Efficacy and clinical predictors of response to rTMS treatment in pharmacoresistant obsessive-compulsive disorder (OCD): a retrospective study

Rostami, Reza; Kazemi, Reza; Jabbari, Arezoo; Madani, Azam Sadat; Rostami, Hosseinreza; Taherpour, Mohammad Amin; Molavi, Parviz; Jaafari, Nématollah; Kuo, Min‐Fang; Vicario, Carmelo M.; Nitsche, Michael A.; Salehinejad, Mohammad Ali

doi:10.1186/s12888-020-02769-9

Cited by 32 publications

(27 citation statements)

References 79 publications

(118 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…On the other hand, there was no significant difference in the mean percent reduction in the total score on the Y-BOCS between males and females or between on- and off-medication. These results were consistent with the previous study that showed no difference in the response rate between males and females or between on- and off-medication [ 16 ].…”

Section: Discussionsupporting

confidence: 93%

A Case Series of Deep Transcranial Magnetic Stimulation Treatment for Patients with Obsessive-Compulsive Disorder in the Tokyo Metropolitan Area

Ikawa¹,

Osawa²,

Sato³

et al. 2022

JCM

View full text Add to dashboard Cite

Obsessive-compulsive disorder (OCD) is a chronic illness in which patients do not achieve remission sufficiently with conventional medication. Deep repetitive transcranial magnetic stimulation (dTMS) for OCD neuromodulates the bilateral anterior cingulate cortex (ACC) and dorsal medial prefrontal cortex (mPFC), which are known to be impaired in OCD. While dTMS treatment for OCD has shown effective results overseas, TMS treatment for OCD has rarely been implemented in Japan, and its effectiveness is unknown. We conducted an FDA-approved dTMS protocol to 26 patients with OCD. In addition, individual exposure stimulation that elicited each patient’s obsessive thoughts was also combined during dTMS treatment. Before and after 30 sessions of TMS treatment, the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was used to assess changes in the severity of each patient’s obsessive-compulsive disorder. Response to dTMS treatment in patients with OCD was determined by whether the total score on the Y-BOCS after a course of treatment was reduced by 30% or more compared with the score at baseline. The percentage of responders in this case series following the 30 sessions of dTMS treatment was 53.9%. In addition, total Y-BOCS scores and scores on each item were significantly improved. The percent changes in total Y-BOCS scores did not differ between the sexes or between on- and off-medication patients. No obvious adverse events were observed in this case series. In line with the results of TMS studies for OCD patients reported overseas, dTMS treatment for Japanese patients with OCD may have a favorable therapeutic effect.

show abstract

Section: Discussionsupporting

confidence: 93%

A Case Series of Deep Transcranial Magnetic Stimulation Treatment for Patients with Obsessive-Compulsive Disorder in the Tokyo Metropolitan Area

Ikawa¹,

Osawa²,

Sato³

et al. 2022

JCM

View full text Add to dashboard Cite

show abstract

“…Hot–cold executive dysfunctions and respective pathophysiology in the prefrontal-cingular network are prominent in psychopathology other neuropsychiatric disorders as well including but not limited obsessive–compulsive disorders ( cold -deficits driven), borderline personality disorder ( hot -deficits driven), and impulse control disorders ( cold–hot deficits driven) ( Gruner and Pittenger, 2017 ; Schulze et al, 2019 ). In this line, recent NIBS studies have also shown than modulating activity of the prefrontal-cingular and relevant subcortical regions are promising for the treatment of these disorders ( Brevet-Aeby et al, 2016 ; Molavi et al, 2020a ; Rostami et al, 2020 ).…”

Section: Clinical Implications Of Hot–cold Efs For Neuropsychiatric Disordersmentioning

confidence: 98%

Hot and cold executive functions in the brain: A prefrontal-cingular network

Salehinejad

Ghanavati

Rashid

et al. 2021

Brain and Neuroscience Advances

Self Cite

153

View full text Add to dashboard Cite

Executive functions, or cognitive control, are higher-order cognitive functions needed for adaptive goal-directed behaviours and are significantly impaired in majority of neuropsychiatric disorders. Different models and approaches are proposed for describing how executive functions are functionally organised in the brain. One popular and recently proposed organising principle of executive functions is the distinction between hot (i.e. reward or affective-related) versus cold (i.e. purely cognitive) domains of executive functions. The prefrontal cortex is traditionally linked to executive functions, but on the other hand, anterior and posterior cingulate cortices are hugely involved in executive functions as well. In this review, we first define executive functions, their domains, and the appropriate methods for studying them. Second, we discuss how hot and cold executive functions are linked to different areas of the prefrontal cortex. Next, we discuss the association of hot versus cold executive functions with the cingulate cortex, focusing on the anterior and posterior compartments. Finally, we propose a functional model for hot and cold executive function organisation in the brain with a specific focus on the fronto-cingular network. We also discuss clinical implications of hot versus cold cognition in major neuropsychiatric disorders (depression, schizophrenia, anxiety disorders, substance use disorder, attention-deficit hyperactivity disorder, and autism) and attempt to characterise their profile according to the functional dominance or manifest of hot–cold cognition. Our model proposes that the lateral prefrontal cortex along with the dorsal anterior cingulate cortex are more relevant for cold executive functions, while the medial–orbital prefrontal cortex along with the ventral anterior cingulate cortex, and the posterior cingulate cortex are more closely involved in hot executive functions. This functional distinction, however, is not absolute and depends on several factors including task features, context, and the extent to which the measured function relies on cognition and emotion or both.

show abstract

“…As rTMS is a focal intervention, it is not clear whether treatments targeting OCD may have an impact on comorbidities too. While open-label studies have shown that rTMS over DLPFC/SMA/DMPFC decreases anxiety and depressive symptoms, 20 sham-controlled studies have not been consistent. [21][22][23] The limited sample sizes of the individual studies might have decreased the power to find statistically significant differences.…”

Section: Introductionmentioning

confidence: 93%

Efficacy of Repetitive Transcranial Magnetic Stimulation on Comorbid Anxiety and Depression Symptoms in Obsessive-Compulsive Disorder: A Meta-Analysis of Randomized Sham-Controlled Trials

et al. 2022

View full text Add to dashboard Cite

Objective To systematically evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) in reducing comorbid anxiety and depressive symptoms in patients with obsessive-compulsive disorder (OCD). Methods Three electronic databases were searched for randomized, sham-controlled clinical trials evaluating rTMS for the treatment of OCD. Hedge's g was calculated as the effect size for anxiety/depression symptom severity (primary outcome) and OCD severity (secondary outcome). Subgroup analyses and meta-regression analyses were carried out to evaluate the most promising target and whether a reduction in OCD severity moderates the change in anxiety or depression scores. Results Twenty studies ( n = 688) were included in the meta-analysis. rTMS had small-medium effect size on OCD (Hedge's g = 0.43; 95% confidence interval [CI]: [0.20, 0.65]; P < 0.001), anxiety (Hedge's g = 0.3; 95% CI: [0.11, 0.48]; P = 0.001) and depression (Hedge's g = 0.24; 95% CI: [0.07, 0.40]; P = 0.003) symptoms. Subgroup analysis showed that protocols targeting dorsolateral prefrontal cortex (DLPFC) were effective for 3 outcome measures. The change in anxiety, but not depression severity, was moderated by a change in OCD symptom scores. However, the findings are uncertain as a majority of the studies had some concerns or a high risk of bias. Conclusions Active rTMS protocol targeting DLPFC is effective in reducing the comorbid anxiety/depression symptoms along with OCD severity. The antidepressant effect is not moderated by the anti-obsessive effect of rTMS. Abrégé

show abstract

Efficacy and clinical predictors of response to rTMS treatment in pharmacoresistant obsessive-compulsive disorder (OCD): a retrospective study

Cited by 32 publications

References 79 publications

A Case Series of Deep Transcranial Magnetic Stimulation Treatment for Patients with Obsessive-Compulsive Disorder in the Tokyo Metropolitan Area

A Case Series of Deep Transcranial Magnetic Stimulation Treatment for Patients with Obsessive-Compulsive Disorder in the Tokyo Metropolitan Area

Hot and cold executive functions in the brain: A prefrontal-cingular network

Efficacy of Repetitive Transcranial Magnetic Stimulation on Comorbid Anxiety and Depression Symptoms in Obsessive-Compulsive Disorder: A Meta-Analysis of Randomized Sham-Controlled Trials

Contact Info

Product

Resources

About