Augmentation Effect of Low-Frequency Repetitive Transcranial Magnetic Stimulation Over Presupplementary Motor Area in Obsessive-Compulsive Disorder: A Randomized Controlled Trial

• Published in: The journal of ECT Vol. 34; no. 4; p. 253
• Main Authors: Arumugham, Shyam Sundar, Vs, Subhasini, Hn, Madhuri, B, Vinay, Ravi, Malvika, Sharma, Eesha, Thirthalli, Jagadisha, Reddy, Y C Janardhan
• Format: Journal Article
• Language: English
• Published: United States 01.12.2018
• Subjects: Adult; Anxiety - etiology; Anxiety - psychology; Anxiety - therapy; Depression - etiology; Depression - psychology; Depression - therapy; Double-Blind Method; Drug Resistance; Female; Humans; Male; Middle Aged; Motor Cortex - physiology; Negative Results; Obsessive-Compulsive Disorder - psychology; Obsessive-Compulsive Disorder - therapy; Psychiatric Status Rating Scales; Transcranial Magnetic Stimulation - methods; Treatment Outcome; Young Adult
• ISSN: 1533-4112
• DOI: 10.1097/YCT.0000000000000509

The current study investigated the efficacy of low-frequency repetitive transcranial magnetic stimulation (rTMS) over bilateral presupplementary motor area (pre-SMA) in patients suffering from obsessive-compulsive disorder (OCD) with partial/poor response to pharmacotherapy, in a double-blinded randomized sham controlled trial. Forty subjects with OCD, who were on stable medications with partial/poor response to pharmacotherapy were randomly divided into 2 groups (n = 20 in each group), to receive either active or sham low-frequency rTMS over bilateral pre-SMA. Thirty-six patients were eligible for intent-to-treat analysis. There was no significant difference in relevant demographic and clinical variables between the 2 groups at baseline. There were no statistically significant differences between the 2 groups after 3 weeks of treatment in the Yale-Brown Obsessive Compulsive Scale score (time*group interaction, F2.48,84.16 = 0.80, P = 0.40) and other secondary outcome measures including responder rates and depressive and anxiety symptoms. Low-frequency rTMS over pre-SMA may not be effective as an augmenting agent in partial/poor responders to SRIs. This study underlines the need to explore alternate rTMS protocols in OCD.