Clinical practice of rTMS reveals a functional dissociation between agency and hallucinations in schizophrenia

Neuropsychologia. 2009 Jan;47(1):132-8. doi: 10.1016/j.neuropsychologia.2008.08.006. Epub 2008 Aug 13.

Abstract

We report here the case of a hospitalized 11 year-old boy (YP) with a positive diagnosis of 'Childhood Onset Schizophrenia'. YP experienced verbal-auditory hallucinations, a delusion of alien control and hetero-aggressive behaviour. Antipsychotic drugs were unsuccessful and furthermore provoked severe acute dystonia. fMRI-guided rTMS applied over several cortical regions provided the means to reveal for the first time a functional dissociation between auditory-verbal hallucinations and agency. These results demonstrate the efficacy of rTMS for young patients suffering from drug-resistant hallucinations but they furthermore question the physiopathology of the hallucinatory process by suggesting that agency and hallucinations may be sub-served by different neural networks.

Publication types

  • Case Reports

MeSH terms

  • Brain Mapping
  • Child
  • Dissociative Disorders / diagnosis*
  • Dissociative Disorders / etiology
  • Electric Stimulation
  • Hallucinations / diagnosis*
  • Hallucinations / etiology
  • Humans
  • Image Processing, Computer-Assisted
  • Magnetic Resonance Imaging / methods
  • Male
  • Neuropsychological Tests
  • Oxygen / blood
  • Schizophrenia, Childhood / complications*
  • Schizophrenia, Childhood / pathology
  • Schizophrenic Psychology*
  • Transcranial Magnetic Stimulation / methods*

Substances

  • Oxygen