Accelerated deep intermittent theta-burst stimulation for obsessive-compulsive disorder: A double-blind, randomized,...

Area of Science:

• Neuroscience
• Psychiatry
• Clinical Trials

Background:

• The standard FDA-approved protocol for Obsessive-Compulsive Disorder (OCD) involves six weeks of 20 Hz deep transcranial magnetic stimulation (dTMS) targeting the medial prefrontal cortex (mPFC).
• The efficacy of accelerated deep intermittent theta burst stimulation (d-iTBS) for OCD, targeting the same region, has not been established through randomized controlled trials.

Purpose of the Study:

• To investigate the efficacy of a modified, shorter-duration d-iTBS protocol for treating OCD.
• To evaluate changes in obsessive-compulsive symptoms (OCS), as well as depressive and anxiety symptoms, following the accelerated d-iTBS intervention.

Main Methods:

• A randomized controlled trial was conducted using a two-week accelerated d-iTBS protocol (50 sessions total) targeting the mPFC.
• Primary outcome measures included the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and Dimensional Obsessive-Compulsive Scale.
• Changes in clinical scores were analyzed using repeated measures ANOVA.

Main Results:

• A statistically significant Group × Time interaction was observed for the reduction in total OCS, indicating a difference between active and placebo groups.
• No significant effects were found for obsessions and compulsions analyzed separately or across specific OCS dimensions.
• Reductions in depressive and anxiety symptoms did not reach statistical significance.
• A trend toward significance (p = 0.051) was noted for score reduction between treatment endpoint and two-week follow-up.

Conclusions:

• Accelerated d-iTBS targeting the mPFC shows potential for reducing OCD symptoms.
• Therapeutic effects of this accelerated d-iTBS protocol may manifest more clearly several weeks post-treatment.
• The trial is registered on ClinicalTrials.gov (NCT06177470).