Heather Burrell Ward, M.D., on personalizing TMS in schizophrenia

An accelerated, one-day course of transcranial magnetic stimulation (TMS) improved processing speed in adults with schizophrenia or schizoaffective disorder, according to a small study published recently in Molecular Psychiatry. Heather Burrell Ward, M.D., assistant professor of psychiatry and behavioral sciences and director of neuromodulation research at Vanderbilt Health, is the paper's corresponding author. While further study is needed, Ward said TMS could lead to the first effective treatment for cognitive impairment in schizophrenia.

Cognitive deficits are a leading cause of disability in schizophrenia, and the ability to process information quickly is among the most affected functions. Antipsychotics help with many symptoms of psychosis, but no medications are approved for cognitive deficits. Researchers from Vanderbilt Health and Harvard Medical School aimed TMS at the default mode network, where the suppression of activity needed for normal cognition is impaired in schizophrenia.

In this interview with Managed Healthcare Executive, Ward describes TMS as a versatile research tool and potential treatment that could eventually be tailored to the symptoms driving an individual patient's illness. First cleared by the FDA for depression in 2008, TMS has since been cleared for obsessive-compulsive disorder and smoking cessation, and it has been explored as an intervention in “nearly every psychiatric disorder” she said.

“TMS is really exciting because you could think of it as an intervention that you could personalize to a particular patient's symptoms,” she said. “If someone comes in with severe cognitive deficits, you could give them TMS for cognitive impairment. If they have severe hallucinations, you could apply TMS to a brain circuit that you know is involved in auditory hallucinations. So, the possibilities are endless.”