Treatment of auditory verbal hallucinations in schizophrenia using tDCS Charlotte Chaze 1 , Vince P. Clark 1,2 , Jessica Turner 1,3 , Rose Bigelow 2 , Jason Long 2 , Vince Calhoun 1,2 , Robert Thoma 2 1 Medical Image Analysis Lab, The Mind Research Network, Albuquerque, United States 2 Departments of Psychology & Psychiatry, University of New Mexico, Albuquerque, United States 3 Department of Psychology, Georgia State University, Atlanta, United States [email protected] References: Brunelin, J. et al. Examining transcranial direct-current stimulation (tDCS) as a treatment for hallucinations in schizophrenia. Am. J. Psychiatry 2012; 169:719-24. Drake, R. et al. The Psychotic Symptom Rating Scales (PSYRATS): their usefulness and properties in first episode psychosis. Schiz. Research 2007; 89:119-122. Results Figure 1. Response to real voices before & after tDCS treatment • There is a decrease in activation in the auditory cortex when listening to real voices post-treatment Question Can transcranial direct current stimulation (tDCS) lessen the severity of auditory verbal hallucinations (AVH) in schizophrenia by modulating neural activation in pertinent brain regions? Background • Brunelin et al (2012) reported reduction in the severity of AVH in a tDCS treatment trial • We use fMRI to measure neural activation before and after treatment Methods • Volunteers with schizophrenia underwent a 5-day tDCS treatment program: • AVH-on and AVH-off were tracked during fMRI scanning using a button-press paradigm • Volunteers also completed tasks that involved listening to stories and imagining scenarios during fMRI scanning Figure 2. Core PSYRATS Variables: Mean AVH Frequency & Duration Scores Figure 3. Mean PANSS Scores • A decrease in PSYRATS and PANSS scores with tDCS treatment is associated with decreased activation in auditory cortex during a listening task • A decrease in PSYRATS and PANSS scores are indicative of: • A decrease in the severity of AVH • A reduction in positive and negative symptoms of schizophrenia Conclusions & Applications • The first 3 participants experienced a decrease in frequency and duration of AVH following treatment with tDCS • Atypical function of auditory cortex is associated with the presence and severity of AVH • tDCS neurostimulation may be used to affect schizophrenia AVH Right index finger: AVH/”voices” on Left index finger: AVH/”voices” off Images from: en.wikipedia.org/wiki/Wernicke's_area, neuroconn.de/dc-stimulator-2 , pixshark.com/duracell-battery-9v.htm, boundless.com/biology/textbooks/boundless-biology-textbook/the-nervous-system-35/how-neurons-communicate- 200/ http://neurosciencenews.com/fmri-brain-differences-drug-use-889/mri-scan-normal-brain-sagital-view Future • Add sham trials • Analyze listening task for controls -70 -55 Resting potential Excitation threshold Mg + Ca 2+ Na + -70 -55 e - e - e - Cathode Wernicke’s area: Language production Anode Broca’s area : Language comprehension tDCS e - Mg + Ca 2+ Na + Anode: Makes neurons fire more easily Cathode: Makes it more difficult for neurons to fire PSYRATS PANSS PSYRATS PANSS Day 1 tDCS Day 2 Day 3 Day 4 Day 5 tDCS tDCS tDCS tDCS PSYRATS PANSS