title: Effects of repetitive transcranial magnetic stimulation over supplementary motor area in patients with schizophrenia with obsessive-compulsive-symptoms: A pilot study.
abstract: In patients with schizophrenia, obsessive-compulsive symptoms (OCS) are associated with lower rates of quality of life and polypharmacy. No previous controlled studies have tested the efficacy of repetitive transcranial magnetic stimulation (rTMS) on the treatment of OCS in this population. The present study examined the therapeutic effects of rTMS applied to the supplementary motor area (1Hz, 20min, 20 sessions) on OCS and general symptoms in patients with schizophrenia or schizoaffective disorder, and whether this intervention can produce changes in plasma levels of brain derived neurotrophic factor (BDNF). A double-blind randomized controlled trial was conducted. Active and sham rTMS were delivered to 12 patients (6 on each group). Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and Brief Psychiatric Rating Scale (BPRS) scores, as well as BDNF levels, were assessed before, after, and 4 weeks after treatment. rTMS did not significantly change the outcomes after treatment and on the follow-up (Y-BOCS: Wald's X(2)=3.172; p=0.205; BPRS: X(2)=1.629; p=0.443; BDNF: X(2)=2.930; p=0.231). There seemed to be a trend towards improvement of BPRS scores 4 weeks after rTMS treatment comparing with sham (Cohen's d=0.875, with 32.9% statistical power). No side effects were reported. Future studies with larger sample sizes are needed.
authors.affiliation: Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul, Porto Alegre (UFRGS), Rio Grande do Sul, Brazil. Electronic address: vautomf@gmail.com.
authors.forename: Vauto Alves
authors.initials: VA
authors.lastname: Mendes-Filho
authors.affiliation: Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Danilo Rocha
authors.initials: DR
authors.lastname: de Jesus
authors.affiliation: Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul, Porto Alegre (UFRGS), Rio Grande do Sul, Brazil.
authors.forename: Paulo
authors.initials: P
authors.lastname: Belmonte-de-Abreu
authors.affiliation: Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul, Porto Alegre (UFRGS), Rio Grande do Sul, Brazil.
authors.forename: Carolina Tosetto
authors.initials: CT
authors.lastname: Cachoeira
authors.affiliation: Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul, Porto Alegre (UFRGS), Rio Grande do Sul, Brazil.
authors.forename: Maria Inês
authors.initials: MI
authors.lastname: Rodrigues Lobato
mesh_terms: D000328:Adult; D019208:Brain-Derived Neurotrophic Factor / Q000097:blood; D010054:Brief Psychiatric Rating Scale; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology; D009771:Obsessive-Compulsive Disorder / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D010865:Pilot Projects; D011788:Quality of Life; D012559:Schizophrenia / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D012565:Schizophrenic Psychology; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D019208:Brain-Derived Neurotrophic Factor; C579455:BDNF protein, human
keywords: Neuromodulation; Obsessive-compulsive symptoms; Schizophrenia; Supplementary motor area; Transcranial magnetic stimulation