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Relevance of noninvasive transcranial electrical stimulation for patients with schizophrenia

Jerome Brunelin1*, Marine Mondino1 and Emmanuel Poulet1
  • 1 CH le vinatier, CH le Vinatier, Lyon 1 university, France

Auditory verbal hallucinations and negative symptoms are prominent and disabling features of schizophrenia. In 25%–30% of patients with schizophrenia, such symptoms are refractory to antipsychotic treatment and their physiopathology remains unclear. Our work aims at using noninvasive transcranial electrical stimulation such as transcranial direct current stimulation (tDCS), transcranial Alternating Current (tACS) or Random Noise (tRNS) stimulation to alleviate and characterize refractory symptoms in schizophrenia. First, we conducted randomized controlled trial and we reported that fronto-temporal tDCS may reduced auditory hallucinations and negative symptoms in patients with schizophrenia (Brunelin et al., 2012). In case-series studies, we reported that theta-tACS (Kallel et al., 2016) and tRNS (Haesebaert et al., 2014) may reduce refractory symptoms and enhance insight into the illness in patients. In another randomized study, we reported that the reduced severity of auditory hallucinations following a tDCS regimen was correlated with improved source-monitoring performances (Mondino et al., 2015), suggesting a link between auditory verbal hallucination, self-recognition and activity of the left fronto-temporal regions. Using functional magnetic resonance imaging, we observed that tDCS modulates the functional connectivity of the left temporo-parietal junction with a distributed network involved in auditory hallucinations, self-recognition and language processing (Mondino et al., 2016). We reported that the reduced severity of auditory hallucinations was correlated with reduced functional connectivity between the left temporo-parietal junction and the left insula. Finally, in a study in healthy volunteers, we observed that the inverse tDCS electrode montage used in patients led to source-monitoring deficits comparable to those observed in patients, suggesting that such processes were associated with activity of the left temporo-parietal junction (Mondino et al., submitted). The study of clinical, cognitive and neural effects of noninvasive transcranial electrical stimulation allows a better understanding of brain mechanisms involved in auditory hallucinations and negative symptoms and of the central role of the left temporo-parietal junction in auditory verbal hallucinations. These works will be discussed together in light of available literature, especially in terms of drug interaction (Brunelin et al., 2015), to pave the way for valuable alternative approaches to alleviate refractory symptoms in schizophrenia.

References

Brunelin J, Hasan A, Haesebaert F, Nitsche MA, Poulet E. Nicotine Smoking Prevents the Effects of Frontotemporal Transcranial Direct Current Stimulation (tDCS) in Hallucinating Patients With Schizophrenia. Brain Stimul, 2015;8(6):1225-7.
Brunelin J, Mondino M, Gassab L, Haesebaert F, Gaha L, Saoud M, Mechri A, Poulet E. Examining transcranial direct-current stimulation (tDCS) as a treatment for hallucinations in schizophrenia. Am J Psychiatry, 2012;169:719-724
Haesebaert F, Mondino M, Saoud M, Poulet E, Brunelin J. Efficacy and safety of fronto-temporal transcranial random noise stimulation (tRNS) in drug-free patients with schizophrenia: a case study. Schizophr Res, 2014;159(1): 251-2
Kallel L, Mondino M, Burnelin J. Effects of theta-rhythm transcranial Alternating Current Stimulation (4.5 Hz-tACS) in patients with clozapine-resistant negative symptoms of schizophrenia: a case series. Journal of Neural Transmission (Vienna), in press
Mondino M, Haesebaert F, Poulet E, Suaud-Chagny MF, Brunelin J. Fronto-temporal transcranial Direct Current Stimulation (tDCS) reduces source-monitoring deficits and auditory hallucinations in patients with schizophrenia. Schizophrenia Research, Schizophr Res, 2015;161 (2-3):515-6.
Mondino M, Jardri R, Suaud-Chagny MF, Saoud M, Poulet E, Brunelin J. Effects of fronto-temporal transcranial direct current stimulation (tDCS) on auditory hallucinations and resting-state functional connectivity of the left temporo-parietal junction in patients with schizophrenia. Schizophr Bull, 2016;42(2):318-26.
Mondino M, Poulet E, Suaud-Chagny MF, Brunelin J. Anodal tDCS targeting the left temporo-parietal junction disrupts verbal source-monitoring. submitted

Keywords: tDCS, Schizophrenia, Hallucinations, TACs, Brain Stimulation

Conference: SAN2016 Meeting, Corfu, Greece, 6 Oct - 9 Oct, 2016.

Presentation Type: Oral Presentation in SAN 2016 Conference

Topic: Oral Presentations

Citation: Brunelin J, Mondino M and Poulet E (2016). Relevance of noninvasive transcranial electrical stimulation for patients with schizophrenia. Conference Abstract: SAN2016 Meeting. doi: 10.3389/conf.fnhum.2016.220.00006

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Received: 29 Jul 2016; Published Online: 30 Jul 2016.

* Correspondence: Dr. Jerome Brunelin, CH le vinatier, CH le Vinatier, Lyon 1 university, bron, 69678, France, jerome.brunelin@ch-le-vinatier.fr