Related Experiment Video
Updated: Jan 12, 2026
Protocol for Repetitive Transcranial Magnetic Stimulation with Symptom Provocation to Treat Obsessive-compulsive Disorder
Published on: November 25, 2025
Efficacy of repetitive transcranial magnetic stimulation as an adjunctive treatment in resistant obsessive-compulsive
Kartikeya R Singh1, D Bhattacharya2, Ravi M Sharma3
1Department of Psychiatry, Mindful Psychiatry Care, Dehradun, Uttarakhand, India.
Background:
Obsessive-compulsive disorder (OCD) is a chronic psychiatric condition, often resistant to pharmacotherapy. Repetitive transcranial magnetic stimulation (rTMS) has emerged as a potential neuromodulatory treatment for resistant OCD. However, evidence regarding its efficacy in an Indian clinical setting remains limited.
Aim:
To evaluate the efficacy of adjunctive low-frequency rTMS applied over the right supplementary motor area (SMA) in patients with treatment-resistant OCD.
Materials And Methods:
A prospective, randomized, double-blind, sham-controlled study was conducted at a tertiary care center. Thirty treatment-resistant OCD patients were recruited and randomized into active rTMS (n = 15) and sham rTMS (n = 15) groups. rTMS was administered at 1 Hz frequency, at 100% motor threshold, for two weeks, followed by a four-week gap, and another two-week session. Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) scores were assessed at baseline, posttreatment (two weeks), and follow-ups at six and eight weeks. A reduction of ≥25% in Y-BOCS score was considered a positive response.
Results:
A total of 28 patients completed the study (active n = 13, sham n = 15). Baseline demographic and clinical variables were comparable. Mean Y-BOCS reduction at eight weeks was significantly higher in the active rTMS group compared to sham (P < 0.05). Active rTMS was well tolerated, with headache being the most common adverse effect.
Conclusion:
Low-frequency rTMS over the SMA shows promise as an adjunctive treatment for resistant OCD. Further studies with larger samples and extended follow-up periods are warranted.
