title: Transcranial Magnetic Stimulation of the Supplementary Motor Area in the Treatment of Obsessive-Compulsive Disorder: A Multi-Site Study.
abstract: Recently, strategies beyond pharmacological and psychological treatments have been developed for the management of obsessive-compulsive disorder (OCD). Specifically, repetitive transcranial magnetic stimulation (rTMS) has been employed as an adjunctive treatment in cases of treatment-refractory OCD. Here, we investigate six weeks of low frequency rTMS, applied bilaterally and simultaneously over the sensory motor area, in OCD patients in a randomized, double-blind placebo-controlled clinical trial. Twenty-two participants were randomly enrolled into the treatment (ACTIVE = 10) or placebo (SHAM = 12) groups. At each of seven visits (baseline; day 1 and weeks 2, 4, and 6 of treatment; and two and six weeks after treatment) the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was administered. At the end of the six weeks of rTMS, patients in the ACTIVE group showed a clinically significant decrease in Y-BOCS scores compared to both the baseline and the SHAM group. This effect was maintained six weeks following the end of rTMS treatment. Therefore, in this sample, rTMS appeared to significantly improve the OCD symptoms of the treated patients beyond the treatment window. More studies need to be conducted to determine the generalizability of these findings and to define the duration of rTMS' clinical effect on the Y-BOCS. Clinical Trial Registration Number (NCT) at www.clinicaltrials.gov: NCT00616486.
authors.affiliation: Departments of Psychiatry, Queen's University, Kingston, ON K7L 4X3, Canada. erhawken@gmail.com.|Biomedical and Molecular Sciences, Queen's University, Kingston, ON K7L 4X3, Canada. erhawken@gmail.com.
authors.forename: Emily R
authors.initials: ER
authors.lastname: Hawken
authors.affiliation: Department of Psychiatry, Military Medical Academy, Sofia 1000, Bulgaria. ddilkov@abv.bg.
authors.forename: Dancho
authors.initials: D
authors.lastname: Dilkov
authors.affiliation: Department of Psychiatry, Military Medical Academy, Sofia 1000, Bulgaria. ekaludiev@abv.bg.
authors.forename: Emil
authors.initials: E
authors.lastname: Kaludiev
authors.affiliation: Department of Psychiatry, Sincan State Hospital, Istanbul 34400, Turkey. selcuk_simsek@yahoo.com.
authors.forename: Selcuk
authors.initials: S
authors.lastname: Simek
authors.affiliation: Departments of Psychiatry, Queen's University, Kingston, ON K7L 4X3, Canada. f.i.zhang67@gmail.com.
authors.forename: Felicia
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Departments of Psychiatry, Queen's University, Kingston, ON K7L 4X3, Canada. roumen.milev@queensu.ca.
authors.forename: Roumen
authors.initials: R
authors.lastname: Milev
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000628:therapy*; D066191:Sensorimotor Cortex / Q000502:physiology* / Q000503:physiopathology; D050781:Transcranial Magnetic Stimulation
keywords: Yale-Brown obsessive compulsive scale; low-frequency rTMS; sensory motor area