Breakthrough in treating schizophrenia may help patients control hallucinations

Pilot study shows sufferers can learn mental strategies to tackle symptoms

About 70 per cent of people with schizophrenia hear voices, and medication is ineffective for about 30 per cent of patients in treating these verbal hallucinations
About 70 per cent of people with schizophrenia hear voices, and medication is ineffective for about 30 per cent of patients in treating these verbal hallucinations

Scientists believe they have made a breakthrough in treating schizophrenia by helping patients train themselves to control verbal hallucinations using an MRI scanner and a computer game.

A pilot study by researchers at King’s College London’s Institute of Psychiatry, Psychology & Neuroscience (IoPPN) and the University of Roehampton has suggested the new technique can help patients who experience hallucinations but do not respond to medication.

They said their research shows sufferers can learn mental strategies to help ease their symptoms.

The study, which is published in the journal Translational Psychiatry, involved 12 patients who experienced verbal hallucinations on a daily basis.

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About 70 per cent of people with schizophrenia hear voices, which can cause a high level of distress and disruption to daily life, and medication is ineffective for about 30 per cent of patients in treating these verbal hallucinations.

Brain imaging experts targeted a region of the brain which is sensitive to speech and human voices, and is hyperactive in people with schizophrenia and verbal hallucinations.

Neural activity

They designed a “neurofeedback” technique, where patients in a MRI scanner could monitor their own neural activity in the speech sensitive region of the brain.

Neural activity was represented by a computerised space rocket, and patients were instructed to land the rocket by bringing it down to earth.

No explicit instructions were given to patients about how to move the rocket, instead patients were asked to develop their own mental strategies to move it.

After four visits to the MRI scanner, patients were able to reduce neural activity in the speech sensitive region of the brain and were able to control their brain activity without the visual feedback from the space rocket.

After training, patients had learned lasting strategies which they could apply during their daily lives.

Researchers said it is the first time neurofeedback techniques have been investigated for schizophrenia and verbal hallucinations.

Dr Natasza Orlov, of King's IoPPN, said: "We encouraged our patients to use the same control strategies that they learnt in the MRI scanner at home.

“The patients know when the voices are about to start – they can feel it, so we want them to immediately put this aid into effect to lessen them, or stop the voices completely. Our study has shown that people with schizophrenia can learn some sort of mental strategy to help their symptoms – something which several years of medication has not helped with.

Larger sample

“Although the study sample size is small and we lacked a control group, these results are promising. We are now planning to conduct a randomised controlled study to test this technique in a larger sample.”

Prof Paul Allen, from the University of Roehampton, said: "The results of this pilot are astonishing as almost everyone in the patient group was able to control the space rocket, successfully bringing the rocket in the game back down to the ground.

“What this means is that by using this technique, patients learnt to control brain activity in the area of the brain that responds to voices – an area we know is hyperactive in people whom experience auditory verbal hallucinations. These are still early days in our research, however, patients who took part in the pilot study have told us that the training has helped them to calm their external voices down, so that they were able to internalise them more.”

– PA