Auditory Verbal Hallucinations (AVH) are the most common type of hallucination in schizophrenia (SZ), experienced by more than 70% of patients, making them a conspicuous target for treatment. AVH treatment with antipsychotic medications can decrease or resolve the symptom, but often at the cost of significant side effects. Additionally, AVH are resistant to pharmacological treatment in 25-30% of patients, rendering this a costly and only partially effective treatment. The present study is designed to be a necessary first step toward the goal of developing effective and non-invasive treatments for AVH. Transcranial direct current stimulation (tDCS) is receiving increasing interest for this purpose, as it relies on a very low energy deposition, is inexpensive to administer, has few side effects, is relatively portable, and is easy to use. tDCS involves neuromodulation by means of constant, low intensity current delivered directly to the brain area of interest via small electrodes placed on the scalp. A recent carefully controlled, double-blind, tDCS treatment trial with randomization to either active treatment or sham groups showed a dramatic reduction in AVH intensity. However, optimized use of any neuromodulatory strategy requires definition of appropriate neuronal targets for modulation. One goal of this project is therefore to refine methods for specifying the spatio-temporal dynamics of the AVH network on a subject-by-subject basis using multi-modal (fMRI+MEG) data analysis and fusion techniques developed by investigators on our COBRE team. A second goal is to apply our knowledge of the AVH neural networks to a trial of tDCS treatment for AVH and determine how tDCS affects AVH nehworks to result in reduction in frequency, duration and intensity of AVH.
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