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.

Dual Target Repetitive Transcranial Magnetic Stimulation In The Treatment Of Comorbid Obsessive-Compulsive Disorder In Patients With Anorexia Nervosa: Preliminary Results Of Two Case Reports

2016 ◽  
Vol 33 (S1) ◽  
pp. S494-S494
Author(s):  
N. De Schryver ◽  
G.M.D. Lemmens ◽  
C. Baeken ◽  
D. Van den Abbeele
Keyword(s):  
Anorexia Nervosa ◽  
Transcranial Magnetic Stimulation ◽  
Obsessive Compulsive Disorder ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
University Hospital ◽  
Hospital Treatment ◽  
Treatment Resistant ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

IntroductionObsessive-compulsive disorder (OCD) is a frequently reported comorbid disorder (20–30%) in patients with anorexia nervosa (AN). Increasing evidence suggests that repetitive transcranial magnetic stimulation (r-TMS) may be effective in the treatment of refractory OCD and to a lesser extent in AN. Hereby, different target areas: supplemental motor area (SMA) and orbitofrontal cortex (OFC) and dorsolateral prefrontal cortex in AN. We report two patients with enduring AN and comorbid treatment resistant OCD treated with r-TMS.MethodsBoth female patients (34 and 26 years respectively) were hospitalized at the Eating Disorder Unit at the Ghent University Hospital. Treatment responses were evaluated with Yale Brown Obsessive Compulsive Scale (Y-BOCS) and weight gain. Inhibitory continuous thetaburst stimulation (cTBS) of the SMA followed by cTBS of the OFC was conducted during 20 sessions, 5 sessions a week, during 4 weeks. Stimulation intensity was respectively 100% and 80% of the motor treshold.ResultsAfter cTBS treatment Y-BOCS score of both patients decreased (31 to 24 and 31 to 23 respectively). Only one patient showed a 10% increase of weight. The treatment was well tolerated. No significant side effects were reported.ConclusionTreatment resistant comorbid OCD in patients with AN may be succesfully treated with cTBS.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Repetitive transcranial magnetic stimulation for the treatment of obsessive compulsive disorder: a double-blind controlled investigation

2007 ◽  
Vol 37 (11) ◽  
pp. 1645-1649 ◽  
Author(s):  
PERMINDER S. SACHDEV ◽  
COLLEEN K. LOO ◽  
PHILIP B. MITCHELL ◽  
TARA F. McFARQUHAR ◽  
GIN S. MALHI
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Obsessive Compulsive Disorder ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Controlled Study ◽  
Treatment Resistant ◽  
Obsessive Compulsive ◽  
Double Blind ◽  
Compulsive Disorder ◽  
Dorsolateral Prefrontal

ABSTRACTBackgroundTo determine the efficacy and tolerability of repetitive transcranial magnetic stimulation (rTMS) as a treatment for obsessive compulsive disorder (OCD) in a double-blind placebo-controlled study.MethodSubjects with treatment-resistant OCD were randomized to rTMS (n=10) or sham rTMS (n=8) for 10 sessions of daily stimulation over the left dorsolateral prefrontal cortex (DLPFC), with subjects and raters being blind to the treatment. Subjects were offered an open extension of up to 20 sessions of rTMS.ResultsThe two groups did not differ on change in Yale–Brown Obsessive Compulsive Scale (YBOCS) or Maudsley Obsessive-Compulsive Inventory scores over 10 sessions, with or without correction for depression ratings. Over 20 sessions, there was a significant reduction in total YBOCS scores, but not after controlling for depression. rTMS over 20 sessions was well tolerated.ConclusionTwo weeks of rTMS over the left DLPFC is ineffective for treatment-resistant OCD.

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