Repetitive transcranial magnetic stimulation for obsessive-compulsive disorder: A systematic review and pairwise/network meta-analysis

Fitzsimmons, Sophie; Werf, Ysbrand D. van der; Campen, A. Dilene van; Arns, Martijn; Sack, Alexander T.; Hoogendoorn, Adriaan W.; Consortium, Tetro; Heuvel, Odile A. van den

doi:10.1016/j.jad.2022.01.048

Cited by 48 publications

(38 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several targets and stimulation parameters have been tested for the treatment of OCD using TMS, but no clear consensus exists regarding the best combination of stimulation parameters and stimulation target. While several studies support low-frequency protocols over the dorsolateral prefrontal cortex ( 6 ), others found greater effectiveness for low frequency rTMS over the supplementary motor area or for specific combinations of different targets and stimulation parameters ( 7 , 8 ). All these studies have used rTMS delivered with a traditional figure-of-eight coil.…”

Section: Introductionmentioning

confidence: 99%

Motor cortical inhibitory deficits in patients with obsessive-compulsive disorder–A systematic review and meta-analysis of transcranial magnetic stimulation literature

et al. 2022

View full text Add to dashboard Cite

IntroductionObsessive-compulsive disorder (OCD) is a highly prevalent chronic disorder, often refractory to treatment. While remaining elusive, a full understanding of the pathophysiology of OCD is crucial to optimize treatment. Transcranial magnetic stimulation (TMS) is a non-invasive technique that, paired with other neurophysiological techniques, such as electromyography, allows for in vivo assessment of human corticospinal neurophysiology. It has been used in clinical populations, including comparisons of patients with OCD and control volunteers. Results are often contradictory, and it is unclear if such measures change after treatment. Here we summarize research comparing corticospinal excitability between patients with OCD and control volunteers, and explore the effects of treatment with repetitive TMS (rTMS) on these excitability measures.MethodsWe conducted a systematic review and meta-analysis of case-control studies comparing various motor cortical excitability measures in patients with OCD and control volunteers. Whenever possible, we meta-analyzed motor cortical excitability changes after rTMS treatment.ResultsFrom 1,282 articles, 17 reporting motor cortex excitability measures were included in quantitative analyses. Meta-analysis regarding cortical silent period shows inhibitory deficits in patients with OCD, when compared to control volunteers. We found no statistically significant differences in the remaining meta-analyses, and no evidence, in patients with OCD, of pre- to post-rTMS changes in resting motor threshold, the only excitability measure for which longitudinal data were reported.DiscussionOur work suggests an inhibitory deficit of motor cortex excitability in patients with OCD when compared to control volunteers. Cortical silent period is believed to reflect activity of GABAB receptors, which is in line with neuroimaging research, showing GABAergic deficits in patients with OCD. Regardless of its effect on OCD symptoms, rTMS apparently does not modify Resting Motor Threshold, possibly because this measure reflects glutamatergic synaptic transmission, while rTMS is believed to mainly influence GABAergic function. Our meta-analyses are limited by the small number of studies included, and their methodological heterogeneity. Nonetheless, cortical silent period is a reliable and easily implementable measurement to assess neurophysiology in humans, in vivo. The present review illustrates the importance of pursuing the study of OCD pathophysiology using cortical silent period and other easily accessible, non-invasive measures of cortical excitability.Systematic review registration[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020201764], identifier [CRD42020201764].

show abstract

Section: Introductionmentioning

confidence: 99%

Motor cortical inhibitory deficits in patients with obsessive-compulsive disorder–A systematic review and meta-analysis of transcranial magnetic stimulation literature

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Note that, to date, various stimulation protocols have been implemented in dTMS treatment for patients with OCD and that a network meta-analysis by Fitzsimmons et al [ 18 ] revealed that (1) low frequency rTMS to the pre-supplementary motor area, (2) high frequency rTMS to the bilateral dorsolateral prefrontal cortex, and (3) low frequency rTMS to the right dorsolateral prefrontal cortex were more effective than dTMS to the bilateral dorsal mPFC, which was used in this study. In addition, Liang et al also reported similar results in their meta-analysis, while reporting that there was no significant difference in the tolerability of each stimulation protocol between any of the stimulation methods [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

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

“…Multiple meta-analyses suggest rTMS is effective [24]. There are a couple of rTMS protocols with different targets like supplementary motor area, orbitofrontal cortex and dorsolateral prefrontal cortex [25,26]. cTBS may also show a therapeutic effect in treating OCD at 6 weeks in terms of Yale-Brown Obsessive-Compulsive Scale and Hamilton Anxiety Rating Scale [27].…”

Section: Obsessive and Compulsive Disorders (Ocd)mentioning

confidence: 99%

Transcranial Magnetic Stimulation, Connectome and Its Clinical Applications

Yuen¹

2023

Advances in Electroencephalography and Brain Connectome

View full text Add to dashboard Cite

Transcranial magnetic stimulation is an non-invasive method of neuromodulation. It uses magnetic field to induce generation of current for cortical stimulation. It can modulate the altered equilibrium in cortical excitability by magnetic field. Though it is famous for its application in treating psychiatric diseases, it has many other applications. Since its introduction in 1985, it has been used to check the integrity of motor pathway. With more understanding of the technique, it has been started to be used to check the integrity of other brain connections like speech and vision. Due to its ability of neuromodulation, it has also been used in cortical mapping in neurosurgery and neurological function rehabilitation.

show abstract

Repetitive transcranial magnetic stimulation for obsessive-compulsive disorder: A systematic review and pairwise/network meta-analysis

Cited by 48 publications

References 45 publications

Motor cortical inhibitory deficits in patients with obsessive-compulsive disorder–A systematic review and meta-analysis of transcranial magnetic stimulation literature

Motor cortical inhibitory deficits in patients with obsessive-compulsive disorder–A systematic review and meta-analysis of transcranial magnetic stimulation literature

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

Transcranial Magnetic Stimulation, Connectome and Its Clinical Applications

Contact Info

Product

Resources

About