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Structural and Functional Correlates of Clinical Response to rTMS Treatment in Schizophrenia Patients With Resistant Auditory Hallucinations

France45 participantsStarted 2015-10-14

Plain-language summary

The potential of non-invasive Transcranial Magnetic Stimulation (TMS) as a therapeutic tool for improving schizophrenic symptoms, in particular resistant hallucinations, has been increasingly studied over the past decades. Several studies have demonstrated that low-frequency patterns of repetitive TMS (rTMS) applied over the left Temporoparietal Junction (TPJ), which are known to decrease local activity, significantly reduced auditory verbal hallucinations in schizophrenic patients. In spite of highly promising results, a high level of inter-individual variability in the responses to non-invasive brain stimulation treatments, and the fact that rTMS may prove ineffective in some patients, keep spurring controversy about the efficacy of these approaches (as currently performed), as well as about how to increase its efficacy and consistency. Accordingly, the objectives of this project are to better understand the impact of rTMS on the brains of patients with resistant auditory hallucinations, and to use this information not only to better understand this condition but to develop more efficient and consistent therapies. Thus, in this study, the investigators focus more specifically on resistant auditory hallucinations in schizophrenia, which is a common symptom in schizophrenic patients, and can be treated by rTMS. The investigators hypothesize that there is a baseline difference in anatomical and/or functional connectivity between responder and non-responder patients who are treated with rTMS. Therefore, our project will aim to determine some anatomical and functional connectivity markers of response to rTMS treatment in patients with schizophrenia

Who can participate

Age range18 Years – 65 Years

SexALL

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Inclusion Criteria: * Patient with a diagnosis of schizophrenia according to DSM-V (Diagnostic and Statistical Manual of Mental Disorder V, 2013) criteria * Clinically stabilized for at least 3 months * Patient with resistant auditory hallucinations * Male or female, 18 to 65 years old * A written agreement from the patient's legal guardian/s, if applicable * Right-handed * A good knowledge of the French language * Signed consent form Exclusion Criteria: * Other diseases than schizophrenia * Indulging in an addiction (alcohol, psychoactive substances) over the last 12 months * Patient who has received rTMS treatment in the last 12 months * Patient who is participating in a concurrent research protocol * Patient with a history of seizures * rTMS contraindications: patient with epilepsy, brain surgery and/or head trauma in the past, use of cardiac pacemaker, or surgical staples on the scalp * MRI contraindications: pregnancy or lactating (n.b. a negative pregnancy test will be required if the patient is a female in reproductive years who does not use contraception); use of cardiac pace maker or surgical staples; patient with a neurological disorder, head trauma or claustrophobia * Patient with severe cardiovascular disease * Patient with medication which reduces the epileptic threshold (bupropion, methadone and theophylline) * Patients placed in psychiatric care either by the state or a third party

What they're measuring

Changes in the integrity of white matter tracts between responder and non-responder patients

Timeframe: Baseline

Changes in the variations of the blood-oxygen-dependent level (BOLD) signal between responder and non-responder patients

Timeframe: Baseline

Trial details

NCT IDNCT02755623

SponsorCentre hospitalier de Ville-Evrard, France

Sponsor typeOTHER

Study typeINTERVENTIONAL

Primary completion2025-09-08

Contact for this trial

Arezki Ourrad

+33143093232 urcve1@gmail.com