Bilateral Temporal 1 Hz rTMS (Repetitive Transcranial Magnetic Stimulation) Treatment in a Left-Handed Patient with Imperative Auditory Hallucinations

This letter describes the case of a left-handed, 37-year-old patient with refractory auditory hallucinations. In spite of antipsychotic treatment with haloperidol, risperidone and clozapine, there was no resolution of symptoms during the entire course of his disease that started at the age of 25 years. The symptoms of auditory hallucinations measured with the SAPS (scale for the assessment of positive symptoms, SS 36–38) improved significantly only after 1-Hz repetitive transcranial magnetic (rTMS) stimulation on the right temporoparietal cortex. Therefore, 1-Hz rTMS of the temporoparietal cortex in patients with auditory hallucinations appears to be a promising approach in the treatment of refractory, and in particular extending disease pictures in schizophrenia. In these circumstances, the question of the localization of the speech centre for the choice of the stimulation site for 1-Hz repetitive TMS treatment seems to be important and should be addressed in future investigations.

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