Repetitive Transcranial Magnetic Stimulation (rTMS) for Obsessive Compulsive Disorder (OCD): A meta-analysis of randomised, sham-controlled trials

2021 ◽  
Author(s):  
M. Prabhavi N. Perera ◽  
Sudaraka Mallawaarachchi ◽  
Aleksandra Miljevic ◽  
Neil W. Bailey ◽  
Sally E. Herring ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Obsessive Compulsive Disorder ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

scholarly journals Effectiveness of repetitive transcranial magnetic stimulation (rTMS) for the treatment of obsessive-compulsive disorder (OCD): a meta-analysis

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S24-S24
Author(s):  
Kabir Garg ◽  
Naomi Fineberg ◽  
Luca Pellegrini ◽  
Arun Enara ◽  
Eduardo Cinosi
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Obsessive Compulsive Disorder ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Meta Analysis ◽  
Mean Difference ◽  
Cochrane Library ◽  
Treatment Resistant ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

AimsOCD is a chronic and debilitating psychiatric illness. Current first-line treatments include serotonin reuptake inhibitors and cognitive behavioural therapy, but a substantial minority of patients fail to respond adequately, requiring further forms of intervention usually provided in a sequenced algorithm. Repetitive Transcranial Magnetic Stimulation (rTMS) uses magnetic pulses passed through a coil placed on the scalp to stimulate the underlying brain region. Clinical trials of r-TMS in OCD have produced conflicting results, possibly related to the variability in the site of stimulation, protocols used, and variability in the selection of patients. We perform an updated systematic review and meta-analysis of the effectiveness of rTMS for the treatment of OCD aimed to determine whether certain rTMS parameters (i.e. site, duration, protocol etc.) or patients’ characteristics (i.e age, duration of illness, illness severity, treatment resistance etc), are associated with effectiveness. Our overarching aim is to determine the place of rTMS in the sequenced OCD care-pathway.MethodThe meta-analysis is pre-registered in PROSPERO (ID: 241381). Potentially relevant studies will be retrieved using the MEDLINE, PsycINFO, and Cochrane Library databases using the parameters [‘obsessive compulsive disorder’ or ‘OCD’ or ‘obsessions’ or ‘compulsions’] AND [‘transcranial magnetic stimulation’ or ‘TMS’]. The reference lists of retained articles will also be scrutinized for additional relevant publications. Only full text English language articles will be included in the review. The methodological quality of the studies will be assessed using CONSORT criteria. A summary of the study's quality as a randomized clinical trial will be produced.ResultOur preliminary analysis shows some efficacy for r-TMS in non-treatment resistant OCD than treatment resistant OCD. Detailed results will be presented in the poster at the event. Effect measure will be either categorical (e.g. relative risk (RR) or odds ratio (OR) or continuous (mean difference or standardized mean difference - Hedge's g or Cohen's d - when taking into consideration the severity of the disorder as a dimension). These outcomes will be measured through validated instruments, in the form of both self- rated scales and observer rated scales including semi-structured interviews.ConclusionThis meta-analysis will identify the patient, illness and protocol parameters that determine clinical outcomes, as guide to optimizing the role of rTMS in the care of patients with OCD.

The Use of Repetitive Transcranial Magnetic Stimulation for Treatment of Obsessive-Compulsive Disorder: A Scoping Review. (Preprint)

2021 ◽  
Author(s):  
Medard Adu ◽  
Ejemai Eboreime ◽  
Adegboyega Sapara ◽  
Andrew J. Greenshaw ◽  
Pierre Chue ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Obsessive Compulsive Disorder ◽  
Scoping Review ◽  
Magnetic Stimulation ◽  
Depressive Disorders ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Relevant Literature ◽  
Invasive Procedure ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

BACKGROUND Background: Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive procedure in which brain neural activity is stimulated by direct application of a magnetic field to the scalp. rTMS is considered a therapeutic tool in various neuropsychiatric conditions. Since its approval in Canada in 2002 and despite its wide and continuous usage for the management of depressive disorders, knowledge on the use of rTMS for Obsessive-Compulsive Disorder (OCD) is sparse. OBJECTIVE Objectives: This scoping review seeks to; (i) explore the relevant literature available regarding the use of rTMS as a mode of treatment for OCD; (ii) To evaluate the evidence to support the use of rTMS as a treatment option for OCD. METHODS Method: We electronically conducted data search in five research databases (MEDLINE, CINAHL, Psych INFO, SCOPUS, and EMBASE) using all identified keywords and index terms across all the data bases to identify empirical studies and randomized controlled trials. We included articles published with randomized control designs which aimed at the treatment of OCD with rTMS. Only full-text published articles written in English were reviewed. Review articles on treatment for conditions other than OCD were excluded. RESULTS NA CONCLUSIONS Conclusion: The application of rTMS as a treatment intervention for OCD looks promising despite diversity in terms of outcomes and clinical significance. Further studies with well-defined stimulation parameters are needed in order to be able to draw a definite conclusion of its clinical effectiveness in the treatment of OCD.

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