Is TBS an effective add-on therapy in treatment-resistant OCD? - A randomized controlled trial

Area of Science:

• Neuroscience
• Psychiatry
• Clinical Trials

Background:

• Obsessive-compulsive disorder (OCD) is a debilitating mental health condition.
• Repetitive Transcranial Magnetic Stimulation (rTMS) and Theta Burst Stimulation (TBS) are emerging treatments for OCD.
• Optimizing TBS parameters and identifying patient subgroups are crucial for effective treatment.

Purpose of the Study:

• To investigate the efficacy of intermittent and continuous TBS as add-on treatments for treatment-resistant OCD.
• To contribute original randomized controlled trial data to the existing body of literature on TBS for OCD.
• To explore the impact of TBS on depressive symptoms and general functioning in OCD patients.

Main Methods:

• A randomized, double-blind, sham-controlled trial was conducted from December 2019 to December 2022.
• Twenty-seven participants with severe OCD were allocated to active TBS (iTBS and cTBS) or sham stimulation groups.
• Outcomes were assessed over a 3-month follow-up period, monitoring OCD symptoms, depression, and general functioning.

Main Results:

• The study yielded inconclusive results regarding the overall efficacy of TBS in treatment-resistant OCD.
• Significant improvements were observed over time across various measures, but many were independent of the intervention group.
• Subgroup analysis and follow-up data suggest potential benefits of continuous TBS (cTBS) for OCD symptom management.

Conclusions:

• The heterogeneity of OCD symptom presentations complicates treatment efficacy assessment.
• Larger sample sizes and more targeted studies are required to confirm the efficacy of TBS, particularly cTBS, in OCD treatment.
• Further research is needed to optimize stimulation parameters and identify patient subgroups who may benefit most from TBS interventions.