Progressive Gray Matter Loss and Changes in Cognitive Functioning Associated With Exposure to Herpes Simplex Virus 1 in Schizophrenia: A Longitudinal Study

Транскраниальная стимуляция постоянным током в терапии вербального галлюциноза при шизофрении

In February 2011, a 44-year-old man with schizophrenia was referred to our hospital for the treatment of auditory verbal hallucinations. He had undergone outpatient treatment with adequate dosages of antipsychotic medications for several months, but he still heard a real-sounding voice that ordered him to commit suicide. We introduced transcranial direct current stimulation (tDCS) as a novel therapeutic approach. Cathodal stimulation diminishes cortical excitability at a circumscribed region (1), and Wernicke's area has been described as an appropriate target region for cathodal stimulation in previous transcranial magnetic stimulation (TMS) studies (2–4). The anodal electrode was placed over the right supraorbital area.

Transcranial direct current stimulation was applied for 15 minutes on 10 consecutive days by using a 1 mA current and 7 cm x 5 cm electrodes, resulting in a current density of 0.029 mA/cm2. The medication doses (5 mg of haloperidol and 20 mg of olanzapine) remained the same 4 weeks before and during the patient's intervention. Before and after tDCS, we measured arterial spin labeling, a noninvasive MR technique that provides a direct quantitative measure of cerebral blood flow (CBF). Arterial spin labeling has been successfully used to measure the difference and changes in regional CBF between healthy individuals and schizophrenia patients experiencing formal thought disorders (5). Clinical assessments showed improvements in our patient's scores on the Hallucination Change Scale (pre-tDCS score=10; post-tDCS score=4), the Positive and Negative Syndrome Scale (pre-tDCS score=61; post-tDCS score=50), and the Psychotic Symptom Rating Scale (pre-tDCS score=51; post-tDCS score=43). The decrease in regional CBF indicated that the intervention had a specific neurobiological effect (Figure 1). At follow-up investigation 6 weeks after the tDCS intervention, our patient's clinical improvement was maintained.

Muting the Voice: A Case of Arterial Spin Labeling-Monitored Transcranial Direct Current Stimulation Treatment of Auditory Verbal Hallucinations

ЭЭГ-диагностика шизофрении

They used electroencephalography (EEG), which measures the brain’s electrical activity or “brain waves”, to study the brain’s response to commonly and rarely presented tones that differed in length.

When these rare “deviant” tones are presented to healthy people, the brain automatically generates a particular electrical wave called mismatch negativity, or MMN. People diagnosed with schizophrenia have reduced MMN.

In this new study, the researchers followed a group of people clinically at high risk for developing psychosis. They found that the individuals who went on to develop schizophrenia had smaller MMN than the subgroup who did not. This finding suggests that MMN might be useful in predicting the later development of schizophrenia.

A “Brain Wave” Test for Schizophrenia Risk?

Индивидуальная музыкальная терапия депрессии

Individual music therapy for depression: randomised controlled trial

Psychopathology of perpetrators of fabricated or induced illness in children: case series

Симптомы дефицита тестостерона

Symptoms and Signs Suggestive of Testosterone Deficiency in Men

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Risks and Comorbid Illnesses Associated With Testosterone Deficiency

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Low Testosterone Medscape CME Expert Column Series. Issue 1: Testosterone Deficiency in Men: Common and Under-recognized