G Harika-Germaneau1, F Rachid2, A Chatard3, C Lafay-Chebassier4, M Solinas5, B Thirioux6, B Millet7, N Langbour6, N Jaafari8. 1. Unité de Recherche Clinique Intersectorielle en Psychiatrie à vocation régionale du Centre Hospitalier Henri Laborit, Poitiers, France; Université de Poitiers, France; INSERM U 1084, Laboratoire de Neurosciences Expérimentales et Cliniques, Poitiers, France. Electronic address: ghina.harika-germaneau@ch-poitiers.fr. 2. Private practice, Place de la Fusterie 7, 1204, Geneva, Switzerland. 3. Unité de Recherche Clinique Intersectorielle en Psychiatrie à vocation régionale du Centre Hospitalier Henri Laborit, Poitiers, France; Université de Poitiers, France; Laboratoire CeRCA, CNRS 7295, Poitiers, France. 4. Université de Poitiers, France; INSERM U 1084, Laboratoire de Neurosciences Expérimentales et Cliniques, Poitiers, France; Service de Pharmacologie clinique et Vigilances, CHU de Poitiers, France. 5. Université de Poitiers, France; INSERM U 1084, Laboratoire de Neurosciences Expérimentales et Cliniques, Poitiers, France. 6. Unité de Recherche Clinique Intersectorielle en Psychiatrie à vocation régionale du Centre Hospitalier Henri Laborit, Poitiers, France. 7. Département de psychiatrie adulte, ICM-A-IHU, UPMC UMR S 975, Inserm U 1127, CNRS UMR 7225, GH Pitié-Salpêtrière, Paris, France. 8. Unité de Recherche Clinique Intersectorielle en Psychiatrie à vocation régionale du Centre Hospitalier Henri Laborit, Poitiers, France; Université de Poitiers, France; INSERM U 1084, Laboratoire de Neurosciences Expérimentales et Cliniques, Poitiers, France.
Abstract
BACKGROUND:Obsessive-compulsive disorder (OCD) is a complex disorder with 40 to 60 % of patients resistant to treatment. Theta burst transcranial magnetic stimulation (TBS) is a promising new technique that has been shown to induce potent and long lasting effects on cortical excitability. The present study evaluated for the first time therapeutic efficacy and tolerability of continuous TBS (cTBS) over the supplementary motor area (SMA) in treatment resistant OCD patients using a double blind, sham-controlled design. METHODS:Thirty treatment resistant OCD outpatients were randomized to receive either active cTBS or sham cTBS for 6 weeks (5 sessions per week). Each treatment session consisted of 600 stimuli at an intensity of 70% of resting motor threshold. Patients were evaluated at baseline, at the end of treatment (week 6), and follow-up (week 12). Response to treatment was defined as at least 25% decrease on the Yale-Brown Obsessive Compulsive Scale. RESULTS: There was no significant difference between active and sham cTBS groups in treatment efficacy. Responder rates were not different between the two groups at week 6 (cTBS 28% versus sham 36%; p = 0.686) and week 12 (cTBS 28% versus sham 36%; p = 0.686). Depressive and anxious symptoms improvements were similar in the two groups. CONCLUSION: This study is the first controlled trial using cTBS in treatment resistant OCD patients. The use of cTBS over the SMA is safe but not sufficient to improve OCD symptoms. Further studies are needed to identify the optimal parameters to be used in OCD patients.
RCT Entities:
BACKGROUND:Obsessive-compulsive disorder (OCD) is a complex disorder with 40 to 60 % of patients resistant to treatment. Theta burst transcranial magnetic stimulation (TBS) is a promising new technique that has been shown to induce potent and long lasting effects on cortical excitability. The present study evaluated for the first time therapeutic efficacy and tolerability of continuous TBS (cTBS) over the supplementary motor area (SMA) in treatment resistant OCDpatients using a double blind, sham-controlled design. METHODS: Thirty treatment resistant OCD outpatients were randomized to receive either active cTBS or sham cTBS for 6 weeks (5 sessions per week). Each treatment session consisted of 600 stimuli at an intensity of 70% of resting motor threshold. Patients were evaluated at baseline, at the end of treatment (week 6), and follow-up (week 12). Response to treatment was defined as at least 25% decrease on the Yale-Brown Obsessive Compulsive Scale. RESULTS: There was no significant difference between active and sham cTBS groups in treatment efficacy. Responder rates were not different between the two groups at week 6 (cTBS 28% versus sham 36%; p = 0.686) and week 12 (cTBS 28% versus sham 36%; p = 0.686). Depressive and anxious symptoms improvements were similar in the two groups. CONCLUSION: This study is the first controlled trial using cTBS in treatment resistant OCDpatients. The use of cTBS over the SMA is safe but not sufficient to improve OCD symptoms. Further studies are needed to identify the optimal parameters to be used in OCDpatients.
Authors: Isidoor O Bergfeld; Eva Dijkstra; Ilse Graat; Pelle de Koning; Bastijn J G van den Boom; Tara Arbab; Nienke Vulink; Damiaan Denys; Ingo Willuhn; Roel J T Mocking Journal: Curr Top Behav Neurosci Date: 2021
Authors: Alexandra Kammen; Jonathon Cavaleri; Jordan Lam; Adam C Frank; Xenos Mason; Wooseong Choi; Marisa Penn; Kaevon Brasfield; Barbara Van Noppen; Stuart B Murray; Darrin Jason Lee Journal: Front Neurol Date: 2022-08-09 Impact factor: 4.086