Repetitive Transcranial Magnetic Stimulation (rTMS) improves symptoms and reduces clinical illness in patients suffering from OCD

Authors:

Haghighi M; Shayganfard M; Jahangard L; Ahmadpanah M; Bajoghli H; Pirdehghan A; Holsboer-Trachsler E; Brand S. Institution Haghighi,Mohammad. Research Center For Behavioral Disorders and Substances Abuse, Hamadan University of Medical Sciences, Hamadan, Iran. Shayganfard,Mehran. Research Center For Behavioral Disorders and Substances Abuse, Hamadan University of Medical Sciences, Hamadan, Iran. Jahangard,Leila. Research Center For Behavioral Disorders and Substances Abuse, Hamadan University of Medical Sciences, Hamadan, Iran. Ahmadpanah,Mohammad. Research Center For Behavioral Disorders and Substances Abuse, Hamadan University of Medical Sciences, Hamadan, Iran. Bajoghli,Hafez. Iranian National Center for Addiction Studies (INCAS), Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. Pirdehghan,Azar. Research Center For Behavioral Disorders and Substances Abuse, Hamadan University of Medical Sciences, Hamadan, Iran. Holsboer-Trachsler,Edith. Psychiatric Clinics of the University of Basel , Center for Affective, Stress and Sleep Disorders, Basel, Switzerland. Brand,Serge. Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland; Department of Sport, Exercise and Health Science, Division of Sport Science, University of Basel, Basel, Switzerland. Electronic address: Serge.brand@upkbs.ch .

Title:

Repetitive Transcranial Magnetic Stimulation (rTMS) improves symptoms and reduces clinical illness in patients suffering from OCD — Results from a single-blind, randomized clinical trial with sham cross-over cond ition. Source Journal of Psychiatric Research. 68:238-44, 2015 Sep.

Abstract OBJECTIVES:

Both psychotherapeutic and psychopharmacological method s are used in the treatment of patients suffering from obsessive-compulsive disorders (OCD), and both with encouraging but also mixed results. Here, we tested the hypothesis that repetitive Transcranial Magnetic Stimulation (rTMS) improves symptoms and reduces illness severity in patients suffering from treatment-resistant OCD.

METHODS:

A total of 21 patients (57% females; mean age: M = 35.8 years) suffering from treatment-resistant OCD were randomly assigned either to an rTMS-first-sham-second, or a sham-first-rTMS-second condition. Treatment sessions lasted for 4 weeks with five sessions per week, each of about 50 min duration. Symptoms were assessed via both self- and expert-ratings. RESULTS: Both self- and expert-reported symptom severity reduced in the rTMS condition as compared to the sham condition. Full- and partial responses were observed in the rTMS-condition, but not in the sham-condition.

CONCLUSIONS:

The pattern of results from this single-blind, sham- and cross-over design suggests that rTMS is a successful intervention for patients suffering from treatment-resistant OCD. Authors de Wit SJ; van der Werf YD; Mataix-Cols D; Trujillo JP; van O ppen P; Veltman DJ; van den Heuvel OA. Institution de Wit,S J. Department of Psychiatry,VU University Medical Center,Amsterdam,The Netherlands. van der Werf,Y D. Neuroscience Campus Amsterdam,The Netherlands. Mataix-Cols,D. Department of Clinical Neuroscience,Centre for Psychiatric Research and Education,Karolinska Institutet,Stockholm,Sweden. Trujillo,J P. Department of Psychiatry,VU University Medical Center,Amsterdam,The Netherlands. van Oppen,P. Department of Psychiatry,VU University Medical Center,Amsterdam,The Netherlands. Veltman,D J. Department of Psychiatry,VU University Medical Center,Amsterdam,The Netherlands. van den Heuvel,O A. Department of Psychiatry,VU University Medical Center,Amsterdam,The Netherlands. Title Emotion regulation before and after transcranial magnetic stimulation in obsessive compulsive disorder. Source Psychological Medicine. 45(14):3059-73, 2015 Oct. Abstract

BACKGROUND:

Impaired emotion regulation may underlie exaggerated emotional reactivity in patients with obsessive compulsive disorder (OCD), yet instructed emotion regulation has never been studied in the disorder. METHOD: This study aimed to assess the neural correlates of emotion processing and regulation in 43 medication-free OCD patients and 38 matched healthy controls, and additionally test if these can be modu lated by stimulatory (patients) and inhibitory (controls) repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (dlPFC). Participants performed an emotion regulation task during functional magnetic resonance imaging before and after a single session of randomly assigned real or sham rTMS. Effect of group and rTMS were assessed on self-reported distress ratings and brain activity in frontal-limbic regions of interest. RESULTS: Patients had higher distress ratings than controls during emotion provocation, but similar rates of distress reduction after voluntary