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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

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Auditory/visual hallucinations and perceptual anomalies are one of the core symptoms experienced by patients with schizophrenia. Studies have implicated 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 of 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 reduction 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 auditory and visual senses.

Abstract

Auditory/visual hallucinations and perceptual anomalies are one of the core symptoms experienced by patients with schizophrenia. Studies have implicated 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 of 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 reduction 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 auditory and visual senses.

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