Psychological Medicine

Original Articles

A sham-controlled trial of left and right temporal rTMS for the treatment of auditory hallucinations

C. K. Looa1 c1, K. Sainsburya1, P. Mitchella1, D. Hadzi-Pavlovica1 and P. S. Sachdeva1

a1 School of Psychiatry, University of NSW and Black Dog Institute, Sydney, Australia


Background Several studies have reported reduction of auditory hallucinations (AH) after repetitive transcranial magnetic stimulation (rTMS) to the left temporal cortex. This study explored the effects of rTMS to the left and right temporal cortex.

Method Eighteen subjects with schizophrenia and frequent AH were enrolled in a double-blind, cross-over trial of 3 days of active rTMS to the left or right temporal cortex, or sham rTMS to the vertex (control condition), followed by an open treatment phase. The effects on AH were assessed by a blinded rater, using the Auditory Hallucination Rating Scale (AHRS).

Results During the double-blind phase, active temporal rTMS did not result in significantly greater improvement in hallucination scores than sham rTMS to the vertex, apart from a reduction in distress scores. Hallucination scores improved during the open continued treatment phase.

Conclusions This study did not demonstrate an advantage for left temporal rTMS compared to right temporal and sham stimulation, over a 3-day stimulation period, but found modest improvement in hallucinations during continued open label treatment.

(Received December 15 2008)

(Revised June 09 2009)

(Accepted June 24 2009)

(Online publication August 06 2009)


c1 Address for correspondence: Dr C. K. Loo, Black Dog Institute, Prince of Wales Hospital, Hospital Road, Randwick, NSW 2031, Australia. (Email: