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Cognitive Function and Treatment Outcomes in Trichotillomania: A Case Series Evaluating the Efficacy of TMS
Beyazit Garip1, Dilara Yüzgüleç
1Department of Psychiatry, Gulhane Training and Research Hospital, Ankara, Turkiye.
Objectives:
Trichotillomania is a psychiatric disorder characterized by the compulsive pulling of one's own hair, eyelashes, or eyebrows. Depression and obsessive-compulsive disorder comorbidity is frequently observed in patients with trichotillomania. In this case series, we will report how a patient diagnosed with trichotillomania was successfully treated with transcranial magnetic stimulation (TMS) therapy in our clinic.
Methods:
The TMS protocol was delivered using the MagVenture X100 device, with treatment intensity calibrated to 100% of each participant's motor threshold. Following the established treatment protocol for trichotillomania, patients received repetitive TMS at 1 Hz, with each train lasting 300 seconds and a 60-second intertrain interval, for a total of 1200 pulses per session. The bilateral supplementary motor area (SMA) was targeted as the site of stimulation.
Results:
The efficacy of TMS in reducing hair-pulling behaviors in patients with trichotillomania was evaluated in a case series of 3 patients who underwent 20 TMS sessions. The findings demonstrated a significant reduction in hair-pulling behaviors post-treatment. According to the Massachusetts General Hospital Hair Pulling Scale (MGH-HP), over 50% improvement was observed in all patients.
Conclusions:
The findings suggest that TMS may serve as a promising intervention for trichotillomania, warranting further exploration in larger, controlled trials. The utilization of the MGH-HP scale provided a robust measure for assessing behavioral changes, highlighting the potential of TMS in managing compulsive disorders.
