Stefano Pallanti1, Anna Marras2, Luana Salerno3, Nikos Makris4, Eric Hollander5. 1. Dipartimento di Neuroscienze, Psicologia, Area del Farmaco e Salute del Bambino (NEUROFARBA), University of Florence, Florence, Italy Department of Psychiatry and Behavioral Sciences, UC Davis Health System, Sacramento, CA, USA Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York, NY, USA stefanopallanti@yahoo.it. 2. Dipartimento di Neuroscienze, Psicologia, Area del Farmaco e Salute del Bambino (NEUROFARBA), University of Florence, Florence, Italy Institute of Neurosciences, Florence, Italy. 3. Institute of Neurosciences, Florence, Italy. 4. Center for Morphometric Analysis, Departments of Psychiatry and Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. 5. Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York, NY, USA.
Abstract
OBJECTIVE: 1 Hz repetitive transcranial magnetic stimulation (rTMS) over the supplementary motor area has been shown to be effective in a subset of obsessive-compulsive disorder (OCD) subjects, yet these results are still to be confirmed. This preliminary study compares the efficacy of augmentation with 1 Hz rTMS over the supplementary motor area and the usual augmentation treatment (TAU; treated as usual) with antipsychoticsin a sample of selective serotonin reuptake inhibitor (SSRI)-refractory OCD patients. METHOD:Fifty SSRI-refractory OCD patients consecutively admitted were studied: 25 were treated with a three-week trial of 1Hz, bilateral rTMS over the supplementary motor area and 25 with antipsychotic drugs. Yale-Brown Obsessive-Compulsive Scale (Y-BOCS; primary outcome measure), Hamilton Depression and Hamilton Anxiety scales were administered at first, second and third week of treatment. RESULTS: Y-BOCS showed a statistically significant time effect from the baseline to the third week, with a 68% of responders (Y-BOCS score reduction of ⩾ 25%), in comparison with 24.0% in the TAU group. In the rTMS group, 17.6% of patients achieved remission. CONCLUSIONS: 1 Hz rTMS over the supplementary motor area appeared to be effective in approximately 2/3 of SSRI-refractory OCD subjects, whereas in the TAU group only 1/4 of subjects were responders. The supplementary motor area might be a new target area to be further explored with neuromodulation for OCD treatment.
RCT Entities:
OBJECTIVE: 1 Hz repetitive transcranial magnetic stimulation (rTMS) over the supplementary motor area has been shown to be effective in a subset of obsessive-compulsive disorder (OCD) subjects, yet these results are still to be confirmed. This preliminary study compares the efficacy of augmentation with 1 Hz rTMS over the supplementary motor area and the usual augmentation treatment (TAU; treated as usual) with antipsychotics in a sample of selective serotonin reuptake inhibitor (SSRI)-refractory OCDpatients. METHOD: Fifty SSRI-refractory OCDpatients consecutively admitted were studied: 25 were treated with a three-week trial of 1Hz, bilateral rTMS over the supplementary motor area and 25 with antipsychotic drugs. Yale-Brown Obsessive-Compulsive Scale (Y-BOCS; primary outcome measure), Hamilton Depression and Hamilton Anxiety scales were administered at first, second and third week of treatment. RESULTS: Y-BOCS showed a statistically significant time effect from the baseline to the third week, with a 68% of responders (Y-BOCS score reduction of ⩾ 25%), in comparison with 24.0% in the TAU group. In the rTMS group, 17.6% of patients achieved remission. CONCLUSIONS: 1 Hz rTMS over the supplementary motor area appeared to be effective in approximately 2/3 of SSRI-refractory OCD subjects, whereas in the TAU group only 1/4 of subjects were responders. The supplementary motor area might be a new target area to be further explored with neuromodulation for OCD treatment.