-Caveat Lector-
"In TMS, an electromagnetic coil is placed on the scalp and current is
turned on and off to create a pulsing magnetic field that reaches into a
small area of the brain. The goal is to make brain cells underneath the coil
fire messages to adjoining cells."
Pulses May Ease Schizophrenic Voices
By MALCOLM RITTER
.c The Associated Press
WASHINGTON (AP) -- Schizophrenia patients whose medication couldn't stop the
imaginary voices in their heads gained some relief after researchers
repeatedly sent a magnetic field into a small area of their brains.
About half of 12 patients studied said their hallucinations became much less
severe after the treatment, which feels like ``having a woodpecker knock on
your head'' once a second for up to 16 minutes, said researcher Dr. Ralph
Hoffman. The voices stopped completely in three of these patients.
The effect lasted for up to a few days for most participants, and one man
reported that it lasted seven weeks after being treated daily for four days.
Hoffman stressed that the study is only preliminary and can't prove that the
treatment would be useful. ``We need to do much more research on this,'' he
said in an interview.
Hoffman, deputy medical director of the Yale Psychiatric Institute, is
scheduled to present the work Thursday at the annual meeting of the American
Psychiatric Association.
Not all people with schizophrenia hear voices, and of those who do, Hoffman
estimated that maybe 25 percent can't control them with medications even when
other disease symptoms abate. So the work could pay off for ``a small but
very ill group of patients,'' he said.
The treatment is called transcranial magnetic stimulation, or TMS. While past
research indicates it might be helpful in lifting depression, it hasn't been
studied much in schizophrenia.
In TMS, an electromagnetic coil is placed on the scalp and current is turned
on and off to create a pulsing magnetic field that reaches into a small area
of the brain. The goal is to make brain cells underneath the coil fire
messages to adjoining cells.
The procedure is much different from electroconvulsive therapy, called ECT,
which applies pulses of electricity rather than a magnetic field to the
brain. Unlike TMS, ECT creates a brief seizure and is performed under general
anesthesia. ECT is used most often for treating severe depression.
In TMS, the magnetic pulses are thought to calm the affected part of the
brain if they're given as slowly as once per second, Hoffman said. He and
colleagues targeted an area involved in understanding speech, above and
behind the left ear, on the theory that hallucinated voices come from
overactivity there.
The treatment can make scalp muscles muscle contract, leading to the
woodpecker feeling, he said, but patients could tolerate it. Headache was the
most common side effect, and there was no sign that the treatment affected
the ability to understand speech, he said.
To make sure the study results didn't reflect just the psychological boost of
getting a treatment, researchers gave sham and real treatments to each study
participant and studied the difference in how patients responded. They also
tested different durations for each treatment, starting with four minutes.
Patients rated the severity of the voices -- a term combining frequency,
loudness and the resulting distress -- on the day after each treatment. The
real treatment did far better than the sham one when both were given for 16
minutes, but not when they were administered for briefer periods.
On a scale of zero to 10, with 10 being the severity patients had before the
study began, the real 16-minute treatments led to an average drop of 3.8
points. Sham treatments made no significant difference.
Dr. Mark S. George, a TMS expert at the Medical University of South Carolina
in Charleston, agreed that the results are preliminary and must be confirmed
by further work. But he called them exciting, saying, ``You have to sit up
and take notice.''
Hoffman and colleagues have begun another study to see if giving more doses
of the 16-minute treatment will improve results.
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