Targeting auditory verbal hallucinations in schizophrenia: effective connectivity changes induced by low-frequency...

Area of Science:

• Neuroscience
• Psychiatry
• Neuromodulation

Background:

• Low-frequency repetitive transcranial magnetic stimulation (rTMS) shows promise for treating psychiatric disorders, especially schizophrenia with auditory verbal hallucinations (AVH).
• The precise neural mechanisms underlying rTMS efficacy in schizophrenia remain unclear.

Purpose of the Study:

• To investigate the impact of low-frequency rTMS on neural connectivity in the left temporoparietal junction (TPJ) in schizophrenia patients experiencing AVH.
• To explore the relationship between altered brain connectivity and clinical symptom improvement.

Main Methods:

• A randomized controlled trial design was utilized.
• Dynamic Causal Modeling (DCM) was employed to analyze directed connectivity patterns.
• Changes in neural connectivity were assessed in relation to AVH severity.

Main Results:

• Significant improvements in auditory verbal hallucinations (AVH) were observed following rTMS treatment.
• Dynamic Causal Modeling revealed significant alterations in both functional and effective connectivity among brain regions.
• Inhibitory effects from the left precentral gyrus and left medial superior frontal gyrus to the left TPJ correlated significantly with AVH symptom reduction.

Conclusions:

• Low-frequency rTMS can effectively modulate neural pathways associated with hallucinations in schizophrenia.
• The study provides a neurobiological framework for understanding rTMS therapeutic effects in schizophrenia.
• Targeted modulation of TPJ connectivity offers a potential therapeutic strategy for AVH.