Shamanna Varsha, Pathak Harsh, Nayok Swarna Buddha, Parlikar Rujuta, Sreeraj Vanteemar S, Venkatasubramanian Ganesan
Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India.
Clin Psychopharmacol Neurosci. 2025 Aug 31;23(3):513-515. doi: 10.9758/cpn.24.1213. Epub 2024 Oct 29.
Incomplete hippocampal inversion (IHI) is associated with epilepsy and schizophrenia, often leading to persistent auditory verbal hallucinations (AVH). This case study discusses a 23-year-old with diagnosed with schizophrenia, intellectual disability, and a seizure disorder, having AVH non-responsive to multiple antipsychotics. Magnetic resonance imaging indicated left hippocampal IHI. In view of the increased risk of seizure with clozapine, transcranial direct current stimulation (tDCS) was administered, targeting the left temporoparietal junction using cathodal stimulation and left dorsolateral prefrontal cortex using anodal stimulation. Following 20 sessions over 10 days, AVH significantly improved, with Scale for the Assessment of Positive Symptoms and Auditory Hallucination Rating Scale scores reducing by over 70%, maintaining at a 3-month follow-up. This case highlights tDCS as an effective adjunctive treatment for AVH in schizophrenia with structural brain abnormalities, emphasizing the need for further research into tDCS effects on hippocampal-temporoparietal connectivity.
不完全海马反转（IHI）与癫痫和精神分裂症有关，常导致持续性幻听（AVH）。本病例研究讨论了一名23岁被诊断患有精神分裂症、智力残疾和癫痫障碍的患者，其幻听对多种抗精神病药物均无反应。磁共振成像显示左侧海马IHI。鉴于使用氯氮平会增加癫痫发作风险，于是采用经颅直流电刺激（tDCS）进行治疗，阴极刺激靶向左侧颞顶叶交界处，阳极刺激靶向左侧背外侧前额叶皮层。在10天内进行20次治疗后，幻听症状显著改善，阳性症状评估量表和幻听评定量表得分降低超过70%，并在3个月的随访中保持这一效果。该病例突出了tDCS作为治疗伴有脑结构异常的精神分裂症患者幻听的有效辅助疗法，强调了有必要进一步研究tDCS对海马 - 颞顶叶连接的影响。
