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First clinical studies indicate an effect of repetitive transcranial magnetic stimulation(rTMS) in the treatment of auditory hallucinations (AH). However, effect size, optimal stimulation site and parameters are unclear. With this randomized, placebo-controlled clinical trial we test the efficacy and safety of bilateral continuous theta burst stimulation (cTBS), a patterned form rTMS, against auditory hallucinations. The treatment will be applied add-on to individual antipsychotic and behavioral therapy. Patients will be treated for 6 weeks each weekday (30 sessions) with 40s of cTBS (halfway between T3/P3 and T4/P4). For weeks 1-3, half of the subjects will be randomized to a sham-stimulation (coil tilted 45°). During weeks 4-6, all subjects receive real cTBS.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| cTBS | Experimental |
| |
| Sham cTBS | Sham Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| continuous theta burst stimulation (cTBS) | Procedure | bilateral continuous theta burst stimulation (bursts of 3 stimuli, 50Hz every 200ms for 40s, 80% active motor threshold) to the temporoparietal cortex (EEG 10/20: halfway T3/P3 and T4/P4) |
| Measure | Description | Time Frame |
|---|---|---|
| Psychotic Symptom Rating Scales (PSYRATS), subscale for auditory hallucinations | Change of PSYRATS AH score compared to baseline after 3 weeks of treatment | 3 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Hallucination change score (HCS) | 3 and 6 weeks | |
| Positive and Negative Symptom Scale (PANSS) | 3 and 6 weeks | |
| PSYRATS subscale for auditory hallucinations |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Christian Plewnia, MD | Universtity of Tuebingen | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Tübingen, Department of Psychiatry and Psychotherapy | Tübingen | Germany |
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| ID | Term |
|---|---|
| D006212 | Hallucinations |
| ID | Term |
|---|---|
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
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| sham cTBS | Procedure | bilateral continuous theta burst stimulation (bursts of 3 stimuli, 50Hz every 200ms for 40s, 80% active motor threshold) to the temporoparietal cortex (EEG 10/20: halfway T3/P3 and T4/P4) with the stimulation coil tilted 45° |
|
Change of PSYRATS AH score compared to baseline after 6 weeks of treatment |
| 6 weeks |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |