European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S116–S348 S275
Objectives The primary goal was to evaluate safety and efficacy of
rTMS in treatment-resistant schizophrenia patients with dominant
depressive and negative symptoms in open non-controlled trial.
Aims and patients Thirty-one schizophrenia (ICD-10) patients
with evident depression (CDSS ≥ 6) and negative symptoms and
with stable low rate positive symptoms on combined adequate
pharmacotherapy (antipsychotic + antidepressant), which have not
been changed for at least 6 weeks, were included to the study.
Methods All patients received 15-Hz rTMS on the left dorsolat-
eral prefrontal cortex (100% intensity, 1800 pulses per session, 5
sessions per week, 15 sessions per course) with 8-shaped coil of
Neuro-MS/D stimulator (Neurosoft). The primary efficacy measure
was 50% CDSS score reduction after the 3rd week of treatment. The
secondary measures were weekly reduction rates for CDSS and for
PANSS negative syndrome scale.
Results Twenty (64,5%) patients respond to rTMS. Final mean
CDSS score reduction was 55,2% (P= 0,000004), and mean PANSS
negative scale score reduction was 21,3% (P = 0,000012). Two
patients (6,5%) were excluded due to persistent headaches, no seri-
ous adverse events were observed.
Conclusions rTMS is safe and effective strategy for the manage-
ment of treatment-resistant depression in schizophrenia and can
alleviate negative symptoms. Further sham-controlled studies are
needed.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW459
Long-term electrical stimulation of
bed nucleus of stria terminalis for
obsessive-compulsive disorder
S. Raymaekers ∗, V. Kristof , C. Bervoets , L. Gabriëls ,
L. Luyten emyttenaere uttin
1 Catholic university of Leuven, neurosciences, Leuven, Belgium
2 University psychiatric centre of KU Leuven, pscyhiatry, Leuven,
Belgium
3 University psychiatric centre of KU Leuven, psychiatry, Leuven,
Belgium
4 Catholic university of Leuven, centre for psychology of learning and
experimental psychopathology, Leuven, Belgium
∗ Corresponding author.
Introduction We previously reported that deep brain stimulation
(DBS) in the anterior limb of the internal capsule/bed nucleus of the
stria terminalis (IC/BST) is effective in reducing symptoms in severe
treatment-resistant obsessive-compulsive disorder patients.
Objective To examine the long-term evolution of obsessive com-
pulsive disorder (OCD) symptoms in 24 patients treated with
chronic electrical stimulation in IC/BST.
Aims We aimed to examine the evolution of the Yale-Brown
Obsessive Compulsive Scale (Y-BOCS) and to determine if a num-
ber of predictors assessed before surgery are significantly related
to this evolution.
Methods We used a linear mixed model to investigate the evo-
lution of the Y-BOCS in 24 patients. Data was collected in a
naturalistic manner. Seven hundred measurements, taken during a
total of 1836 follow-up months, are included in this analysis.
Results Our analysis showed a long-term, sustained effect of
electrical stimulation in the IC/BST. After a fast initial decline of
OCD symptoms, these symptoms stay relatively stable. In addition,
results show a strong ON/OFF effect of stimulation (e.g., due to bat-
tery depletion). Beside the ON/OFF effect of stimulation, the surgery
itself has no additional effect on OCD symptoms. The Beck Depres-
sion Inventory (BDI) at baseline was the only predictor significantly
related to the evolution of the Y-BOCS. A higher BDI at baseline
seemed to be related to a smaller decrease of the Y-BOCS over time.
Conclusion Electrical stimulation in the IC/BST has a fast and sus-
tained effect on OCD symptoms.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW460
Superficial neurostimulation
application, alpha rhythm and clinical
effects
P. Rico ∗ ranguren
1 Universidad Alcala de Henares, medical specialities, Madrid, Spain
2 Universidad complutense, psychology, Madrid, Spain
∗ Corresponding author.
Introduction The alpha rhythm (EEG) in prefrontal regions has
been related with the emotional equilibrium, predisposition for
a positive mood (Urry et al., 2004) and the activation of the
approximation system (Davidson and Irwin, 1999). Superficial neu-
rostimulation application (SNSA) provokes an increase of such
rhythm in prefrontal and temporal areas (Bardasano et al., 2010).
Aims To demonstrate that the increase of alpha synchronization
is a common factor in the satisfactory evolution of patients with
different pathologies.
Methods Thirty patients with different symptoms (hostility,
anxiety, bruxism and obsessive symptoms) received 20 weekly
sessions of 45 minutes long using the SNSA.
Materials –SNSA topology system: it is a machine for superfi-
cial stimulation that uses electricity through superficial electrodes
which are placed on feet and hands and an electrode over the 7th
cervical vertebra;
–digital encephalogram;
–Faraday cage.
Results The alpha rhythm was incremented in 85% of the cases
in anterior regions of the brain, related with the improvement of
scale’s punctuation.
Conclusion The alpha rhythmhas been showed to be presented in
all individuals that improved their symptoms after the application
of SNSA
Fig. 1 Distribution of cranial calotte activity post-SNSA. 20th
session. Distribution of cranial calotte activity pre-SNSA. 1st
session.