Continuous theta burst stimulation over the supplementary motor area in refractory obsessive-compulsive disorder treatment: A randomized sham-controlled trial

Harika‐Germaneau, Ghina; Rachid, Fady; Chatard, Armand; Lafay-Chebassier, Claire; Solinas, Marcello; Thirioux, Bérangère; Millet, Bruno; Langbour, Nicolas; Jaafari, Nématollah

doi:10.1016/j.brs.2019.07.019

Cited by 39 publications

(49 citation statements)

References 40 publications

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“…Interestingly, the sham group showed a mild but significant symptom improvement in our study. A similar phenomenon was also found in previous studies on OCD (Harika-Germaneau et al, 2019), depression (Li et al, 2020) and schizophrenia (Dollfus, Lecardeur, Morello, & Etard, 2016). These findings indicate a considerable placebo effect in patients with psychiatry disorders, and emphasize the importance of sham controls in rTMS studies.…”

Section: Discussionsupporting

confidence: 89%

Pre‐supplementary motor network connectivity and clinical outcome of magnetic stimulation in obsessive–compulsive disorder

Xie

Yang

et al. 2021

Human Brain Mapping

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A large proportion of patients with obsessive-compulsive disorder (OCD) respond unsatisfactorily to pharmacological and psychological treatments. An alternative novel treatment for these patients is repetitive transcranial magnetic stimulation (rTMS). This study aimed to investigate the underlying neural mechanism of rTMS treatment in OCD patients. A total of 37 patients with OCD were randomized to receive real or sham 1-Hz rTMS (14 days, 30 min/day) over the right presupplementary motor area (preSMA). Resting-state functional magnetic resonance imaging data were collected before and after rTMS treatment. The individualized target was defined by a personalized functional connectivity map of the subthalamic nucleus. After treatment, patients in the real group showed a better improvement in the Yale-Brown Obsessive Compulsive Scale than the sham group (F 1,35 = 6.0, p = .019). To show the neural mechanism involved, we identified an "ideal target connectivity" before treatment. Leave-one-out cross-validation indicated that this connectivity pattern can significantly predict patients' symptom improvements (r = .60, Gong-Jun Ji and Wen Xie contributed equally to this work.

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Section: Discussionsupporting

confidence: 89%

Pre‐supplementary motor network connectivity and clinical outcome of magnetic stimulation in obsessive–compulsive disorder

Xie

Yang

et al. 2021

Human Brain Mapping

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“…It is not clear whether increasing the intensity of stimulation can enhance the efficacy. This study chose a stimulus intensity of 80% RMT used in most cTBS studies, but it may be somewhat insufficient in treatment-resistant OCD; d. We locate the OFC target convenient and straightforward through the international 10–20 EEG system, and this method is not as accurate as neuronavigation because of each person’s brain’s anatomical differences; e. The sample size of this study was small, and there may be high individual differences between responses to noninvasive brain stimulation regimens, including routine rTMS and TBS; 47 f. We used was a commonly used figure-of-8 shaped coil, which was also used in the studies of Dutta et al and Harika-Germaneau et al, 17 , 18 but did not achieve clinical efficacy. It may be due to the shallow penetration depth of the magnetic field, which cannot reach the depth of the target stimulation.…”

Section: Discussionmentioning

confidence: 99%

“… 33 , 34 Among the published randomized-controlled trials, only two have reported cTBS in treatment-resistant OCD, and the results showed that cTBS was not effective in treating obsessive symptoms, which was consistent with ours. 17 , 18 …”

Section: Discussionmentioning

confidence: 99%

“…However, studies involving DLPFC and SMA areas had reported inconsistent results. 7 , 18 , 20 Neuroimaging studies have found that the excitability of OFC and other cortical/subcortical structures are increased in patients with OCD. 21 Further evidence links the improvement in OCD to decreased hypometabolism in the prefrontal cortex (PFC) and OFC.…”

Section: Introductionmentioning

confidence: 99%

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Continuous Theta-Burst Stimulation Over the Right Orbitofrontal Cortex in Treatment-Resistant Obsessive-Compulsive Disorder Treatment: A Randomized Sham-Controlled Trial

Liu¹,

Shao²,

Liao³

et al. 2021

IJGM

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Purpose Examining whether modulation of right orbitofrontal cortex (OFC) activity by continuous theta-burst stimulation (cTBS) affects obsessive-compulsive disorder (OCD) symptoms. Patients and Methods A total of 28 treatment-resistant OCD participants were treated with either active or sham cTBS of the OFC twice per day, for five days a week, for 2 weeks, in a double-blinded manner. Clinical response to treatment was determined using the Yale–Brown Obsessive-Compulsive Scale (Y-BOCS). Results There were no statistically significant differences between the 2 groups after two weeks of treatment in the Yale–Brown Obsessive-Compulsive Scale score (group*time interaction, F2,20=0.996, p=0.387) and other secondary outcome measures, including anxiety symptoms and responder rates. Depressive symptoms improved significantly in the active group (p=0.027), but the significant difference disappeared at 6 weeks (p=0.089). Conclusion This is the first randomized controlled study using cTBS in the right OFC to observe the improvement of treatment-resistant OCD symptoms. It is safe to use cTBS, but 2 weeks of treatment is not enough to achieve a curative effect. Future studies are needed to explore more advanced stimulation parameters suitable for the treatment of OCD. Clinical Trial Registration www.chictr.org.cn , identifier ChiCTR2000034814.

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“…A recent trial demonstrated superior efficacy of this protocol over antipsychotic augmentation in treatment-resistant OCD subjects (Pallanti et al, 2016). However, given recent inconsistent reports on inhibitory rTMS protocols targeting the SMA (Arumugham et al, 2018;Harika-Germaneau et al, 2019;Pelissolo et al, 2016), there is a need for large multicentre trials to confirm its efficacy at this location.…”

Section: Treatment-resistant Obsessive-compulsive Disorder -Noninvasimentioning

confidence: 99%

Clinical advances in obsessive-compulsive disorder: a position statement by the International College of Obsessive-Compulsive Spectrum Disorders

Fineberg

Hollander

Pallanti

et al. 2020

International Clinical Psychopharmacology

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In this position statement, developed by The International College of Obsessive-Compulsive Spectrum Disorders, a group of international experts responds to recent developments in the evidence-based management of obsessive-compulsive disorder (OCD). The article presents those selected therapeutic advances judged to be of utmost relevance to the treatment of OCD, based on new and emerging evidence from clinical and translational science. Areas covered include refinement in the methods of clinical assessment, the importance of early intervention based on new staging models and the need to provide sustained well-being involving effective relapse prevention. The relative benefits of psychological, pharmacological and somatic treatments are reviewed and novel treatment strategies for difficult to treat OCD, including neurostimulation, as well as new areas for research such as problematic internet use, novel digital interventions, immunological therapies, pharmacogenetics and novel forms of psychotherapy are discussed.

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Continuous theta burst stimulation over the supplementary motor area in refractory obsessive-compulsive disorder treatment: A randomized sham-controlled trial

Cited by 39 publications

References 40 publications

Pre‐supplementary motor network connectivity and clinical outcome of magnetic stimulation in obsessive–compulsive disorder

Pre‐supplementary motor network connectivity and clinical outcome of magnetic stimulation in obsessive–compulsive disorder

Continuous Theta-Burst Stimulation Over the Right Orbitofrontal Cortex in Treatment-Resistant Obsessive-Compulsive Disorder Treatment: A Randomized Sham-Controlled Trial

Clinical advances in obsessive-compulsive disorder: a position statement by the International College of Obsessive-Compulsive Spectrum Disorders

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