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TMS Shows Promise in Effective Obsessive-Compulsive Disorder Treatment
A recent systematic review and meta-analysis published in the journal Life reveals promising results for the use of Transcranial Magnetic Stimulation (TMS) in the treatment of obsessive-compulsive disorder (OCD).
According to the authors, "TMS of several brain targets represents a safe and effective treatment option for OCD patients."
Despite the US Food and Drug Administration's approval of an rTMS protocol for OCD treatment in 2017, the precise neural target and protocol have remained subjects of debate. In this study, researchers wanted to answer significant clinical questions related to the efficacy of TMS and potential improvements for OCD treatment.
The primary analysis was a pairwise meta-analysis spanning over 31 trials. Researchers then delved deeper into subgroup analyses tailored to each targeted brain region before conducting meta-regression analyses. The studies reviewed enrolled patients over 18 diagnosed with OCD and included open trials, randomized controlled trials, and single- or double-blind trials with either a parallel or crossover design.
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In addition to revealing TMS as an effective treatment for OCD, the study highlighted the importance of identifying the optimal neural target for the procedure. Notably, the post-treatment Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score saw a significant reduction in the active TMS group compared to the sham TMS group. Moreover, specific brain targets, such as the right orbitofrontal cortex (OFC), showed more promising results than others.
Given the high rates of unresponsiveness to conventional forms of treatments—up to 40-60%— authors are particularly interested in TMS enabling increased stimuli in less time compared to conventional rTMS, allowing multiple daily sessions.
“The current evidence is still not sufficient to provide clear indications of a TMS protocol and/or a brain target over the others,” researchers wrote in the study. “This fact is at least partially due to the small sample size and heterogeneity of the TMS protocols and devices across studies. Thus, future controlled multicenter trials directly comparing different targets and protocols are needed.”
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