# Mechanistic clinical trial of individualized tDCS for hallucinations in schizophrenia

> **NIH NIH K23** · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2022 · $192,456

## Abstract

The large majority of patients with schizophrenia (Sz) experience auditory verbal hallucinations (AVH) as a
core feature of their disorders. AVH can be associated with increased aggression, distress, suicide rates, and
difficulty navigating the social environment. They are refractory to treatment with antipsychotics in ~30% of
patients. Physiological dysfunction of posterior auditory/language regions, such as left auditory cortex and
temporoparietal junction, and anterior language regions, such as left inferior frontal cortex and anterior insula,
is thought to play a major role in generating AVH. Noninvasive brain stimulation (NIBS) approaches such as
transcranial magnetic stimulation and transcranial direct current stimulation (tDCS) have shown promise in
treating AVH but have been difficult to reproduce often due to lack of individualized targeting and lack of target
engagement biomarkers. This project investigates individualized high-definition tDCS (HD-tDCS), a novel
technique that produces a more focal electrical field than conventional tDCS, for treatment of AVH. Inhibitory
HD-tDCS is used to test hypotheses regarding two targets, posterior (PosT) and anterior (AntT)
auditory/language regions, and their role in influencing the sensory features (e.g. loudness) and evaluative
features (e.g. salience) of AVH, respectively. Participants are randomized to receive either sham, active
conventional, active PosT, or active AntT stimulation. Individualized targeting and standardized dosing is
achieved by MR-guided computational modeling of electrical fields produced in each participant’s brain
anatomy. Furthermore, functional target engagement is verified by measuring pre/post treatment changes in
elevated resting state functional connectivity (rsFC) within and between PosT and AntT. Etiological biomarkers
that track source monitoring, prediction error, and neurophysiological abnormalities associated with AVH are
also tested pre/post treatment. The project builds on the candidate’s background in basic auditory
neurophysiology, clinical expertise in psychotic disorders and noninvasive brain stimulation, and more recent
fellowship training in basic neuroimaging and neurophysiology. The application proposes a 5-year career
development program which will provide essential and additional training in basic science of AVH, clinical trials
design and implementation, translational neuroimaging, translational neurophysiology, noninvasive brain
stimulation, and academic career skills. The acquired skills will allow the candidate to transition into an
independent patient-oriented researcher investigating individualized noninvasive brain stimulation for treatment
of neuropsychiatric symptoms and disorders. During the project he will work directly with experts in Sz, AVH,
fMRI, rsFC, aEPs, computational modeling, NIBS, and clinical trial design. The results of the proposed clinical
trial will guide future novel interventions for neuropsychiatric disorders using in...

## Key facts

- **NIH application ID:** 10300065
- **Project number:** 5K23MH119318-03
- **Recipient organization:** COLUMBIA UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** Michael Avissar
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $192,456
- **Award type:** 5
- **Project period:** 2019-12-01 → 2024-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10300065

## Citation

> US National Institutes of Health, RePORTER application 10300065, Mechanistic clinical trial of individualized tDCS for hallucinations in schizophrenia (5K23MH119318-03). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10300065. Licensed CC0.

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