Altered brain network stability in OCD following rTMS intervention: Insights from structural balance theory

Repetitive Transcranial Magnetic Stimulation (rTMS) is a promising intervention for Obsessive-Compulsive Disorder (OCD). However, understanding brain network changes following rTMS remains limited, despite its potential to enhance treatment efficacy. In this retrospective study, we investigated brain network reorganization in OCD patients after rTMS, using structural balance theory as a framework. We hypothesized that rTMS-induced functional plasticity would alter brain network topology, particularly affecting triadic associations, and leading to increased balance energy levels, indicative of a less stable network state. Brain functional networks were constructed from resting-state EEGs of OCD patients, with phase lag indexes calculated both before and after rTMS treatment. These networks were analyzed by comparing global parameters, including positive and negative links, triadic interactions (balanced/unbalanced), hub formation tendencies, and balance energy levels. We observed a significant decrease in weak-balanced triads and an increase in strong-unbalanced triads within the Beta І frequency band (12-15 Hz). Additionally, there was a notable reduction in the tendency of negative links to form hubs across certain frequency bands. These changes led to an increase in the network's balanced energy level, pushing it toward a less stable state. We hope these findings will refine rTMS strategies by facilitating brain network reorganization.