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HA

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High-frequency rTMS shows schizophrenic benefits
08 Nov 2004

High-frequency repetitive transcranial magnetic stimulation (rTMS) appears to be effective for reducing depressive and negative symptoms in patients with schizophrenia, German investigators have found.
They warn, however, that there is also a tendency for a worsening of positive symptoms with this type of treatment.

Recognizing that recent publications have provided increasing evidence that rTMS may be useful for the treatment of schizophrenia, the team, led by Göran Hakak from the University of Regensburg, randomly assigned 20 patients with the disorder to undergo high-frequency 10 Hz rTMS or sham stimulation over a 10-day period.

All of the patients were takiing stable antipsychotic medication at least 2 weeks prior to entering the study.

High-frequency rTMS led to a significant reduction in negative symptoms, as measured on the Positive and Negative Symptoms Scale, compared with sham stimulation.

Patients receiving active treatment also showed a non-significant improvement in depressive symptoms relative to those given sham treatment.

This demonstrates that treatment efficacy of high-frequency rTMS in schizophrenia is "not due to a selective improvement of depressive symptoms, as has been shown in treating post-traumatic stress disorder, but has specific beneficial effects preferentially on negative symptoms," the team writes in the journal Psychological Medicine.

Nevertheless, rTMS also had a negative effect on positive symptoms, with a trend for worsening of such symptoms seen in those receiving active therapy.

Hakak and team suggest that "the significant reduction of negative symptoms together with similar trend for improvement of depressed mood may reflect correction of dysfunctional dopaminergic neurotransmission."

Based on their findings, they conclude: "High-frequency rTMS may be of particular benefit in patients with a low level of subcortical dopamine function."

Article Source http://www.psychiatrysource.com/psychsource/News/Schizophrenia/Psychosis/article963.htm
 

attical

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I understand the Clarke is now conducting research on using rTMS for Schizophrenia, with positive results.
 

HA

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Hi Attical,

Here is what I found about TMS that is being studied at CAMH in Toronto.

Special Article

Transcranial Magnetic Stimulation
A New Investigational and Treatment Tool in Psychiatry

Zafiris J. Daskalakis, M.D., Ph.D., F.R.C.P.C., Bruce K. Christensen, Ph.D., C.Psych., Paul B. Fitzgerald, M.B.B.S., M.P.M., F.R.A.N.Z.C.P. and Robert Chen, M.B.B.Chir., M.Sc., F.R.C.P.C.
Received March 19, 2001; revised July 11, 2001; accepted July 25, 2001. From the Centre for Addiction and Mental Health, University of Toronto, Ontario, Canada (Z.J.D., B.K.C.); Dandenong Psychiatry Research Centre, Dandenong, Victoria, Australia (P.B.F.); and Division of Neurology, Toronto Western Hospital, University of Toronto, Ontario, Canada (R.C.). Address correspondence to Dr. Daskalakis, Schizophrenia and Continuing Care Program, Centre for Addiction and Mental Health, 7th Floor, Clarke Division, 250 College Street, Toronto, Ontario, Canada. E-mail: Jeff_Daskalakis@camh.net.

Transcranial magnetic stimulation (TMS) is a new investigational technique used to explore various neural processes and treat a variety of neuropsychiatric illnesses. The most notable advantage of TMS is its ability to directly stimulate the cortex with little effect on intervening tissue. Single-pulse stimulation techniques can measure cortical inhibition, facilitation, connectivity, reactivity, and cortical plasticity, providing valuable insights into the cortical physiology. Repetitive TMS (rTMS) is currently being used to investigate cognitive processes and as a treatment tool in disorders such as depression and schizophrenia. Both TMS and rTMS are safe and well tolerated. The most serious side effect of high-frequency rTMS is seizures. TMS represents an exciting new frontier in neuroscience research, providing insights into the pathophysiology and treatment of various neuropsychiatric disorders.

Abstract source http://neuro.psychiatryonline.org/cgi/content/abstract/14/4/406
 

attical

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Obviously, this quote is three years old. Some staff from the Clarke were observing my treatment in Hamilton, and acknowledged they are using it to treat schizophrenia...perhaps only on a research basis at this time. I'm surprised there is no mention on the CAMH website, but I assume they aren't ready to publicly unveil what they are doing.
 

HA

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Yea, I was surprised I could not find anything on rTMS and depression at the CAMH site, Attical. My understanding is that it is still only being used at the research stage for schizophrenia.

Beyond Drugs and Psychotherapy: Magnetic Stimulation as a Treatment

Drs. Jeff Daskalakis and Bruce Christensen have been conducting studies using a new research technique called transcranial magnetic stimulation (TMS). Our studies have shown, for the first time, that people having an active psychotic episode of schizophrenia show abnormal inhibition of neuronal activity of the front part of the brain (Archives of General Psychiatry, 2002).

These studies show the path to possible new treatments. We are now working to see if magnetic stimulation can be used to treat these inhibition deficits and lessen hallucinations for people with schizophrenia that does not respond to conventional treatments.

Source http://www.camh.net/research/schizophrenia_rar2003.html
 

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