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Yale grants expands
research in schizophrenic, auditory hallucinations
(July
2006 Issue)
By Jennifer Chase Esposito
The National Institute of Mental Health has awarded Yale School
of Medicine a $2.1 million grant to help further test transcranial
magnetic stimulation (TMS) as a method for pinpointing and potentially
soothing the voices that plague 60 to 70 percent of people with
schizophrenia.
Ralph Hoffman, M.D., a professor of psychology in the Yale School
of Medicine's Department of Psychiatry and a lead researcher in
the study, says the grant stems from a "robust study" funded by
the NIMH in 2005 that showed TMS having some efficacy in helping
people suffering from auditory hallucinations or voices, as they're
most commonly referred to.
According to Hoffman, stimulating certain neurons in the brain
helps modestly reduce the capacity of those neurons to activate
each other. "As a result, the neural populations become less excitable,"
he says, which suggests that voices can be cut down through the
TMS approach, without interfering with brain activity.
The grant money will allow Yale to conduct a five-year trial during
which 90 patients will receive treatment. And the TMS will be administered
as follows: while awake, with an electromagnetic coil on their scalp,
patients will receive repetitive magnetic pulses, once per second,
over one 16-minute period, daily. A magnetic resonance imaging brain
scan will help doctors accurately position TMS over the required
region.
The stimulation is designed to reduce excitement in the part of
the brain that's stimulated, known as Wernicke's region, which is
located in the part of the brain where speech is registered.
One third of the patients will be stimulated on the left side of
their brain, the other third on the right and the rest will be given
a placebo treatment. Depending on where and how well the treatment
was received, patients will advance in the program with stimuli
in different parts of the brain. The process could take up to six
weeks.
The goal of the trial is to show researchers the origins of the
voices, as well as offer improvements to those who have constantly
heard more than just their own thoughts for 10-20 years.
"Sometimes [auditory hallucinations] go away," says Hoffman. "But
the interesting thing is that once they start, if patients go into
remission, they'll always have the voices. "Often," he says, "[the
voices] say similar things, even four years later"…. So for Hoffman
and his team to offer patients an opportunity to participate in
studies such as these is "gratifying, when they do improve," he
says.
Patients ages 18 to 55 suffering from voices are eligible for the
study. Participation costs nothing. Yale is offering a stipend of
about $400 to participants; it will fly patients from around the
country to New Haven and give them a place to stay if they need
it.
During the 2005 study, many patients traveled from the opposite
coast and places in between. This time, Hoffman hopes New England
patients will take advantage of this trial. He encourages psychologists
to refer patients, as well as families or patients with questions
to call his office at 203.688.9734 or joint researcher Joan Nye
at 203.737.2762 with any questions or concerns they may have about
the trial.
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