Is twice daily LF-rTMS a viable treatment option for treatment-resistant OCD? Results from an open-label feasibility study

Tandt, Hannelore; Velde, N. Van de; Witte, Sara De; Audenaert, Kurt; Baeken, Chris; Lemmens, Gilbert

doi:10.1007/s00406-020-01142-x

Cited by 5 publications

(4 citation statements)

References 20 publications

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“… 35 A previous open-label study found that low-frequency rTMS twice a day could improve the symptoms of treatment-resistant OCD in 10 days, while traditional rTMS needed at least four weeks. 36 Neuroimaging studies had shown that accelerated rTMS requires at least a 10-minute interval, otherwise, the additional neuroplasticity effects may not occur. 37 However, the optimal time interval is still a topic to be researched through clinical trials.…”

Section: Discussionmentioning

confidence: 99%

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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Section: Discussionmentioning

confidence: 99%

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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“…24 Following the DLPFC, the dorsal medial prefrontal cortex (DMPFC) has received the most attention as it serves as a hyperconnected hub between distinct neural networks involved in depression. 25 DMPFC-rTMS is safe, tolerable, and effective to benefit patients with treatment-refractory depression, 26,27 obsessive-compulsive disorder, 28 posttraumatic stress disorder, 29 eating disorders, 30 and tinnitus. 31 Because the pathogenesis of insomnia involves genetic, environmental, behavioral, and physiological factors that culminate in hyperarousal, 13 low-frequency inhibitory rTMS should decrease hyperarousal in insomnia patients.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of low-frequency repetitive transcranial magnetic stimulation as adjunctive treatment for insomnia patients under hypnotics: A randomized, double-blind, sham-controlled study

Lin

Chen

Liou

et al. 2023

Journal of the Chinese Medical Association

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Background: Pharmacotherapy of insomnia is prescribed often but may be complicated by drug dependence. Cognitivebehavioral therapy for insomnia is effective, but requires time to take effect. Repetitive transcranial magnetic stimulation (rTMS) is effective for depression but of uncertain benefit for insomnia. We studied low-frequency rTMS of the left dorsal medial prefrontal cortex (DMPFC) as an adjunctive therapy of insomnia. Methods: We recruited 60 patients with insomnia, of whom 49 completed the study. We applied 1 Hz rTMS to the DMPFC in the experimental group (n = 36) and sham coil for the placebo group (n = 13). Outcome measures included objective polysomnography (PSG) and subjective Pittsburgh Sleep Quality Index (PSQI). All participants were requested to continue prescribed pharmacotherapy.Results: After 10 sessions of low-frequency DMPFC-rTMS, the experimental group demonstrated a reduction of duration of wake after sleep onset (WASO) from 75.4 (±53.3) to 51.2 (±75.1) min (p = 0.011). Sleep efficiency (SE) increased from 74.6% (±15.6) to 80.8% (±13.8) (p = 0.004). The sham group experienced improved SE from 79.4% (±30.7) to 88.9% (±5.6) (p = 0.039). After controlling for baseline PSG parameters and hypnotic dosage, the sham group exhibited better effects of sleep onset latency and SE than the rTMS group but no difference on PSQI. Conclusion: Although the effects of rTMS and sham coil on insomnia were similar (which implied significant placebo effect), low-frequency DMPFC-rTMS might offer a safe, non-invasive, and useful adjunctive therapy of insomnia by reducing WASO. The DMPFC may represent a new target for future rTMS insomnia studies.

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“…This is a major improvement and extension of the repertoire of psychiatrists. Examples are the use of tDCS to improve decision making in gambling disorders or for acute depression [3,4], the use of doubleddosed rTMS treatment to alleviate obsessive compulsive disorder (OCD) symptoms [5]. Second, brain stimulation allows for novel combinations of treatments.…”

mentioning

confidence: 99%

Non-invasive brain stimulation: the next frontier in psychiatry

Walther

Baeken

2021

Eur Arch Psychiatry Clin Neurosci

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Is twice daily LF-rTMS a viable treatment option for treatment-resistant OCD? Results from an open-label feasibility study

Cited by 5 publications

References 20 publications

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

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

Effect of low-frequency repetitive transcranial magnetic stimulation as adjunctive treatment for insomnia patients under hypnotics: A randomized, double-blind, sham-controlled study

Non-invasive brain stimulation: the next frontier in psychiatry

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