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PubMed2004

Responsiveness to repeated speech stimuli persists in left but not right auditory cortex.

Activation of the auditory cortex habituates with repeated stimulation. While behaviorally adaptive in most circumstances, decreasing auditory responsiveness could interfere with speech perception. We therefore tested whether auditory habituation differs for speech and non-speech stimuli and for left and right auditory cortex. We examined seven right-handed subjects in whom we had determined left-hemispheric language dominance by event-related blood flow assessment. We recorded magnetoencephalographic-evoked responses to trains of four sine tones or vowels and measured the decrement from the first to the last stimulus of the response component about 100 ms after stimulus onset (N1). For the sine tones there was a decrement in both hemispheres. Conversely, for vowels there was significant attenuation of the auditory decrement in the left compared with the right hemisphere (p=0.017). This left-hemisphere persistence in auditory responsiveness to vowels demonstrates that the human brain processes speech stimuli differently than non-speech stimuli and that the left-hemisphere plays a dominant role in this speech-specific auditory processing.

Acoustic Stimulation↗
PubMed1988

Cortical auditory disorders: clinical and psychoacoustic features.

The symptoms of two patients with bilateral cortical auditory lesions evolved from cortical deafness to other auditory syndromes: generalised auditory agnosia, amusia and/or pure word deafness, and a residual impairment of temporal sequencing. On investigation, both had dysacusis, absent middle latency evoked responses, acoustic errors in sound recognition and matching, inconsistent auditory behaviours, and similarly disturbed psychoacoustic discrimination tasks. These findings indicate that the different clinical syndromes caused by cortical auditory lesions form a spectrum of related auditory processing disorders. Differences between syndromes may depend on the degree of involvement of a primary cortical processing system, the more diffuse accessory system, and possibly the efferent auditory system.

Adult↗
PubMed1993

Tonotopic and functional organization in the auditory cortex of the big brown bat, Eptesicus fuscus.

1. In Eptesicus the auditory cortex, as defined by electrical activity recorded from microelectrodes in response to tone bursts, FM sweeps, and combinations of FM sweeps, encompasses an average cortical surface area of 5.7 mm2. This area is large with respect to the total cortical surface area and reflects the importance of auditory processing to this species of bat. 2. The predominant pattern of organization in response to tone bursts observed in each cortex is tonotopic, with three discernible divisions revealed by our data. However, although cortical best-frequency (BF) maps from most of the individual bats are similar, no two maps are identical. The largest division contains an average of 84% of the auditory cortical surface area, with BF tonotopically mapped from high to low along the anteroposterior axis and is part of the primary auditory cortex. The medium division encompasses an average of 13% of the auditory cortical surface area, with highly variable BF organization across bats. The third region is the smallest, with an average of only 3% of auditory cortical surface area and is located at the anterolateral edge of the cortex. This region is marked by a reversal of the tonotopic axis and a restriction in the range of BFs as compared with the larger, tonotopically organized division. 3. A population of cortical neurons was found (n = 39) in which each neuron exhibited two BF threshold minima (BF1 and BF2) in response to tone bursts. These neurons thus have multipeaked frequency threshold tuning curves. In Eptesicus the majority of multipeaked frequency-tuned neurons (n = 27) have threshold minima at frequencies that correspond to a harmonic ratio of three-to-one. In contrast, the majority of multipeaked neurons in cats have threshold minima at frequencies in a ratio of three-to-two. A three-to-one harmonic ratio corresponds to the "spectral notches" produced by interference between overlapping echoes from multiple reflective surfaces in complex sonar targets. Behavioral experiments have demonstrated the ability of Eptesicus to use spectral interference notches for perceiving target shape, and this subpopulation of multipeaked frequency-tuned neurons may be involved in coding of spectral notches. 4. The auditory cortex contains delay-tuned neurons that encode target range (n = 99). Most delay-tuned neurons respond poorly to tones or individual FM sweeps and require combinations of FM sweeps. They are combination sensitive and delay tuned.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMedDate not supplied

Central auditory processing disorder as the presenting manifestation of subtle brain pathology.

The objective of this case-report study was to assess the presence of central auditory impairment in a patient with a normal neurological examination. This subject was a 45-year-old female with gradually deteriorating hearing difficulties over a period of 5 years and a borderline normal audiogram. Behavioural central auditory tests were used, including Dichotic Sentence Identification Test, Competing Sentences Test, and auditory event-related potentials (mismatch negativity). Behavioural central auditory tests and mismatch negativity results were abnormal and indicated disordered central auditory processing. Subsequent magnetic resonance imaging of the brain identified subtle changes consistent with small-vessel ischaemic disease. Adult patients who present with hearing difficulties that cannot be explained on the basis of their audiogram should undergo central auditory assessment, as the auditory symptoms may be the first and only manifestation of central nervous system pathology.

Audiometry, Pure-Tone↗
PubMed1993

Auditory evoked potentials recorded from different skull locations in the rat.

Auditory evoked potentials were recorded from different skull sites in the rat. From over the cerebellum, the inferior colliculus, the thalamus and the auditory cortex, a series of discrete slow potentials of positive polarity were identified. The timing of these waveforms was compared with each other and with the high frequency components of the brainstem auditory evoked potential. Potentials recorded from over the inferior colliculus and the thalamus consisted of two possible responses, one of which predominated in an individual animal. Tentative origins for these slow potentials include the cerebellar cortex, the termination of the lateral lemniscus, the brachium of the inferior colliculus, the medial geniculate body, the auditory radiations and primary auditory cortex. It is concluded that as the afferent volley ascends the central auditory pathways, it generates initially the fast waves of the brainstem auditory potential followed by a series of slow positivities.

Acoustic Stimulation↗
PubMed2006

[Auditory evoked potentials].

Auditory evoked potentials (AEPs) are an electrical manifestation of the brain response to an auditory stimulus. The waveform represents the passage of electrical activity provoked by auditory stimuli from the cochlea to cortex. The waves represented by I-VII are generated mainly in the brainstem. These waves are called the brain stem auditory evoked potentials (BAEPs) or the auditory brain stem response (ABR). The middle latency AEPs (MLAEP) are generated from the medial geniculate and primary auditory cortex. The long latency AEPs (LLAEP) are generated from the frontal cortex and association areas. The BAEPs appear to be an exquisitely sensitive monitor for pathological events during surgery. Anesthetics and mild hypothermia have minimum effect, if any, on the BAEPs. The BAEPs are useful during the microvascular decompression of the fifth or seventh cranial nerve, resection of acoustic neuroma and posterior fossa operations. Because the auditory pathway occupies a small area in the brainstem, combined use of other evoked potentials such as short latency sensory evoked potentials is recommended. The MLAEPs are most promising evoked responses for monitoring awareness or depth of anesthesia. When the concentration of anesthetics is increased, the amplitudes of the MLAEP's peaks are decreased and their latencies are elongated. Commercially developed A-line AEP monitor or aepEX can extract the AEPs waveform in a short period and automatically analyze the changes in the MLAEPs. These AEP based monitors may be superior to bispectral index (BIS) in detecting the transition from unconsciousness to consciousness.

Anesthesia↗
PubMed1993

[Monitoring intraoperative processing of acoustic stimuli with auditory evoked potentials].

130 Patients undergoing elective intra-abdominal, gynaecological, urological or cardiac surgery were studied after institutional approval and informed consent. In all patients auditory-evoked potentials (AEP) were recorded in the awake state and during general anaesthesia. Latencies of the peaks V, Na, Pa, Nb and P1 were measured. V belongs to the brainstem-generated potentials, which demonstrates that auditory stimuli were correctly transduced. Na, Pa, Nb, P1 are generated in the primary auditory cortex of the temporal lobe. During anaesthesia with isoflurane, enflurane, thiopentone, etomidate and propofol the peak V remains unchanged, whereas the mid-latency auditory-evoked potentials (MLAEP) show marked increases in latencies and decreases in amplitudes or are even completely suppressed. This indicates a successful stimulus transmission up to the level of the brainstem and midbrain. However, stimulus processing in the primary auditory cortex is blocked. Under increasing end-expiratory concentrations of isoflurane MLAEP show a dose-dependent increase of latencies and decrease of amplitudes. Under surgical anaesthesia with 1.2 vol%, MLAEP are nearly completely suppressed. A different picture can be seen when MLAEP were recorded during anaesthesia with the receptor-specific anaesthetics midazolam, flunitrazepam, diazepam, fentanyl and ketamine. During anaesthesia with receptor-specific anaesthetics, the brainstem peak V as well as the mid-latency components remain nearly unchanged compared with AEP from awake patients. This indicates that auditory stimuli reach the primary auditory cortex and are processed at a primary cortical level. With increasing doses of fentanyl one can observe only a significant decrease of amplitudes for the late component P1.(ABSTRACT TRUNCATED AT 250 WORDS)

Acoustic Stimulation↗
PubMed1996

Topography of auditory evoked cortical potentials in children with severe language impairment.

Development of normal speech and language functions is closely related to normal hearing. However, most children with delayed or disturbed speech development show normal tone thresholds and here the investigation has to include higher levels in the auditory system. There is evidence for a connection between language impairment and a central auditory processing disorder, but the underlying mechanisms are not well understood. There is also a need for objective diagnostic methods of central auditory function. In the present study, a computerised method of mapping the scalp topography of long-latency (cortical) auditory evoked potentials (LAEP) was used for assessment of the function in central auditory pathways. Topographic mapping of the LAEP component N1, in adults and normal children, showed reproducible and valid results. In adults, a focal negativity, focus of NI (FNI), with a frontocentral position and contralateral to the stimulated ear was observed. The N1 maps in normal children showed a pattern similar to that in adults, but with some age-related changes. The N1 latencies declined significantly with age in normal children and reached adult values at the ages of 14-16 years. The topography of the LAEP components N1, P2, N2 and the T complex was investigated in 20 children with severe language impairment (LI). The study also included auditory brainstem responses (ABR), electroencephalography (EEG), quantitative EEG (qEEG) and magnetic resonance imaging (MRI). Twenty normal children served as controls (C). A similar topographic pattern was found in the LI and the C children, but with a higher proportion of deviating and non-focal maps in the LI group. The latencies of all components were significantly longer in the LI than in the C children. The diagnostic value of LAEP topography, latency and amplitude was estimated with a scoring system, whereby significantly higher scores were found in the LI group than in the C group. With all three parameters together the sensitivity was 65%, with a specificity of 90%. There was a high degree of pathological EEGs in the LI group. ABR abnormalities were seen in some LI subjects. MRI was normal in all but two LI children. There was no significant correlation between the results of EEG, ABR, MRI and the total score of LAEP, but some LI children showed a wide pathological pattern. In 17 of the 20 LI subjects a pathological result was obtained in one or more of the investigations. In conclusion, our results may indicate that language impairment has a dual pathophysiology, a specific auditory disorder (LAEP, ABR) and a non-specific general cerebral disturbance (EEG, MRI). The highly varying results among the present LI children, with specific and/or non-specific deviations, may be due to heterogeneity of the group with different aetiologies of their language impairment, or to a general developmental disturbance with a varying distribution and penetrance. The scoring system of LAEP proved to be the most sensitive method in separating the LI children from the controls. This may be a promising model for individual diagnostic criteria and for classification of language impairment.

Adolescent↗
PubMed2004

Effect of age at cochlear implantation on auditory skill development in infants and toddlers.

OBJECTIVES: To investigate the effect of age at cochlear implantation on the auditory development of children younger than 3 years and to compare these children's auditory development with that of peers with normal hearing. DESIGN: Using a repeated-measures paradigm, auditory skill development was evaluated before and 3, 6, and 12 months after implantation. Data were compared with previously published data from cohorts with normal hearing. PARTICIPANTS: One hundred seven hearing-impaired children (age range, 12-36 months) who received a cochlear implant during clinical trials in North America. MAIN OUTCOME MEASURE: Auditory skill development was assessed using the Infant-Toddler Meaningful Auditory Integration Scale, a tool that provides a quantitative measure in children as young as newborns. RESULTS: Infants and toddlers who receive implants show rapid improvement in auditory skills during the first year of device use regardless of age at implantation, although younger children achieve higher scores. Children who undergo implantation at a younger age acquire auditory skills nearer to those of their peers with normal hearing at a younger age. The mean rate of acquisition of auditory skills is similar to that of infants and toddlers with normal hearing regardless of age at implantation. CONCLUSION: Performing implantation in children with profound hearing loss at the youngest age possible allows the best opportunity for them to acquire communication skills that approximate those of their peers with normal hearing.

Age Factors↗
PubMed1998

Potassium currents and excitability in second-order auditory and vestibular neurons.

Potassium channels are involved in the control of neuronal excitability by fixing the membrane potential, shaping the action potential, and setting firing rates. Recently, attention has been focused on identifying the factors influencing excitability in second-order auditory and vestibular neurons. Located in the brainstem, second-order auditory and vestibular neurons are sites for convergence of inputs from first-order auditory or vestibular ganglionic cells with other sensory systems and also motor areas. Typically, second-order auditory neurons exhibit two distinct firing patterns in response to depolarization: tonic, with a repetitive firing of action potentials, and phasic, characterized by only one or a few action potentials. In contrast, all mature vestibular second-order neurons fire tonically on depolarization. Already, certain fundamental roles have emerged for potassium currents in these neurons. In mature auditory and vestibular neurons, I(K), the delayed rectifier, is required for the fast repolarization of action potentials. In tonically firing auditory neurons, I(A), the transient outward rectifier, defines the discharge pattern. I(DS), a delayed rectifier-like current distinguished by its low threshold of activation, is found in phasically firing auditory and some developing vestibular neurons where it limits firing to one or a few spikes, and also may contribute to forming short-duration excitatory postsynaptic potential (EPSPs). Also, I(DS) sets the threshold for action potential generation rather high, which may prevent spontaneous discharge in phasically firing cells. During development, there is a gradual acquisition and loss of some potassium conductances, suggesting developmental regulation. As there are similarities in membrane properties of second-order auditory and vestibular neurons, investigations on firing pattern and its underlying mechanisms in one system should help to uncover fundamental properties of the other.

Action Potentials↗
PubMed1996

Neurotrophic factors as pharmacological agents for the treatment of injured auditory neurons.

Mature auditory neurons degenerate in response to a loss of target-derived trophic factors. Neurotrophic factors influence the health and viability of auditory neurons. This suggests that neurotrophic factors can be used as therapeutic agents to prevent neuronal cell death and to initiate repair of damaged neuronal processes in the injured auditory system. Both in vitro and in vivo experiments have been performed to determine which of the vast array of neurotrophic factors affect mature auditory neurons and how they can be delivered to the sites of injury within the auditory system. Neurotrophin 3 was found to be a major survival factor for auditory neurons. Brain-derived neurotrophic factor is a minor survival factor for auditory neurons and nerve growth factor, although not promoting survival, does elicit the repair of neuronal processes. Fibroblast growth factor 2, transforming growth factor beta 1 and ciliary neurotrophic factor function as injury-response factors in the auditory system. Combination of different classes of growth factors has an additive effect on neuronal survival. Growth factors may be able to be delivered to sites of injury within the cochlea by either direct perfusion or gene therapy (e.g. a defective virus expressing a growth factor gene).

Animals↗
PubMed1983

Studies on cell migration and axon guidance in the developing distal auditory system of the mouse.

The events that take place along the potential route of distal auditory axons (future vestibular component) prior to and during their outgrowth were examined morphologically using timed mouse embryos. During embryonic (E) day 9.5 a discrete zone of cell death appears in the rostrolateral wall of the otic cup. Necrosis is accompanied by outward migration of epitheloid cells from the same region of the otic wall. Temporally and spatially correlated with these two events is the widening of extracellular spaces between otic neuroepithelial cells and the breakdown of basement membrane. During E 10.5 migrating epitheloid cells condense to form a funnel-shaped configuration. This cellular "funnel" begins narrowly at the dorsorostrolateral wall of the otocyst and broadens as it reaches the auditory ganglion. During E 11.5 through E 12.5, "pioneer" distal auditory axons take a circuitous route and ascend from the auditory ganglion to enter the otocyst. Axons extend toward the otocyst moving along cells of the "funnel," maintaining an orientation similar to that of the cells that compose it. Axon growth cones enter the otocyst at sites devoid of basement membrane and invade the wall of the otocyst moving tangentially along radially arranged cells that bridge the otocyst and the "funnel." These observations demonstrate that a preformed, funnel-shaped tissue exists along the future route of the auditory fibers. We suggest that the "funnel" may influence the growth and directionality of distal auditory axons as they extend from the auditory ganglion to the wall of the otocyst. At the otic wall, the transition provided by "bridge" epitheloid cells, together with the absence of basement membrane at specific sites of the otic wall, provide the auditory axons with a route into the otocyst.

Animals↗
PubMed2000

Low-level toluene disrupts auditory function in guinea pigs.

Toluene appears to have adverse effects on the human auditory system, but it is difficult to estimate its potency since it is commonly present in the workplace in combination with noise exposure; workplace noise exposures are often highly variable. Studies designed to assess toluene ototoxicity specifically have been limited to high-dose studies in a single laboratory animal model, the rat. Here permanent hearing loss has been observed at concentrations of 1000 ppm toluene and greater after inhalation exposure for 5 days, 6 h/day. The OSHA threshold limit value for toluene is only 100 ppm. The current study focuses on the onset of toluene ototoxicity acutely in the guinea pig and in adducing a mechanism of effect. In this study, evidence is presented for the impairment of auditory function by toluene in the guinea pig, at a concentration substantially lower than that used for studying permanent impairment in the rat. The impaired function was correlated with reduced energy metabolism in outer hair cells. Assessment of auditory function was made using distortion product otoacoustic emissions (DPOAE) with subsequent measurement of succinate dehydrogenase (SDH) staining density in hair cells using surface preparations. Temporary disruption of auditory function in guinea pigs is seen in subjects exposed to 250, 500, and 1000 ppm toluene for 8 h/day, 5 day/week for 1 and 4 weeks. Concentrations as low as 250 ppm toluene were able to disrupt auditory function acutely in the guinea pig, and 500 and 1000 ppm toluene produced greater acute dysfunction. SDH staining suggests that reduced enzyme activity in the midfrequency region of the cochlea occurs acutely following toluene exposure. Although the auditory dysfunction progressed between 1 and 4 weeks of exposure, a permanent loss did not develop for these subjects and hair cell death was not seen. The current study identifies early evidence of auditory system impairment in the guinea pig at low toluene concentration and evidence for impairment of energy production in hair cells. While even a transient auditory impairment has implications for workplace safety, additional study on the transition from such acute effects to permanent impairment is essential.

Animals↗
PubMed1995

Effects of eye position on saccadic eye movements and on the neuronal responses to auditory and visual stimuli in cat superior colliculus.

Many neurons in the deeper layers of the superior colliculus (SC) respond to multiple sensory inputs--visual, auditory, and somatic--as well as provide signals essential for saccadic eye movements to targets in different modalities. When the eyes and pinnae are in primary position, the neural map of auditory space is in rough topographic alignment with the map of visual space, and if the auditory map is based solely on headpinna coordinates, any changes in eye position in the orbit will cause misalignment of the maps. We investigated the effects of eye position on the response of sound-sensitive neurons in the SC of cats because previous work on cats and on monkeys had suggested the possibility of species differences in the representation of auditory signals in the SC. We also investigated the effects of eye position on the accuracy of saccades to auditory, visual, and bimodal stimuli. All studies were conducted in alert, trained cats with the head restrained in a fixed position. Neuronal and behavioral responses were studied during periods when the eyes were steadily directed to different positions relative to the position of the sound. Cats showed partial compensation for eye position in making saccades, regardless of the modality of the target, and they showed similar patterns of error in saccades to auditory and visual targets. These behavioral data are consistent with coding the location of visual and auditory targets in the same coordinate system. In the vast majority of intermediate-layer neurons, eye position significantly affected the number of spikes evoked by sound stimuli. For most of these neurons, changes in eye position produced significant shifts in the speaker location producing maximal response. In some neurons, eye position significantly facilitated the magnitude of neuronal response evoked by sounds from a variety of speaker locations. Because few pinna movements could be detected, in is unlikely that these changes in neuronal response could be due to changes in the position of the pinnae. Our results indicate that the deep layers of the SC contain an eye-centered representation of sound location. Because eye position did not affect the percentage of neurons exhibiting multimodal integration, visual and auditory maps appear to remain integrated in the SC even when the eyes are directed eccentrically.(ABSTRACT TRUNCATED AT 400 WORDS)

Acoustic Stimulation↗
PubMed2005

Auditory environmental cells and visual fixation effect in area 8B of macaque monkey.

Area 8B may be treated as part of either the prefrontal cortex or the premotor cortex. Previous investigations showed an involvement of area 8B in both eye and ear motor control and in auditory perception. In this report, we studied 139 neurons in three macaque monkeys of these, 32 neurons showed an activity related to environmental auditory stimuli. Fifteen cells with auditory characteristics (15/32) presented a firing discharge inhibited during the execution of visual fixation. The remaining 107 units presented complex or indefinable behaviour. The presence of auditory environmental cells which activity is related prevalently to the voice of persons (researchers) suggests that area 8B may be an area involved in auditory cross-modal association, in natural behaviour. The inhibitory effects during visual fixation suggest that area 8B is part of the inhibitory network preventing the gaze shift in relation to an auditory stimulus. This may be the consequence of the engagement of attention during fixation that may affect the auditory perception. Both aspects indicate that area 8B is involved in high cognitive processes in auditory and orienting processes.

Acoustic Stimulation↗
PubMed1991

Children's auditory and visual processing of narrated and nonnarrated television programming.

Two experiments with 5- and 7-year-old children tested the hypotheses that auditory attention is used to (a) monitor a TV program for important visual content, and (b) semantically process program information through language to enhance comprehension and visual attention. A direct measure of auditory attention was the latency of the child's restoration of gradually degraded sound quality. Restoration of auditory clarity did not vary as a function of looking. Restoration of visual clarity was faster when looking than when not looking. Restoration was faster for visual than auditory degrades, but audiovisual degrades were restored most rapidly of all, suggesting that dual modality presentation maximizes children's attention. Narration enhanced visual attention and comprehension including comprehension of visually presented material. Auditory comprehension did not depend on looking, suggesting that children can semantically process verbal content without looking at the TV. Auditory attention did not differ with the presence or absence of narration, but did predict auditory comprehension best while visual attention predicted visual comprehension best. In the absence of narration, auditory attention predicted visual comprehension, suggesting its monitoring function. Visual attention indexed overall interest and appeared to be most critical for comprehension in the absence of narration.

Attention↗
PubMed1984

The auditory neurophonic: basic properties.

In anesthetized cats an AC signal or neurophonic can be recorded from the auditory nerve and from the scalp when the cochlea is stimulated with low frequency tones. This study examines some of the basic properties of the auditory neurophonics. The auditory nerve signal, termed the auditory nerve neurophonic (ANN), was differentially recorded with a pair of platinum-iridium ball electrodes placed on either side of the auditory nerve as it exits the internal meatus. The signal recorded from the scalp, termed the frequency following response (FFR), was recorded with silver wire. For purposes of comparison the round window-recorded cochlear microphonic was also examined under identical stimulus conditions. Several measures of the response to acoustic stimulation were taken for each recording configuration. Among these were total response amplitude as a function of stimulus level, spectral component amplitude and phase as a function of stimulus level, fundamental component amplitude as a function of stimulus frequency, response amplitude as a function of time after stimulus onset, response amplitude as a function of forward masker intensity. By all these measures the neurophonic responses are signals that are distinct from the CM and share many of the properties of single units in the auditory nerve. In addition, micro-injections of kainic acid into the cochlear nucleus leave these responses largely unaffected, while tetrodotoxin injections into the cochlea greatly diminish both neurophonic responses, while leaving the CM largely intact. From these results, we conclude that at stimulus levels below 90 dB SPL the ANN is almost entirely neural in origin, while the FFR is certainly largely neural, that is, that both responses are quite distinct from the CM. We also conclude that they represent a spatial summation of neural activity in the auditory nerve, probably arising from the phase-locked response of single units to low frequency stimuli. In addition to demonstrating that the neurophonics are neural responses, we have begun the process of relating their properties to the distributed phase-locked activity in the auditory nerve.

Acoustic Stimulation↗
PubMed2005

Repetitive transcranial magnetic stimulation in schizophrenic patients reporting auditory hallucinations.

Auditory hallucinations are experienced by 60-80% of person with schizophrenia and can often cause significant distress behavioural dyscontrol. The application of rTMS in the left temporoparietal cortex could modulate the neuronal activation and reduce the occurrence of auditory disperceptions. Sixteen schizophrenic patients (treated with atypical antipsycothic drugs) reporting auditory hallucinations were included in the study. Low frequency rTMS (1 Hz) was performed at the 90% of resting motor threshold (MT), during 4 sessions in four consecutive days for 15 minutes each application. Eight patients received active stimulation, while eight patients received sham stimulation. Scale for the assessment of positive symptoms (SAPS), scale for the assessment of negative symptoms (SANS) and a scale to asses the severity of the auditory hallucinations (SAH) were administered at the beginning and at regular intervals during the follow-up. The present study confirms the reduction in auditory hallucinations by means of rTMS. The main finding was the long-term reduction in auditory hallucinations in the active group, with a return to the baseline in the sham group. The negative symptomatology improved only in the later sessions and lasted during the follow-up. The improvements in auditory hallucinations and positive symptomatology increased and lasted during the follow-up till the end-point. These data suggest that this approach may lead to an alternative somatic intervention for auditory hallucination in patients with schizophrenia.

Adult↗