Figure 2.

fMRI activation maps of hallucination events for 2 patients with intermittent hallucinations. Images are in the axial oblique orientation. Arrows illustrate the rTMS sites selected. Numbers next to arrows are Brodmann areas per Talairach and Tournoux (1988). Left side of the brain corresponds to the right side of images. (A) Representative subject in the 3-site version of the protocol. Activation associated with hallucination periods was focused bitemporally and in inferior frontal and prefrontal regions. Stimulation was limited to 3 sites and directed to posterior superior temporal cortex (BA 22), the right-sided homologous region, and a prefrontal region (BA 46). (B) Representative subject in the later version of the protocol where number of sites probed varied according to functional maps and site-specific clinical response. Activation in posterior temporal regions was largely absent with much more prominent involvement in frontal areas. Four sites were selected for rTMS to cover Broca’s area and right-sided homologous regions. The patient also received rTMS over primary auditory cortex and supramarginal cortex on the right side. Especially prominent temporalis muscle mass can be visualized on the right side over BA 44/45 as a thickening under the patient’s skin, which corresponds to the white rim in these images.