Lateral Occipital Cortex as a Novel Target for Neuromodulation to Attenuate Auditory and Visual Hallucinations in a Patient with Ultra-treatment-resistant Schizophrenia: A Case Report
Kiran Bagali 1, Harsh Pathak Pathak 1, Swarna Buddha Nayok 1, Srinivas Balachander 1, Vanteemar S Sreeraj 1*, Ganesan Venkatasubrmanian 1
WISER Neuromodulation Program, National Institute of Mental Health and Neurosciences (NIMHNAS), Bengaluru
Received: April 13, 2024; Revised: June 20, 2024; Accepted: June 24, 2024; Published online: June 24, 2024.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Abstract
Auditory/visual hallucinations and perceptual anomalies are some of the core symptoms experienced by patients with schizophrenia. Studies have implicated the lateral occipital cortex (LOC) as one of the areas to be aberrantly functioning in schizophrenia, possibly associated with the auditory/visual symptoms of schizophrenia. Here, we report a case of a 29-year-old female diagnosed with treatment-resistant schizophrenia on clozapine with persistent auditory verbal hallucinations (AVH) and visual anomalies. Upon targeting the LOC (-40 -66 -8) in this patient, there was a >25% reduction in AVH, with a decrease in the frequency of most visual anomalies and an overall significant response in terms of reduction of symptoms and improvement in functioning. We further discuss the potential of LOC as a novel target for neuromodulation in patients exhibiting perceptual abnormalities, especially in the auditory and visual senses.
Keywords: Hallucination, treatment-resistant schizophrenia, Schizophrenia, Lateral occipital cortex, transcranial direct current stimulation, transcranial electrical current stimulation, Clozapine-resistance


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