Transcranial Magnetic Stimulation (TMS) is a non-invasive brain stimulation technique used for various neurological and psychiatric conditions. Schizophrenia is a complex mental health condition affecting thought, perception, emotion, and behavior. This article explores TMS as a potential therapeutic option for individuals with schizophrenia, examining its principles and how it may influence symptoms.
Understanding Transcranial Magnetic Stimulation
Transcranial Magnetic Stimulation uses magnetic fields to stimulate nerve cells in the brain. A treatment coil placed near the scalp generates a rapidly changing magnetic field. This field passes through the skull, inducing a weak electrical current in the underlying brain tissue. These induced currents cause neurons to depolarize, leading to nerve cell activity. The technique is non-invasive, requiring no surgery or direct contact with brain tissue.
How TMS Addresses Schizophrenia Symptoms
TMS influences brain activity by modulating neuronal excitability and connectivity. High-frequency repetitive TMS (rTMS) applied to the left dorsolateral prefrontal cortex (DLPFC) can increase excitability in this region, which is often hypoactive in schizophrenia. This stimulation improves cognitive control and reduces negative symptoms like apathy or social withdrawal. Conversely, low-frequency rTMS applied to the temporoparietal junction, a region implicated in auditory hallucinations, can decrease excitability. This may reduce the frequency and intensity of these experiences.
What to Expect During TMS Treatment
TMS for schizophrenia involves outpatient sessions, with each lasting 20 to 40 minutes depending on the protocol and target area. Treatment courses involve daily sessions, five days a week, over several weeks, ranging from four to six weeks. During a session, the patient sits comfortably while the magnetic coil is positioned over the targeted scalp area. The patient may hear clicking sounds and feel a tapping sensation, which is well-tolerated. Patients can resume their regular activities immediately after each session.
Effectiveness and Suitability for Schizophrenia
Research indicates TMS can reduce symptoms of schizophrenia, especially refractory auditory hallucinations (those not responding to medication). Repetitive TMS applied to the temporoparietal junction significantly reduces the severity and frequency of these voices. Evidence suggests a benefit for negative symptoms, though further investigation is needed. TMS is considered for individuals with schizophrenia who have not achieved sufficient symptom control with conventional treatments like antipsychotic medications.
Suitability for TMS requires assessment by a healthcare professional. Contraindications include metallic implants in or near the head, such as cochlear implants, pacemakers, or deep brain stimulators. Individuals with a history of seizures or certain neurological conditions may also not be suitable. The decision to pursue TMS weighs potential benefits against risks.