Adjunctive high-frequency right prefrontal repetitive transcranial magnetic stimulation (rTMS) was not effective in obsessive–compulsive disorder but improved secondary depression

Sarkhel, Sujit; Sinha, Vinod Kumar; Praharaj, Samir Kumar

doi:10.1016/j.janxdis.2010.03.011

Cited by 109 publications

(76 citation statements)

References 25 publications

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“…However, it should be noted that in the setting of refractory OCD, previously reported effects of sham rTMS are relatively minimal, ranging from 1% tõ 20% improvement in YBOCS scores; indeed, even active stimulation of lateral targets such as dlPFC has consistently achieved less than 25% YBOCS improvement across several independent studies (Alonso et al, 2001;Sachdev et al, 2007;Mantovani et al, 2010a;Sarkhel et al, 2010). Thus, it is unlikely that placebo effects can fully account for the present observations of a~40% overall improvement in the present study, a bimodal outcome distribution, distinct patterns of functional connectivity through the dmPFC-ventral striatal target circuit in responders vs nonresponders (who were not otherwise distinct on clinical measures), distinct patterns of change in this circuit in responders and nonresponders, and the concordance of these results with the previous findings of an independent study using DBS rather than rTMS.…”

Section: Discussionmentioning

confidence: 95%

“…Previous studies of rTMS in OCD have encountered little therapeutic benefit with stimulation of lateral prefrontal targets such as the dlPFC (Alonso et al, 2001;Prasko et al, 2006;Sachdev et al, 2007;Sarkhel et al, 2010), but somewhat more success with medial prefrontal targets such as the SMA or pre-SMA (Mantovani et al, 2006(Mantovani et al, , 2010aKumar and Chadda, 2011). The results of the present study are congruent with this latter literature in suggesting that rTMS of a slightly more anterior medial prefrontal target, the dmPFC, can also yield substantial symptom reduction in a proportion of OCD cases, even when multiple previous medication trials have failed.…”

Section: Discussionmentioning

confidence: 99%

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Reductions in cortico-striatal hyperconnectivity accompany successful treatment of obsessive-compulsive disorder with dorsomedial prefrontal rTMS

et al. 2015

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Reductions in cortico-striatal hyperconnectivity accompany successful treatment of obsessive-compulsive disorder with dorsomedial prefrontal rTMS

et al. 2015

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“…Repetitive TMS (rTMS) to the DLPFC has generally failed to demonstrate superiority over sham. Despite initial reports from open studies [121], multiple sham-controlled studies of rTMS to the DLPFC at 1 or 10 Hz, 110% motor threshold (MT), found no benefit of active treatment over placebo [122][123][124]. This lack of benefit was replicated in a group of 30 patients receiving active or sham rTMS of the right DLPFC [125].…”

Section: Transcranial Magnetic Stimulationmentioning

confidence: 98%

Neuromodulation for Obsessive–Compulsive Disorder

et al. 2014

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Neuromodulation shows increasing promise in the treatment of psychiatric disorders, particularly obsessivecompulsive disorder (OCD). Development of tools and techniques including deep brain stimulation, transcranial magnetic stimulation, and electroconvulsive therapy may yield additional options for patients who fail to respond to standard treatments. This article reviews the motivation for and use of these treatments in OCD. We begin with a brief description of the illness followed by discussion of the circuit models thought to underlie the disorder. These circuits provide targets for intervention. Basal ganglia and talamocortical pathophysiology, including cortico-striato-thalamo-cortical loops is a focus of this discussion. Neuroimaging findings and historical treatments that led to the use of neuromodulation for OCD are presented. We then present evidence from neuromodulation studies using deep brain stimulation, electroconvulsive therapy, and transcranial magnetic stimulation, with targets including nucleus accumbens, subthalamic nucleus inferior thalamic peduncle, dorsolateral prefrontal cortex, supplementary motor area, and orbitofrontal cortex. Finally, we explore potential future neuromodulation approaches that may further refine and improve treatment.

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“…Sarkhel et al reported that high-frequency rTMS as an adjunctive treatment over right prefrontal cortex was not effective in OCD, while it significantly improved the comorbid secondary depression. [70] Reviewing the findings of randomized clinical trials as well as the previous conducted meta analyses, the main findings on the efficacies of rTMS for OCD treatment are as follow: Low frequencies rTMS are more efficient than high frequencies. The sites of stimulation including orbitofrontal cortex and the supplementary motor area are more likely to respond to the treatment compared with the DLPFC or temporal or temporoparietal cortices.…”

Section: Ocdmentioning

confidence: 99%

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Rashidi

2017

AJP

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Psychiatric disorders are the most common debilitating diseases worldwide. Repetitive transcranial magnetic stimulation (rTMS) has shown therapeutic outcomes in different neurophysiology and neuropsychiatric disorders. Despite controversial findings on the therapeutic outcomes of this technique in different psychiatric disorders, researchers emphasize on developing this technique as an alternative or adjunctive modality for these disorders. Depression, different hallucinations, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and substance abuse are the main disorders have shown good treatment response to rTMS. This study aims to comprehensively overview the applications and recent advances in rTMS applications in psychiatric disorders. The databases of PubMed (1985PubMed ( -2017, Web of Sciences (1985-2017, Embase (1985-2017), Cochrane Central Library (1985-2017), and Google Scholar (1985-2017 were searched using the keywords of repetitive transcranial magnetic stimulation OR rTMS AND psychiatric disorders AND treatment. The retrieved records were reviewed, and the relevant studies were selected for further review. Repeated sessions of low frequency (≤5 Hz) rTMS induce long-lasting neural inhibition or depotentiation, whereas high frequency (>5 Hz) induces long-lasting neural excitability or potentiation. Depending on the neural alteration induced by a disorder, low-or high-frequency rTMS is used for the treatment. The rTMS is approved as acute treatment for major depression. The other diseases with promising outcomes are different hallucinations, OCD, and PTSD. rTMS seems to be an alternative or adjunctive therapeutic modality in different psychiatric disorders. To reach efficient clinical application for each disorder, further randomized clinical trials, as well as preclinical studies, are needed.

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Adjunctive high-frequency right prefrontal repetitive transcranial magnetic stimulation (rTMS) was not effective in obsessive–compulsive disorder but improved secondary depression

Cited by 109 publications

References 25 publications

Reductions in cortico-striatal hyperconnectivity accompany successful treatment of obsessive-compulsive disorder with dorsomedial prefrontal rTMS

Reductions in cortico-striatal hyperconnectivity accompany successful treatment of obsessive-compulsive disorder with dorsomedial prefrontal rTMS

Neuromodulation for Obsessive–Compulsive Disorder

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