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Thirty-Third Annual Meeting of the Society for Research in Psychopathology

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Treatment of Auditory Hallucinations with Single-Session tDCS and Cognitive Remediation Training

Perceptual models of auditory verbal hallucinations (AVH) in schizophrenia (Sz) include hyper-excitability of auditory/verbal perception (in left temporoparietal junction; l-TPJ), and hypo-excitability of cognitive control which normally inhibits or reattributes perceptual misrepresentations (in right ventrolateral prefrontal cortex; r-VLPFC). We examined a single-session treatment to enhance cognitive control with Cognitive Remediation Training (CRT) plus anodal tDCS applied to r-VLPFC, and to reduce AVH with cathodal tDCS applied to l-TPJ. Participants were 12 Sz with persistent daily AVH despite stable antipsychotic medication for >2 months. tDCS (2mA, n=7) or sham (0.1mA, n=5) was delivered during CRT. We assessed AVH at baseline and 1-week later. Participants also completed the AX-CPT during electroencephalography (EEG) testing at baseline and immediately after CRT+tDCS. We analyzed beta-band event-related desynchronization (ERD) during the cue evaluation period (200-400ms after ‘A’ stimulus onset) in left central electrodes, which has been linked to cognitive control of attention, and accuracy and RT. AVH was reduced by CRT+tDCS (36% reduction) compared to CRT+sham (18% reduction; d=0.82). In the AX-CPT, RT improvement was greater for CRT+tDCS (ΔRT=73ms) than CRT+sham (ΔRT=21ms; d=0.80). Beta ERD in the evaluation period was increased more for CRT+tDCS (ΔERD=0.49µV2) than CRT+sham (ΔERD=0.00µV2; d=0.89). Accuracy did not change for either group. These preliminary results suggest that a single session of CRT+tDCS may reduce AVH severity and enhance cognitive control in treatment-refractory schizophrenia patients. These findings could lead to a new adjunct biomedical treatment for improving cognition and reducing auditory verbal hallucinations in schizophrenia.

Brian Coffman
The University of Pittsburgh School of Medicine

Timothy Murphy
The University of Pittsburgh School of Medicine

Natasha Torrence
The University of Pittsburgh School of Medicine

Dean Salisbury
The University of Pittsburgh School of Medicine

 


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