Journal Article

FZJ-2026-05161

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png fMRI-guided rTMS in the treatment of auditory verbal hallucinations in schizophrenia: a case report

Aytulun, A. (Corresponding author) ; Brouzou, K. ; Campana, M. ; Aliakbari, N. ; Pessanha-Schlegel, F. ; Faustmann, T. J. ; Kujovic, M. ; Kamp, D. ; Lahnakoski, J. M.FZJ* ; Schilbach, L. (Corresponding author)

2026
Frontiers Research Foundation Lausanne

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Please use a persistent id in citations: doi:10.3389/fpsyt.2026.1752143  doi:10.34734/FZJ-2026-05161

Abstract: Auditory verbal hallucinations (AVH) are a core symptom of schizophrenia and contribute substantially to patient suffering and disability. They are among the most persistent symptoms and do not respond to medication in a substantial portion of patients. Here, we report the application of task-based functional magnetic resonance imaging (fMRI)-guided repetitive transcranial magnetic stimulation (rTMS) in a patient with treatment-resistant AVH. An individualized stimulation target was identified in the left temporal cortex near Heschl’s gyrus using a validated fMRI task. Over a period of 18 months, the patient underwent three cycles of inhibitory 1 Hz rTMS of this target. As a result, AVH severity decreased by 33% and the global symptom score improved by 40%. Functional connectivity analyses revealed an increase in coupling between the temporal target seed and a fronto-cingulate-insular network that has been implicated in reality and performance monitoring. This case highlights the potential of fMRI-guided rTMS as a personalized neuromodulatory therapy for refractory AVH in schizophrenia, warranting further systematic investigation.

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Contributing Institute(s):

1. Gehirn & Verhalten (INM-7)

Research Program(s):

1. 5252 - Brain Dysfunction and Plasticity (POF4-525) (POF4-525)

Appears in the scientific report 2026

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