%0 Journal Article
%T Transcranial Magnetic Stimulation for the Treatment of Pharmacoresistant Nondelusional Auditory Verbal Hallucinations in Dementia
%A Anna Marras
%A Stefano Pallanti
%J Case Reports in Psychiatry
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/930304
%X Auditory verbal hallucinations (AVHs) are known as a core symptom of schizophrenia, but also occur in a number of other conditions, not least in neurodegenerative disorders such as dementia. In the last decades, Transcranial Magnetic Stimulation (TMS) emerged as a valuable therapeutic approach towards several neurological and psychiatric diseases, including AVHs. Herein we report a case of a seventy-six-years-old woman with vascular-degenerative brain disease, complaining of threatening AVHs. The patient was treated with a high-frequency temporoparietal (T3P3) rTMS protocol for fifteen days. A considerable reduction of AVHs in frequency and content (no more threatening) was observed. Although further research is needed, this seems an encouraging result. 1. Introduction Transcranial Magnetic Stimulation (TMS) is a noninvasive technique of neuromodulation and neurostimulation based on the principle of electromagnetic induction of an electric field in the brain. It was originally developed for the of study brain function [1]. Since Barker and colleagues first demonstrated TMS, it has been widely used earlier to investigate motor conduction and control, later in the study of cognitive functions and brain plasticity. TMS is widely studied in the diagnosis and treatment of neurological and psychiatric diseases, too. A hallucination is often referred to as ¡°a sensory experience, which occurs in the absence of corresponding external stimulation of the relevant sensory organ, has a sufficient sense of reality to resemble a veridical perception, over which the subject does not feel s/he has direct and voluntary control and which occurs in the awake state¡± [2]. Auditory verbal hallucinations (AVHs) are defined as perceptions of speech without actual auditory stimulation and represent one of the most common hallucinatory experience, which are a characteristic symptom of schizophrenia [3] but also occur in a wealth of conditions, both neurological/neurodegenerative (e.g., epilepsy, Alzheimer¡¯s disease, Parkinson¡¯s disease, dementia, and hearing impairment) or psychiatric (e.g., dissociative disorders, mood disorders, and borderline personality disorder). 2. TMS and Auditory Hallucinations Hoffman and colleagues [4] published the first report demonstrating a reduction in auditory verbal hallucinations (AVHs) after a low-frequency (1£¿Hz) rTMS treatment to the posterior superior temporal gyrus (STG). This brain area and, overall, the temporoparietal cortex (TPC) are involved in speech perception [5, 6] and are active during auditory hallucinations [7¨C9]. After the
%U http://www.hindawi.com/journals/crips/2013/930304/