title: Update on repetitive transcranial magnetic stimulation in obsessive-compulsive disorder: different targets.
abstract: Obsessive-compulsive disorder (OCD) is a chronic, disabling disorder. Ten percent of patients remain treatment refractory despite several treatments. For these severe, treatment-refractory patients, repetitive transcranial magnetic stimulation (rTMS) has been suggested as a treatment option. Since 1997, in published trials, a total of 110 OCD patients have been treated with rTMS. This review aims to provide an update on rTMS treatment in patients with OCD. First, the mechanism of action is discussed, followed by the efficacy and side effects of rTMS at various brain targets, and finally implications for the future. Due to the lack of studies with comparable stimulation or treatment parameters and with reliable designs, it is difficult to draw clear conclusions. In general, rTMS appears to be effective in open-label studies; however, this has not yet been replicated in randomized, sham-controlled trials.
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam, PA.3-127, P.O. Box 75867, 1070 AW, Amsterdam, The Netherlands. r.m.blom@amc.uva.nl
authors.forename: Rianne M
authors.initials: RM
authors.lastname: Blom
authors.forename: Martijn
authors.initials: M
authors.lastname: Figee
authors.forename: Nienke
authors.initials: N
authors.lastname: Vulink
authors.forename: Damiaan
authors.initials: D
authors.lastname: Denys
mesh_terms: D005625:Frontal Lobe / Q000503:physiopathology; D006801:Humans; D009044:Motor Cortex / Q000503:physiopathology; D009771:Obsessive-Compulsive Disorder / Q000503:physiopathology / Q000628:therapy*; D017397:Prefrontal Cortex / Q000503:physiopathology; D050781:Transcranial Magnetic Stimulation / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome