{"doi":"10.1016/j.brs.2021.01.014","title":"A case study of the feasibility of weekly tACS for the treatment of auditory hallucinations in schizophrenia","abstract":"In a previous double-blind placebo-controlled clinical trial for the treatment of auditory hallucinations in patients with schizophrenia, we administered five consecutive days of transcranial alternating current stimulation (tACS) targeted to increase network synchronization between the prefrontal cortex and auditory cortex [[1]Ahn Sangtae Mellin Juliann M. Alagapan Sankaraleengam Alexander Morgan L. Gilmore John H. Jarskog L Fredrik Fröhlich Flavio Targeting reduced neural oscillations in patients with schizophrenia by transcranial alternating current stimulation.Neuroimage. 2019; 186: 126-136Crossref PubMed Scopus (40) Google Scholar]. Our initial study found that tACS restored impaired alpha oscillations and that this increase correlated with clinical benefit. These findings suggest that tACS may be of future therapeutic value, and weekly tACS may be a means of increasing the durability of clinical benefit [[2]Riddle Justin Rubinow David R. Frohlich Flavio A case study of weekly tACS for the treatment of major depressive disorder.Brain Stimul: Basic Transl Clin Res Neuromodul. 2020; 13: 576-577Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar]. However, the feasibility of weekly tACS sessions for the treatment of auditory hallucinations is currently unknown. To address this question, we recruited a single patient from those who completed an ongoing randomized, clinical trial of tACS to participate in an exploratory open-label study of weekly tACS. In this letter, we report on the successful completion of 20 weekly 40-min tACS sessions and a shift in the sense of controllability captured by the auditory hallucination rating scale (AHRS) and a personal log provided by the patient after study completion. Our study supports the feasibility and safety of prolonged, weekly tACS paradigms in patients with schizophrenia. However, due to the exploratory, open-label nature of this study, no conclusions can be drawn about the efficacy of weekly tACS. The patient was a 35-year-old woman diagnosed with schizophrenia at least 10 years prior to study enrollment who was stabilized on lurasidone 80 mg per day before enrolling in the study. The patient is a single female in a long-term relationship and a successful entrepreneur. Her primary complaint was the frequency, duration, and hostile content of her auditory hallucinations and the adverse impact these symptoms had on her ability to run her business. Prior to enrolling in this open-label feasibility study, the patient completed NCT#03221270. As the trial is ongoing, her group assignment in the clinical trial remains undisclosed to the authors. Each week, the patient rested quietly with her eyes open while receiving alpha-frequency tACS for 40 minutes. Stimulation was delivered at 10 Hz with 1 mA zero-to-peak amplitude in-phase to left dorsolateral prefrontal cortex (between F3 and Fp1) and temporal parietal junction (between T3 and P3) with 5 × 5 cm electrodes (see Ref. [[1]Ahn Sangtae Mellin Juliann M. Alagapan Sankaraleengam Alexander Morgan L. Gilmore John H. Jarskog L Fredrik Fröhlich Flavio Targeting reduced neural oscillations in patients with schizophrenia by transcranial alternating current stimulation.Neuroimage. 2019; 186: 126-136Crossref PubMed Scopus (40) Google Scholar]). A 5 × 7 cm return electrode was centered on Cz. Side effects were quantified using a systematic assessment, and all side effects of stimulation reported were expected and determined to be mild [[3]Mellin Juliann M. Alagapan Sankaraleengam Lustenberger Caroline Lugo Courtney E. Alexander Morgan L. Gilmore John H. Jarskog L Fredrik Fröhlich Flavio 'Randomized trial of transcranial alternating current stimulation for treatment of auditory hallucinations in schizophrenia.Eur Psychiatr. 2018; 51: 25-33Abstract Full Text Full Text PDF PubMed Scopus (36) Google Scholar]. There were no serious adverse events and side effects were well tolerated. The patient demonstrated 100% attendance with all 20","journal":"Brain stimulation","year":2021,"id":178090,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":19,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9688,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":236458,"name":"Justin Riddle","orcid":"0000-0003-2251-3643","position":1,"is_corresponding":false},{"id":414158,"name":"L. Fredrik Jarskog","orcid":"0000-0001-6296-3767","position":2,"is_corresponding":false},{"id":395860,"name":"Flavio Frӧhlich","orcid":"0000-0002-3724-5621","position":3,"is_corresponding":false},{"id":723816,"name":"Rachel B. Force","orcid":null,"position":0,"is_corresponding":true}],"reference_count":12,"raw_metadata":null,"created_at":"2026-07-18T23:47:36.112170Z","pmid":"33515747","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}