Neural Regeneration Research ›› 2013, Vol. 8 ›› Issue (28): 2666-2676.doi: 10.3969/j.issn.1673-5374.2013.28.009

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Repetitive transcranial magnetic stimulation for hallucination in schizophrenia spectrum disorders A meta-analysis

Yingli Zhang1, Wei Liang2, Shichang Yang3, Ping Dai4, Lijuan Shen5, Changhong Wang6   

  1. 1 Psychological Counseling Center, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, Henan Province, China
    2 Department of Clinical Psychology, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, Henan Province, China
    3 Department of Psychology, Xinxiang Medical University, Xinxiang 453000, Henan Province, China
    4 Library of Sichuan University, Chengdu 610041, Sichuan Province, China
    5 Mental Health Institute, Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China
    6 Department of Psychiatry, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, Henan Province, China
  • Received:2013-04-23 Revised:2013-07-24 Online:2013-10-05 Published:2013-10-05
  • Contact: Changhong Wang, M.D., Professor, Department of Psychiatry, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, Henan Province, China, wangch3669@yahoo.com.cn
  • About author:Yingli Zhang, Studying for doctorate, Chief physician. Yingli Zhang and Wei Liang contributed equally to this paper.
  • Supported by:

    This study was financially sponsored by the Special Funding of Henan Health Science and Technology Innovation Talent Project, No. 4173(2010-2015); Xinxiang Medical University of High-Level Personnel of Scientific Research Projects, No. 08BSKYQD-004, and the Key Projects of Science and Technology Research of Department of Education in Henan, No. 13A320869.

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Abstract:

OBJECTIVE: This study assessed the efficacy and tolerability of repetitive transcranial magnetic stimulation for treatment of auditory hallucination of patients with schizophrenia spectrum disorders.
DATA SOURCES: Online literature retrieval was conducted using PubMed, ISI Web of Science, EMBASE, Medline and Cochrane Central Register of Controlled Trials databases from January 1985 to May 2012. Key words were “transcranial magnetic stimulation”, “TMS”, “repetitive transcranial magnetic stimulation”, and “hallucination”.
STUDY SELECTION: Selected studies were randomized controlled trials assessing therapeutic ef-ficacy of repetitive transcranial magnetic stimulation for hallucination in patients with schizophrenia spectrum disorders. Experimental intervention was low-frequency repetitive transcranial magnetic stimulation in left temporoparietal cortex for treatment of auditory hallucination in schizophrenia spectrum disorders. Control groups received sham stimulation.
MAIN OUTCOME MEASURES: The primary outcome was total scores of Auditory Hallucinations Rating Scale, Auditory Hallucination Subscale of Psychotic Symptom Rating Scale, Positive and Negative Symptom Scale-Auditory Hallucination item, and Hallucination Change Scale. Secondary outcomes included response rate, global mental state, adverse effects and cognitive function.
RESULTS: Seventeen studies addressing repetitive transcranial magnetic stimulation for treatment of schizophrenia spectrum disorders were screened, with controls receiving sham stimulation. All data were completely effective, involving 398 patients. Overall mean weighted effect size for repeti-tive transcranial magnetic stimulation versus sham stimulation was statistically significant (MD = –0.42, 95%CI: –0.64 to –0.20, P = 0.000 2). Patients receiving repetitive transcranial magnetic stimulation responded more frequently than sham stimulation (OR = 2.94, 95%CI: 1.39 to 6.24, P =0.005). No significant differences were found between active repetitive transcranial magnetic stimulation and sham stimulation for positive or negative symptoms. Compared with sham stimulation, active repeti-tive transcranial magnetic stimulation had equivocal outcome in cognitive function and commonly caused headache and facial muscle twitching.
CONCLUSION: Repetitive transcranial magnetic stimulation is a safe and effective treatment for auditory hallucination in schizophrenia spectrum disorders.

Key words: neural regeneration, meta-analysis, transcranial magnetic stimulation, auditory hallucination, schizophre-nia, schizophrenia spectrum disorders, schizophreniform disorder, temporoparietal cortex, cognitive func-tion, positive symptom, grants-supported paper, neuroregeneration