| Treatment of Alice in Wonderland Syndrome and Verbal Auditory Hallucinations Using Repetitive Transcranial Magnetic Stimulation: A Case Report with fMRI Findings. | |
| | |
MedLine Citation:
|
PMID: 21734437 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
Background: Alice in Wonderland syndrome (AIWS) is a rare cluster of CNS symptoms characterized by visual distortions (i.e. metamorphopsias), body image distortions, time distortions, and déjà experiences. Verbal auditory hallucinations (VAHs) are the most prevalent type of hallucination in adults with or without a history of psychiatric illness. Here, we report the case of a woman with AIWS, long-lasting VAHs, and various additional perceptual and mood symptoms. Methods: Semi-structured interviews were used to assess symptoms, and functional MRI (fMRI) was employed to localize cerebral activity during self-reported VAHs. Treatment consisted of repetitive transcranial magnetic stimulation (rTMS) at a frequency of 1 Hz at T3P3, overlying Brodmann's area 40. Results: Activation during VAHs was observed bilaterally in the basal ganglia, the primary auditory cortex, the association auditory cortex, the temporal poles, and the anterior cingulated gyrus. The left and right inferior frontal gyri (Broca's area and its contralateral homologue) were involved, along with the dorsolateral prefrontal cortex. Interestingly, synchronized activation was observed in the primary visual cortex (areas V1 and V2), and the bilateral dorsal visual cortex. The higher visual association cortex also showed significant, but less prominent, activation. During the second week of rTMS treatment, not only the VAHs, but also the other sensory deceptions/distortions and mood symptoms showed complete remission. The patient remained free of any symptoms during a 4-month follow-up phase. After 8 months, when many of the original symptoms had returned, a second treatment phase with rTMS was again followed by complete remission. Conclusions: This case indicates that VAHs and metamorphopsias in AIWS are associated with synchronized activation in both auditory and visual cortices. It also indicates that local rTMS treatment may have global therapeutic effects, suggesting an effect on multiple brain regions in a distributed network. Although a placebo effect cannot be ruled out, this case warrants further investigation of the effects of rTMS treatment in AIWS. |
| | |
Authors:
|
Jan Dirk Blom; Jasper Looijestijn; Rutger Goekoop; Kelly M J Diederen; Anne-Marije Rijkaart; Christina W Slotema; Iris E C Sommer |
Related Documents
:
|
20231177 - Shared brain activity for aesthetic and moral judgments: implications for the beauty-is... 17415777 - Neural activity of the anterior insula in emotional processing depends on the individua... 22190367 - Early factors associated with axonal loss after optic neuritis. 3219867 - Spontaneous facial expression of emotions in brain-damaged patients. 23206677 - Neurophysiology of deep brain stimulation. 21741887 - The repair function of the multifunctional dna repair/redox protein ape1 is neuroprotec... |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-7-07 |
Journal Detail:
|
Title: Psychopathology Volume: 44 ISSN: 1423-033X ISO Abbreviation: - Publication Date: 2011 Jul |
Date Detail:
|
Created Date: 2011-7-7 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8401537 Medline TA: Psychopathology Country: - |
Other Details:
|
Languages: ENG Pagination: 337-344 Citation Subset: - |
Copyright Information:
|
Copyright © 2011 S. Karger AG, Basel. |
Affiliation:
|
Parnassia Bavo Group, The Hague, The Netherlands. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Maternal Rejection of the Young Child: Present Status of the Clinical Syndrome.
Next Document: Comparative Analysis of Skin Surface Lipids of the Labia Majora, Inner Thigh, and Forearm.