Treatment of auditory verbal hallucinations in schizophrenia using tDCS Charlotte Chaze 1, Vince P. Clark 1,2, Jessica Turner 1,3, Rose Bigelow 2, Jason Long 2, Vince Calhoun 1,2, Robert Thoma 2 1 Medical Image Analysis Lab, The Mind Research Network, Albuquerque, United States 2 Departments of Psychology & Psychiatry, University of New Mexico, Albuquerque, United States 3 Department of Psychology, Georgia State University, Atlanta, United States References: Brunelin, J. et al. Examining transcranial direct-current stimulation (tDCS) as a treatment for hallucinations in schizophrenia. Am. J. Psychiatry 2012; 169: Drake, R. et al. The Psychotic Symptom Rating Scales (PSYRATS): their usefulness and properties in first episode psychosis. Schiz. Research 2007; 89: Results Figure 1. Response to real voices before & after tDCS treatment There is a decrease in activation in the auditory cortex when listening to real voices post-treatment Question Can transcranial direct current stimulation (tDCS) lessen the severity of auditory verbal hallucinations (AVH) in schizophrenia by modulating neural activation in pertinent brain regions? Background Brunelin et al (2012) reported reduction in the severity of AVH in a tDCS treatment trial We use fMRI to measure neural activation before and after treatment Methods Volunteers with schizophrenia underwent a 5-day tDCS treatment program: AVH-on and AVH-off were tracked during fMRI scanning using a button-press paradigm Volunteers also completed tasks that involved listening to stories and imagining scenarios during fMRI scanning Figure 2. Core PSYRATS Variables: Mean AVH Frequency & Duration Scores Figure 3. Mean PANSS Scores A decrease in PSYRATS and PANSS scores with tDCS treatment is associated with decreased activation in auditory cortex during a listening task A decrease in PSYRATS and PANSS scores are indicative of: A decrease in the severity of AVH A reduction in positive and negative symptoms of schizophrenia Conclusions & Applications The first 3 participants experienced a decrease in frequency and duration of AVH following treatment with tDCS Atypical function of auditory cortex is associated with the presence and severity of AVH tDCS neurostimulation may be used to affect schizophrenia AVH Images from: en.wikipedia.org/wiki/Wernicke's_area, neuroconn.de/dc-stimulator-2, pixshark.com/duracell-battery-9v.htm, boundless.com/biology/textbooks/boundless-biology-textbook/the-nervous-system-35/how-neurons-communicate- 200/ Future Add sham trials Analyze listening task for controls Right index finger: AVH/”voices” on Left index finger: AVH/”voices” off Resting potential Excitation threshold Cathode Wernicke’s area: Language production Anode Broca’s area: Language comprehension tDCS e-e- Mg + Ca 2+ Na + Anode: Makes neurons fire more easilyCathode: Makes it more difficult for neurons to fire PSYRATS PANSS PSYRATS PANSS Day 1 tDCS Day 2Day 3Day 4Day 5 tDCS