Effects of Sequential Frontotemporal Repetitive Transcranial Magnetic Stimulation (rTMS) on Schizophrenia

The study was designed to investigate the influence of sequential fronto-temporal high frequency rTMS on schizophrenic symptoms in a single blind randomized design. The cortical silent period (CSP), which reflects a deficit of the cortical inhibition as an objective marker of reactivity, was also measured. The rTMS treatment was divided into two parts. The patient was treated with sham rTMS during the first three weeks and then with actual rTMS during the next three weeks. Both rTMS treatments were applied 5 times per week, up to a total of 15 treatments per three week. The actual rTMS procedure included two subsequent stimulations: a high-frequency rTMS above the left dorsolateral prefrontal cortex followed by a low-frequency rTMS above the left TPC with a 5 minutes delay between treatments. Severity of the psychopathology was rated on the Positive and Negative Syndrome Scale (PANSS) before and after sham treatment and after actual rTMS treatment. The CSP was measured at the same times The stimulation paradigm caused a 50% reduction in positive subscale PANSS. In addition to the complete disappearance of the auditory hallucinations there was also a significant reduction in delusions. A reduction in the severity of schizophrenic symptoms which occurred during rTMS therapy was associated with a prolongation of the CSP interval. The unipolar left sequential fronto-temporal rTMS caused alleviation of the symptoms of schizophrenia and was well tolerated. Therefore it may represent a new alternative for treatment of schizophrenic patients.