Therapeutic response and neurobiological prediction markers in auditory verbal hallucinations

Lay summary

Schizophrenia is a disorder of communication, cognition and emotion and thus leads to a high degree of personal and familiar suffering as well as burden on the society. Up till 80% of the patients suffer from auditory verbal hallucinations (AVH) being one of the most common symptoms of this disorder with diagnostic value. AVH can be extremely emotional distressing to the patients, often endangering themselves as well as others. Thus an efficient therapeutic regime is indispensable to lower suffering and costs. Unfortunately the therapeutic options are rather limited and the most conventional therapeutic strategy is the use of antipsychotic drugs, however, in about 20-30 % of the patients even extended antipsychotic medication does not ameliorate AVH. Thus new therapeutic options and/or regimens are needed. Based upon neurobiological research regarding the generation of AVH non-pharmacological treatments like transcranial magnetic stimulation (TMS) were developed. Recently we additionally introduced transcranial direct current stimulation (tDCS) for AVH treatment and initial experience and results indicate a positive effect in patients. Recent studies has indicated that patients with AVH respond differently to various therapeutic approaches. Thus the aims of the project are to identify treatment responders based upon a better understanding of the neurobiological mechanisms responsible for responsiveness and to investigate if TMS/tDCS are effective treatment alternatives to conventional antipsychotic treatment in patients with schizophrenia and as a result to reduce both the individual suffering in patients and their relatives as well as the burden upon the society.