Targeted neural network interventions for auditory hallucinations: Can TMS inform DBS?

Area of Science:

• Neuroscience
• Psychiatry
• Neuromodulation

Background:

• Auditory hallucinations (AH) in schizophrenia are debilitating and refractory.
• Current neuromodulatory interventions, including deep brain stimulation (DBS), face challenges in predicting patient response and guiding treatment.
• Non-invasive brain stimulation like transcranial magnetic stimulation (TMS) shows therapeutic promise but is underutilized for research.

Purpose of the Study:

• To propose transcranial magnetic stimulation (TMS) as a tool to inform deep brain stimulation (DBS) development for auditory hallucinations (AH).
• To highlight the potential of TMS in providing individualized causal evidence for DBS evaluation.
• To explore how combining TMS with computational modeling can improve network modulation strategies.

Main Methods:

• Review of current neuromodulatory interventions for refractory schizophrenia with AH.
• Proposal for integrating transcranial magnetic stimulation (TMS) as an investigational probe.
• Conceptual framework for combining TMS with computational modeling, neuroimaging, and neurophysiological data.

Main Results:

• TMS can offer individualized causal evidence to complement DBS evaluation processes.
• Integration of TMS with computational modeling may yield critical insights for network modulation.
• Addressing limitations and safety concerns of DBS through advanced investigational approaches.

Conclusions:

• Transcranial magnetic stimulation (TMS) holds significant potential to enhance the development and application of deep brain stimulation (DBS) for auditory hallucinations (AH).
• A combined approach utilizing TMS, computational modeling, and neuroimaging data can lead to more robust and personalized neuromodulatory treatments.
• Further research is warranted to explore the synergistic potential of these techniques in managing treatment-refractory psychiatric disorders.