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TMS Therapy for Schizophrenia

TMS Therapy for Schizophrenia

Many people experience some type of mental illness. But some psychiatric disorders are less known and less accepted than others - this is the case with schizophrenia.

In one of its current reports, the World Health Organization cites that schizophrenia affects around one in 300 people around the globe. Yet, approximately 66% of people with this mental health condition do not receive appropriate treatment and suffer discrimination and stigma in their communities.

Suffering from or loving someone who has schizophrenic symptoms is quite challenging. But thanks to current advances in neurosciences, psychology, medicine, and technology, schizophrenia has become a treatable condition. Nowadays, we are in an era where people with schizophrenia benefit from different effective treatments. The first step is awareness. 

TMS for Schizophrenia

If you are reading this because you received a diagnosis of schizophrenia or love someone suffering schizophrenic symptoms, you may be wondering what treatments can help. You may have also come to understand that transcranial magnetic stimulation (TMS) could be an effective solutiMeon.

We want to honor your motivation by offering an insight into this mental health condition, including its symptoms, causes, and risk factors. We also want to provide you with insight into how transcranial magnetic stimulation may become a great ally in helping you or a loved one treat symptoms of schizophrenia.

Related: TMS Therapy for stroke patients

Understanding Schizophrenia

People with schizophrenia do not have multiple personalities. There is a widespread misconception that this mental illness causes split personalities, but this could not be further from the truth. Schizophrenia is a disorder that affects how people think, act, feel, make decisions, and regulate their emotions.

When a person has schizophrenia, their perception of reality differs from ordinary perceptions. People may hear, see, or feel things that no one else perceives, and they may also believe things that are far from common sense. However, these perceptions and beliefs may seem as real as any event happening in reality.

People with schizophrenia may find it extremely hard to distinguish facts from hallucinations or delusions. This challenge may lead them to become victims of discrimination and experience further mental health issues such as major depression or addiction.

The initial symptoms of schizophrenia in men appear in their late teens or 20's. In contrast, symptoms often arise in women in early adulthood (in their 20's or 30's). So far, mental health professionals agree that it is infrequent that a person shows schizophrenic symptoms when they are under 12 years old or over 45 years of age.

Schizophrenia Symptoms

When mental health professionals evaluate symptoms of schizophrenia, they often divide them into two categories: positive symptoms and negative symptoms. These adjectives do not mean that some of these signs are good and others bad. Instead, positive symptoms refer to the presence of some conditions most people do not have. In contrast, negative symptoms suggest a reduced mental or cognitive function.

To give you a better picture of these two categories, we have shared some of the symptoms that belong to each below.

Positive Symptoms

  • Hallucinations - These may be related to any of the five senses (visual, gustatory, olfactory, tactile, or auditory hallucinations). The hallucination severity varies from case to case. Often younger people experience more potent forms of hallucinations.
  • Delusions - While schizophrenia is often associated with persecutory or grandiose delusions, these are not the only ones. People with schizophrenia may also experience:
  • somatic delusions (the belief that one is suffering from illnesses).
  • religious delusions (the idea that one embodies a deity or has superpowers).
  • referential delusion (the impression that the media is sending an implicit message to that person).
  • Other psychotic symptoms - Engaging in disorganized behaviors or speech. An example of disorganized behavior can be to remain still for hours or to engage in repetitive movements. Sometimes, people share that they feel as though they do not control their bodies, but someone else makes them act in a certain way. Examples of disorganized speech include saying words that do not make sense or speaking about something completely unrelated to the conversation.

Negative Symptoms of Schizophrenia

Withdrawal

Many mental health disorders, such as major depression, social anxiety disorder, and post-traumatic stress disorder (PTSD), cause people to withdraw from interacting with others. Sometimes, teens also isolate themselves from their families or some friends.

To evaluate if someone has schizophrenia, withdrawal and the following negative symptoms should accompany other positive symptoms.

Avolition

Mental health professionals use this term to express a complete lack of motivation to engage in or complete even the most basic life activities, such as taking a bath, brushing teeth, doing grocery shopping, etc. From the outside, some people with schizophrenia may seem neglectful with their hygiene, college, work, or home responsibilities.

Restricted Emotions

Clinical studies have shown that people with schizophrenia may experience intense emotions triggered by a present situation. Still, they have difficulties feeling emotions linked to past or future events — for example, a happy experience or feeling excited about a future event.

Read more: Pros and Cons of TMS Therapy

Emotions and thoughts are interconnected. Having distorted thinking or cognitive issues may compromise the ability to fully feel the wide range of feelings other people may experience.

Poverty of Speech

In clinical terms, this negative symptom is called alogia. It refers to a withdrawal from speaking to others. Most of the time, alogia occurs when there are interruptions in the thought process. These interruptions create a barrier to engaging or following conversations.

Attention Issues

Among other symptoms of schizophrenia, it is common for people to concentrate and focus on activities or tasks. Studies have shown that this may result from some brain circuits working faster and other brain regions functioning at a much slower pace.

Since the 1980s, mental health professionals have been using the negative syndrome scale - The Scale for the Assessment of Negative Symptoms - to evaluate the presence and intensity of these five symptoms in people experiencing this mental disorder.

Read more: TMS Therapy for chronic pain

What Are the Causes of Schizophrenia?

The actual cause of schizophrenia remains unknown. However, some risk factors increase the chances of some people developing symptoms of schizophrenia:

Genetics

Even though schizophrenia is not a prevalent mental health illness, research has shown that it deeply runs in families' genetics. This does not mean that you will develop this condition if someone in your family experiences schizophrenia.

Instead, scientists have found that there are "over 250 places in the genome that contribute to overall risk for schizophrenia." Not one gene, but the combination of many increases a person's risks.

Brain Chemistry

Thanks to neuroimaging, scientists have found that there are significant differences in the structure and brain circuits of people with schizophrenia. For example, people with schizophrenia usually have different levels of dopamine (a neurotransmitter), higher or lower activation of some brain circuits, and a different structure in some brain regions (dorsolateral prefrontal cortex or prefrontal cortex).

Environment

Environmental factors play a crucial role in triggering psychotic symptoms in people who have a predisposition to schizophrenia. Since long ago, scientists have established the connection between the adverse effects that stressful and chaotic environments have on a person's health.

This link is also valid for schizophrenia. Challenging life circumstances, poverty, a disruptive household, and a violent environment are all risk factors that may trigger a schizophrenic episode.

Substance Abuse

Alcohol and drugs do not cause schizophrenia, but they do increase a person's risk of experiencing psychotic symptoms when they have a genetic predisposition. In addition, studies have shown that the use of alcohol, cannabis, amphetamine, cocaine, or LCD may be detrimental for schizophrenia as it could compromise treatment or lead to a relapse.

Are There Treatments for Schizophrenia?

Schizophrenia is a psychiatric disorder that has no cure. However, this does not mean that a person cannot live everyday life. The advances in medicine, neuroscience, and technology have made it possible to manage positive symptoms and improve negative symptoms of schizophrenia.

Nowadays, most mental health professionals use a combined treatment of antipsychotic medication, talking therapy, and treatment groups to help people improve their quality of life. All of these approaches have been helpful to a certain extent.

The use of antipsychotic medication helps reduce positive symptoms of schizophrenia (i.e., hallucinations and delusions) by lowering the level of dopamine in brain circuits. High levels of dopamine contribute to an increase in hallucination severity.

However, lower dopamine levels worsen negative symptoms (i.e., lack of motivation and a flat emotional state). So, while antipsychotic medication may cause a significant improvement of positive symptoms, it may trigger or worsen negative symptoms of schizophrenia.

Talk therapies, treatment groups, and developing self-care practices are all practical approaches to treating symptoms of schizophrenia. However, these approaches have some limitations related to addressing positive symptoms.

TMS for Schizophrenia

Transcranial magnetic stimulation (TMS) treatment is a form of non-invasive brain stimulation. Developed in 1985 by Dr. Anthony Baker, transcranial magnetic stimulation has since won international recognition and received Food and Drug Administration (FDA) approval for treating major depression, obsessive-compulsive disorder (OCD), and pain associated with migraines. TMS treatments also have helped to address symptoms that are resistant to medication.

But how does transcranial magnetic stimulation work? During a session, a magnetic coil is placed on your scalp. The electromagnet emits a painless magnetic pulse that activates or decreases the activity of the affected brain circuits. The activation or reduction of brain activity depends on the magnetic frequency level during TMS treatments.

For example, low-frequency TMS aims to decrease brain regions experiencing hyperactivity. High-frequency TMS does precisely the opposite; its goal is to reactivate brain circuits that are not functioning at their best capacity.

Transcranial magnetic stimulation treatments often follow two phases. First, a doctor may recommend applying a single or double magnetic pulse to explore which brain areas are not functioning correctly. Following this, most transcranial magnetic stimulation treatments will involve repetitive use of magnetic stimulation. This repetitive approach is called repetitive transcranial magnetic stimulation (rTMS).

Now, you may be wondering, how can transcranial magnetic stimulation treatment or repetitive transcranial magnetic stimulation help someone with schizophrenia? To help you understand, we have outlined a few ways this treatment helps below.

  • Transcranial magnetic stimulation can target specific brain areas, alternating low-frequency TMS and high-frequency TMS to address specific symptoms of schizophrenia.
  • Low-frequency TMS reduces positive symptoms of schizophrenia, while high-frequency transcranial magnetic stimulation helps reduce negative symptoms.
  • Studies have also shown that repetitive transcranial magnetic stimulation can help with positive and negative symptoms of schizophrenia, especially auditory verbal hallucinations.

Clinical Research and Studies

In the last few decades, there has been an increase in the number of clinical studies exploring the use of transcranial magnetic stimulation for treating schizophrenia. Most of these clinical trials apply repetitive transcranial magnetic stimulation to one group of participants and sham TMS to another group.

In 2015, the scientific journal, Innovation in Clinical Neuroscience published a literature review on the effectiveness of transcranial magnetic stimulation in clients with schizophrenia. After reviewing clinical trials and studies published that apply the treatment to a group of participants and sham treatment to another group, the authors concluded that:

"Research over the past 15 years supports the use of TMS treatment as a safe and efficacious means of treating positive and negative symptoms of schizophrenia, with the most notable body of evidence supporting the reduction of auditory hallucinations."

A similar literature review published in 2021 supports these findings. After reviewing 56 studies, there was a significant superiority using transcranial magnetic stimulation (TMS) to treat positive symptoms and negative symptoms of schizophrenia.

Seeking Help

If you or someone you love is experiencing signs of schizophrenia, please know that help is available. Schizophrenia does not have to prevent you or your loved one from living a fulfilling life.

Our caring team at GIA Miami is ready to welcome you and your family members. We are more than happy to talk to you about available treatment options to improve this debilitating condition, including different TMS treatments such as prefrontal TMS, repetitive transcranial magnetic stimulation, and deep transcranial magnetic stimulation.

If you would like to find out more about this non-invasive brain stimulation treatment, all you need to do is to give us a call at 561.462.4099.

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