomized trial of transcranial alternating current stimulation for treatment of auditory hallucinations in schizophrenia

Juliann M Mellin et al. Eur Psychiatry. 2018 Jun.

Abstract

Background: Approximately 30% of patients with schizophrenia experience auditory hallucinations that are refractory to antipsychotic medications. Here, we evaluated the feasibility and efficacy of transcranial alternating current stimulation (tACS) that we hypothesized would improve auditory hallucination symptoms by enhancing synchronization between the frontal and temporo-parietal areas of the left hemisphere.

Method: 22 participants were randomized to one of three arms and received twice daily, 20 min sessions of sham, 10 Hz 2 mA peak-to-peak tACS, or 2 mA tDCS over the course of 5 consecutive days. Symptom improvement was assessed using the Auditory Hallucination Rating Scale (AHRS) as the primary outcome measure. The Positive and Negative Syndrome Scale (PANSS) and the Brief Assessment of Cognition in Schizophrenia (BACS) were secondary outcomes.

Results: Primary and secondary behavioral outcomes were not significantly different between the three arms. However, effect size analyses show that tACS had the greatest effect based on the auditory hallucinations scale for the week of stimulation (1.31 for tACS; 1.06 and 0.17, for sham and tDCS, respectively). Effect size analysis for the secondary outcomes revealed heterogeneous results across measures and stimulation conditions.

Conclusions: To our knowledge, this is the first clinical trial of tACS for the treatment of symptoms of a psychiatric condition. Further studies with larger sample sizes are needed to better understand the effect of tACS on auditory hallucinations.

Keywords: Auditory hallucinations; Schizophrenia; Transcranial alternating current stimulation.

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Conflict of interest statement

Disclosure of interest

Flavio Frohlich is the lead inventor of an IP filed by UNC. The clinical studies performed in the Frohlich Lab have received a designation as conflict of interest with administrative considerations. Flavio Frohlich is the founder, CSO and majority owner of Pulvinar Neuro LLC. No devices from Pulvinar Neuro LLC were used and Pulvinar Neuro LLC played no role in this study.

Figures

Figure 1
Figure 1
A Symbolic representation of tACS (left) and tDCS (right) stimulation waveforms. B Location of electrodes on scalp. C Electric field simulation: 2D (top) and 3D (bottom) representation. Two stimulators were used, one connected to the electrode located over F3/Fp1, one connected to the electrode over T3/P3 and both connected to the Cz electrode.
Figure 2
Figure 2
Normalized AHRS scores for tACS, tDCS and sham groups at baseline (before first stimulation), Day 5 (after the last stimulation), at the one week follow up (F1), and at the one month follow up (F2).
Figure 3
Figure 3
Change in Auditory Hallucination Rating Scale (AHRS) score for each participant in transcranial alternating current stimulation (tACS) arm, transcranial direct current stimulation (tDCS) arm, or sham arm. AHRS scores were collected at baseline (before first stimulation), after stimulation (after last stimulation, at the one week follow up (F1), and the one month follow up (F2).
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References

    1. Shergill SS, Murray RM, McGuire PK. Auditory hallucinations: a review of psychological treatments. Schizophr Res. 1998;32(3):137–50. - PubMed
    1. Cole JC, Green Bernacki C, Helmer A, Pinninti N, O'Reardon JP. Efficacy of Transcranial Magnetic Stimulation (TMS) in the Treatment of Schizophrenia: A Review of the Literature to Date. Innov Clin Neurosci. 2015;12(7–8):12–9. - PMC - PubMed
    1. Philip NS, Nelson BG, Frohlich F, Lim KO, Widge AS, Carpenter LL. Low-Intensity Transcranial Current Stimulation in Psychiatry. Am J Psychiatry. 2017 appiajp201716090996. - PMC - PubMed
    1. Brunelin J, Mondino M, Gassab L, Haesebaert F, Gaha L, Suaud-Chagny MF, et al. Examining transcranial direct-current stimulation (tDCS) as a treatment for hallucinations in schizophrenia. Am J Psychiatry. 2012;169(7):719–24. - PubMed
    1. Frohlich F, Burrello TN, Mellin JM, Cordle AL, Lustenberger CM, Gilmore JH, et al. Exploratory study of once-daily transcranial direct current stimulation (tDCS) as a treatment for auditory hallucinations in schizophrenia. Eur Psychiatry. 2016;33:54–60. - PubMed

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