[Brain stimulation for the selective treatment of schizophrenia symptom domains : Non-invasive and invasive concepts]

Nervenarzt. 2019 Jan;90(1):73-88. doi: 10.1007/s00115-018-0640-z.
[Article in German]

Abstract

Given that one third of patients with schizophrenia (SZ) only show limited response to established treatments, alternative therapeutic strategies such as non-invasive/invasive brain stimulation approaches have emerged as an adjunctive treatment option for distinct SZ symptom domains (e.g. acoustic hallucinations, negative/positive symptoms and cognitive impairment). Taking comparative interventional studies and standardized technical parameters into consideration, current meta-analyses indicate that adjunctive electroconvulsive therapy, repetitive transcranial magnetic stimulation and transcranial direct current stimulation have a positive effect. Invasive deep brain stimulation and MR-guided ultrasound brain ablation procedures represent treatment modalities that are currently being clinically tested. Complementary pre-interventional screening approaches (e.g. electrophysiology, neuroimaging and molecular inflammatory profiling) have been recommended in order to identify symptom-tailored predictive measures for diagnosis and treatment.

Keywords: Electroconvulsive therapy; Personalized, predictive brain stimulation; Repetitive transcranial magnetic stimulation; Stereotactic, deep brain modulation; Transcranial direct current/alternating current stimulation.

MeSH terms

  • Electroconvulsive Therapy*
  • Humans
  • Schizophrenia* / therapy
  • Transcranial Direct Current Stimulation*
  • Transcranial Magnetic Stimulation*