An international team of researchers has used a "computerized rocket game" to help patients with schizophrenia visualize and reduce the level of activity in a region of the brain associated with auditory hallucinations. The condition is known to affect more than 21 million people across the globe.
Schizophrenia is a complex, debilitating mental health condition that can affect a person's ability to distinguish their thoughts and feelings from the reality around them. Symptoms of the disorder range from delusions and muddled thoughts to auditory and visual hallucinations.
Roughly 70 percent of patients suffering from schizophrenia experience verbal hallucinations – internal voices caused by psychosis, that aren't really there. This symptom causes a great deal of distress and can seriously disrupt an individual's day to day life. To make matters worse, traditional antipsychotic drugs have little or no effect for 30 percent of schizophrenia sufferers that experience verbal hallucinations.
The cause of the hallucinations is not fully understood, however, previous studies have identified specific regions of the brain that appear to be connected to the distressing symptom. For example, the superior temporal gyrus (STG), a part of the brain that is known to be sensitive to speech and human voices, has been observed to be hyperactive in patients suffering from auditory hallucinations.
The new pilot study sought to determine whether patients suffering from verbal hallucinations could be trained to regulate the level of activity in their STGs. The researchers selected 12 patients who experienced the hallucinations on a daily basis, and used MRI scanning to observe the STG brain regions in real time during four sessions spread over a two-week period.
During each MRI session, participants in the study were shown a visual representation of their SGT activity in the form of a rocket in a computer game. Without being told how to control the rocket, the patients were asked to devise their own mental strategies to land the spacecraft, which would indicate a lowering of activity in the SGT brain region.
On the fourth and final MRI session, the patients were able to successfully lower their STG activity apparently using the techniques that they had devised themselves, without the visual indicator of the rocket landing.
"We encouraged our patients to use the same control strategies that they learnt in the MRI scanner at home," said Dr. Natasza Orlov of the King's College London's Institute of Psychiatry, Psychology & Neuroscience. "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."
Individuals who participated in the study told the researchers that they were able to apply the techniques developed while playing the rocket game, in their day to day lives to calm and internalize the hallucinations.
Whilst the results of the study appear to be positive, the researchers note two significant drawbacks to the experiment – that the sample size of 12 patients was very small, and that they did not include a control group fed with false SGT data. The lack of a control group leaves open the possibility that the results of the study are the consequence of a placebo effect, rather than the actual ability of participants to manage their brain functions.
Looking to the future, the team is planning a larger test to build on the pilot study and address uncertainties. The research has the potential to open up an entirely new avenue of treatment for tackling verbal hallucinations in schizophrenia patients who cannot rely on traditional methods of treatment.
A paper detailing the research has been published in the journal Translational Psychiatry.
Source: King's College London
