Say the word schizophrenia and what comes to mind?
Most likely it’s an image of a person who hears voices — someone who is carrying on a conversation in a loud manner with themselves.
In a clinic setting, the voices that patients hear are known as auditory verbal hallucination (AVH).
It’s just one in a long list of symptoms that people with schizophrenia endure.
Still, nearly 70 per cent of people who are diagnosed with schizophrenia often experience the symptom of “hearing voices.”
“The voices remain dominant, and most of the time they are unpleasant. They are very intrusive,” Dr Sophia Frangou, a professor of psychiatry at the Icahn School of Medicine at Mount Sinai, told Healthline. “People have been trying to find a way to target these symptoms.”
Treating the voices
Scientists believe a technique called transcranial magnetic stimulation (TMS) therapy can help quell AVH.
A 2015 analysis of more than a decade of research on the treatment showed that it’s effective at reducing AVH.
Earlier this month, a study presented at the ECNP Conference in Paris by a group of French researchers provides further support for this form of therapy for schizophrenia.
TMS essentially calls for an electromagnetic coil to be placed against the scalp. The electromagnet delivers a pulse that stimulates nerve cells in a specific region of the brain that controls mood. It’s often used to treat depression.
The French researchers said they successfully pinpointed the part of the brain that’s identified with AVH. What’s more, they saw a reduction in AVH after treatment.
In a controlled study, a little more than two dozen people with schizophrenia were treated with a “series of 20 Hz high-frequency magnetic pulses over two sessions a day for two days,” according to a press release.
By the end of the treatment session, researchers said there was approximately 30 to 35 per cent reduction in hearing voices. Roughly 9 per cent of patients in the placebo group reported the same decrease.
Dr William Carpenter of the University of Maryland School of Medicine told Healthline that the study was encouraging. But he noted that more research is needed in the area.
“They do have an important finding,” he said.
Frangou noted that there are about 35 other studies on the use of TMS and that this report “adds to the existing evidence” that the technique can work.
Schizophrenia symptoms, treatments
People who have schizophrenia experience a combination of both positive and negative symptoms.
AVH, along with delusions and racing thoughts, are considered positive symptoms.
Negative symptoms are best described as apathy, social withdrawal, and indifference. Diminished cognition is yet another symptom.
Combined, these symptoms make it challenging for an individual with schizophrenia to live a so-called normal life, according to Carpenter.
Not that some don’t, but the disorder is truly life-altering.
“They are far less likely to be employed or married,” he said. “Many end up in prison, or homeless.”
Antipsychotic drugs do help to lessen symptoms, particularly second-generation drugs. These include aripiprazole, clozapine, and olanzapine, and ziprasidone.
“Twenty per cent [of people with schizophrenia] respond extremely well to antipsychotic drugs with in the first five years,” Frangou said.
A 20 per cent response rate doesn’t sound like much to brag about. But she said when you look back over the past 50 years of mental health treatment; the entire industry has come a long way.
“This is a tremendous improvement,” she said.
In another generation or so, she expects to see more targeted and personalised intervention.
The key, she said, is to focus on finding “biological pathways that are modifiable.” Investing in technology that will “change the cross talk in the brain” would be a significant achievement in treating schizophrenia.
In the far-off future, Frangou expects to see microchips capable of delivering drugs to specific parts of the brain.
Carpenter, who’s worked in the field for nearly 60 years, said there are still many unanswered questions as to why schizophrenia develops in some people and not others. Genetics is only part of it.
“What we really need to know is why,” he said.
Ironically, the greatest barrier in finding successful treatments for schizophrenia is the brain itself.
The brain is by far the least accessible organ in the body, compared to what doctors are capable of today in a live organ such as the heart and the liver.
“Figuring out what is wrong with the liver is a whole lot easier,” he said. “We cannot put probes in the brain.”