Skip to main content
SpringerLink
Log in

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

  • Short Communication
  • Published:
European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Abstract

Several reports point to the beneficial effects of repetitive transcranial magnetic stimulation (rTMS) in the treatment of resistant obsessive–compulsive disorder (OCD). This study aimed to evaluate the safety and efficacy of rTMS targeting the dmPFC in the treatment of treatment-resistant OCD patients. Twelve patients received 20 sessions of low-frequency (LF) rTMS (1 Hz, 1200 pulses) in a twice daily protocol during 10 weekdays. Y-BOCS and IDS scores modestly but significantly decreased after treatment and at follow-up and HADS anxiety improved at follow-up. LF rTMS may improve OCD, anxiety, and depressive symptoms in treatment-resistant OCD and was a safe and well-tolerated treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Horwath E, Weissman M (2000) The epidemiology and cross-national presentation of obsessive-compulsive disorder. Psychiatr Clin North Am 23:493–550. https://doi.org/10.1016/S0193-953X(05)70176-3

    Article  CAS  PubMed  Google Scholar 

  2. Fineberg N A, Brown A, & Pampaloni I (2012). Evidence-based pharmacotherapy of obsessive–compulsive disorder. In: Essential evidence-based psychopharmacology, 2nd edn. Cambridge University Press, pp 128–170

  3. Veale D, Miles S, Smallcombe N, Ghezai H, Goldacre B, Hodsoll J (2014) Atypical antipsychotic augmentation in SSRI treatment refractory obsessive-compulsive disorder: a systematic review and meta-analysis. BMC Psychiatry 14:1–13. https://doi.org/10.1186/s12888-014-0317-5

    Article  Google Scholar 

  4. Atmaca M (2016) Treatment-refractory obsessive compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry 70:127–133. https://doi.org/10.1016/j.pnpbp.2015.12.004

    Article  PubMed  Google Scholar 

  5. Dunlop K, Woodside B, Olmsted M, Colton P, Giacobbe P, Downar J (2016) Reductions in cortico-striatal hyperconnectivity accompany successful treatment of obsessive-compulsive disorder with dorsomedial prefrontal rTMS. Neuropsychopharmacology 41:1395–1403. https://doi.org/10.1038/npp.2015.292

    Article  CAS  PubMed  Google Scholar 

  6. Modirrousta M, Shams E, Katz C, Mansouri B, Moussavi Z, Sareen J, Enns M (2015) The efficacy of deep repetitive transcranial magnetic stimulation over the medial prefrontal cortex in obsessive compulsive disorder: results from an open-label study. Depression and Anxiety. 32:445–450. https://doi.org/10.1002/da.22363

    Article  PubMed  Google Scholar 

  7. Berlim MT, Neufeld NH, Van den Eynde F (2013) Repetitive transcranial magnetic stimulation (rTMS) for obsessive-compulsive disorder (OCD): An exploratory meta-analysis of randomized and sham-controlled trials. J Psychiatr Res 47:999–1006. https://doi.org/10.1016/j.jpsychires.2013.03.022

    Article  PubMed  Google Scholar 

  8. National Institute for Health and Care Excellence (NICE) (2020). Interventional procedure consultation document: transcranial magnetic stimulation for obsessive-compulsive disorder, draft recommendations. NICE 2020

  9. Hallet M (2007) Transcranial magnetic stimulation: a primer. Neuron 55:187–199

    Article  Google Scholar 

  10. Speer AM, Kimbrell TA, Wasserman EM et al (2000) Opposite effects of high and low frequency rTMS on region brain activity in depressed patients. Biol Psychiatry 4:1133–1141

    Article  Google Scholar 

  11. Morgiève M, N'Diaye K, Haynes W et al (2014) Dynamics of psychotherapy-related cerebral haemodynamic changes in obsessive compulsive disorder using a personalized exposure task in functional magnetic resonance imaging. Psychol Med 44:1461–1473

    Article  Google Scholar 

  12. Rotge JY, Guehl D, Dilharreguy B et al (2008) Provocation of obsessive-compulsive symptoms: a quantitative voxel-based meta-analysis of functional neuroimaging studies. J Psychiatry Neurosci 33:405–412

    PubMed  PubMed Central  Google Scholar 

  13. Pittenger C, Bloch MH, Williams K (2011) Glutamate abnormalities in obsessive compulsive disorder: neurobiology, pathophysiology, and treatment. Pharmacol Ther 132(3):314–332

    Article  CAS  Google Scholar 

  14. Menzies L, Chamberlain S, Laird A, Thelen S, Sahakian BJ, Bullmore E (2008) Integrating evidence from neuroimaging and neuropsychological studies of obsessive-compulsive disorder: the orbitofronto-striatal model revisisted. Neurosci Biobehav Rev 32:525–549

    Article  Google Scholar 

  15. Baeken C (2018) Accelerated rTMS: a potential treatment to alleviate refractory depression. Fron Psychol 9:2017. https://doi.org/10.3389/fpsyg.2018.02017

    Article  Google Scholar 

  16. Duprat R, Desmyter S, Rudi DR, Van Heeringen K, Van Den Abbeele D, Tandt H et al (2016) Accelerated intermittent theta burst stimulation treatment in medication-resistant major depression: a fast road to remission? J Affect Disord 200:6–14. https://doi.org/10.1016/j.jad.2016.04.015

    Article  PubMed  Google Scholar 

  17. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E et al (1998) The mini-international neuropsychiatric interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 59(Suppl 20):22–33. https://doi.org/10.1016/S0924-9338(99)80239-9

    Article  PubMed  Google Scholar 

  18. Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL et al (1989) The yale-brown obsessive compulsive scale: I. Development, use, and reliability. Archives General Psychiatry. 46:1006–1011. https://doi.org/10.1001/archpsyc.1989.01810110048007

    Article  CAS  Google Scholar 

  19. Rush AJ, Gullion CM, Basco MR, Jarrett RB, Trivedi MH (1996) The inventory of depressive symptomatology (IDS): psychometric properties. Psychol Med 26:477–486. https://doi.org/10.1017/S0033291700035558

    Article  CAS  PubMed  Google Scholar 

  20. Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x

    Article  CAS  PubMed  Google Scholar 

  21. Mataix-Cols D, Fernández de la Cruz L, Nordsletten AE, Lenhard F, Isomura K, Simpson HB (2016) Towards an international expert consensus for defining treatment response, remission, recovery and relapse in obsessive-compulsive disorder. World Psychiatry 15:80–81. https://doi.org/10.1002/wps.20299

    Article  PubMed  PubMed Central  Google Scholar 

  22. Rossi S, Hallett M, Rossini PM, Pascual-Leone A, Avanzini G, Bestmann S et al (2009) Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clin Neurophysiol 120:2008–2039. https://doi.org/10.1016/j.clinph.2009.08.016

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

CB and SdW were funded by a Concerted Research Action of Ghent University, Grant/Award Number: BOF16/GOA/017, an Applied Biomedical (TBM) grant of the Agency for Innovation through Science and Technology (IWT), part of the Research Foundation–Flanders (FWO), awarded to the PrevenD project (B/14730/01), and het Fonds Wetenschappelijk Onderzoek Rode Neuzen, Grant/Award Number: G0F4617N.

Author information

Authors and Affiliations

  1. Department of Psychiatry, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium

    Hannelore L. N. Tandt, Nele Van de Velde, Kurt Audenaert, Chris Baeken & Gilbert M. D. Lemmens

  2. Department of Head and Skin—Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium

    Sara De Witte, Kurt Audenaert, Chris Baeken & Gilbert M. D. Lemmens

  3. Department of Psychiatry, Free University of Brussels, Brussels, Belgium

    Chris Baeken

Authors
  1. Hannelore L. N. Tandt
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nele Van de Velde
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sara De Witte
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kurt Audenaert
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Chris Baeken
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Gilbert M. D. Lemmens
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hannelore L. N. Tandt.

Ethics declarations

Conflict of interest

None of the authors declare any conflicts of interest.

Additional information

Communicated by Sebastian Walther.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tandt, H.L.N., Van de Velde, N., De Witte, S. et al. Is twice daily LF-rTMS a viable treatment option for treatment-resistant OCD? Results from an open-label feasibility study. Eur Arch Psychiatry Clin Neurosci 271, 211–214 (2021). https://doi.org/10.1007/s00406-020-01142-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00406-020-01142-x

Keywords

Search

Navigation