A Yale psychiatrist testing the use of magnetic stimulation to provide relief to schizophrenics who hear voices says increasing the duration of the stimulation produces longer periods of quiet in patients' minds.
"From 50% to 70% of patients with schizophrenia have auditory hallucinations," explains Dr. Ralph Hoffman, associate professor and assistant medical director of the Yale Psychiatric Institute. "In most cases they are very distressing and can interrupt and disrupt judgment and behavior. In a small fraction of these people, they can lead to pathological behavior, such as violence and suicide.
"The real challenge," he adds, "is to find something to help the 25% of patients with this symptom for whom medications don't have much effect."
Hoffman's research involves administering repetitive transcraneal magnetic stimulation (TMS) to the area of the brain involved with processing spoken speech.
The stimulation is intended to reduce the excitability of this area of the brain -- the left cerebral cortex, midway between the temporal and parietal region of the brain.
Early results show that TMS provides significant relief for some patients -- a minimum of 50% fewer episodes of auditory hallucinations. Twenty-five patients were administered TMS in the last two years and 70% to 80% experienced improvement, he says.
"The duration of improvement with the increased exposure is now three months and more," Hoffman says. "When we gave a much lesser amount in our first study, the duration of improvement ranged from one day to three weeks."
TMS is administered with a handheld electromagnetic coil held over the specified portion of the brain. The patients are awake at the time and report feeling a tingling in their scalp and sometimes a contraction of muscles in their scalp and face. "About 10% of the patients have reported some pain, but no one has ever decided not to have this because of the pain," Hoffman says.
TMS is based on perceptual testing and neuroimaging data that suggests auditory hallucinations arise from the pathological activation of the neurocircuitry responsible for speech processing and speech perception.
-- By Jacqueline Weaver
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