Table 1.
Summary of studies of repetitive transcranial magnetic stimulation in treatment of obsessive-compulsive disorder
| Study (year) | Target | N | Diagnosis | Medication continuation | Intervention | Time | Mean score (SD) on Y-BOCS pre-rTMS | Mean score (SD) on Y-BOCS post-rTMS | Mean score on mood scale pre-rTMS | Mean score on mood scale post-rTMS | |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Intervention | Greenberg et al. [7] (1997) | Right PFC or left DLPFC | 12 | OCD | Yes, n = 8 (stable SRI treatment) | 20 Hz/2 s/min (80% of motor threshold) | 1 session of 20 min; measurement after 8 h | – | Compulsions decreased right PFC (P = 0.02) (left PFC P = 0.05) | – | No significant mood improvement |
| Control | Midoccipital | 12a | OCD | 20 Hz/2 s/min (80% of motor threshold) | 1 session of 20 min; measurement after 8 h | – | Compulsions decreased (midoccipital P = 0.07) | – | No significant mood improvement | ||
| Intervention | Sachdev et al. [21] (2001) | Right PFC | 6 | Treatment-resistant OCD | Yes, n = 10 (stable SRI, benzodiazepine, neuroleptic treatment) | 10 Hz (110% motor threshold) | 10 sessions of 2.5 min in 2 week; measurement 4 week after last session | 27.2 (9.0) | 12.0 (3.9) | 23.2 (12.5) on BDI | 11.6 (14.6) on BDI |
| Control | Left PFC | 6 | Treatment-resistant OCD | 10 Hz (110% motor threshold) | 10 sessions of 2.5 min in 2 week; measurement 4 week after last session | 22.5 (6.3) | 16.5 (8.3) | 19.7 (12.5) on BDI | 10.8 (7.9) on BDI | ||
| Intervention | Alonso et al. [16] (2001) | Right DLPFC | 10 | OCD | Yes, n = 7 (stable SRI, TCA treatment) | 1 Hz (110% of motor threshold) | 18 sessions of 20 min in 10 week; measurement after 10 week | 24.0 (5.3) | 20.6 (9.1) | 11.1 (5.1) on HAM-D | 10.8 (4.8) on HAM-D |
| Control | Right DLPFC | 8 | OCD | Yes, n = 6 (stable SRI, TCA treatment) | Sham condition | 18 sessions of 20 min in 10 week; measurement after 10 week | 25.6 (6.1) | 25.3 (8.3) | 11.7 (2.7) on HAM-D | 12.0 (3.0) on HAM-D | |
| Intervention | Mantovani et al. [14] (2006) | SMA | 10 | OCD/TS | Yes, n = 10 (stable SRI, benzodiazepine, neuroleptic treatment) | 1 Hz (100% of motor threshold) | 10 sessions of 20 min in 2 week; measurement 2 week after last stimulation | 36.4 (7.5) | 26.0 (10.5) | 20.7 (11.4) on HAM-D | 10.8 (10.7) on HAM-D |
| Control | – | – | – | – | – | – | – | – | – | ||
| Intervention | Prasko et al. [19] (2006) | Left DLPFC | 15 | SRI-resistant OCD | Yes, n = 15 (stable SRI treatment) | 1 Hz (110% of motor threshold) | 10 sessions of 30 min in 2 week; measurement 2 week after last stimulation | 29.8 (5.8) | 21.4 (9.2) | – | – |
| Control | Left DLPFC | 15 | SRI-resistant OCD | Yes, n = 15 (stable SRI treatment) | Sham condition | 10 sessions of 30 min in 2 week; measurement 2 week after last stimulation | 23.4 (5.0) | 16.9 (5.9) | – | – | |
| Intervention | Sachdev et al. [12] (2007) | Left DLPFC | 10 | OCD | Yes, n = 9 (unknown treatment) | 10 Hz (110% of motor threshold) | 10 sessions of 2.5 min in 2 week; measurement directly after last stimulation | 26.0 | 20.0 | – | Symptoms improved over time but no difference between groups |
| Control | Left DLPFC | 8 | OCD | Yes, n = 4 (unknown treatment) | Sham condition | 10 sessions of 2.5 min in 2 week; measurement directly after last stimulation | 24.0 | 19.0 | – | Symptoms improved over time but no difference between groups | |
| Intervention | Ruffini et al. [13] (2009) | Left OFC | 16 | Drug-resistant OCD | Yes, n = 23 (stable SRI, neuroleptic, antiepileptic, benzodiazepine treatment) | 1 Hz (80% of motor threshold) | 15 sessions of 10 min in 3 week; measurement 12 week after last session | 32.1 (6.0) | 27.3 (9.4) | – | No mood improvement over time |
| Control | Left OFC | 7 | Drug-resistant OCD | Sham condition | 15 sessions of 10 min in 3 week; measurement 12 week after last session | 31.4 (6.9) | 29.6 (6.7) | – | No mood improvement over time | ||
| Intervention | Kang et al. [17•] (2009) | Right DLPFC and SMA | 10 | Treatment-resistant OCD | Yes, n = 10 (stable SRI, benzodiazepine treatment) | 1 Hz (110% of motor threshold) | 14 sessions of 10 min in 2 week; measurement 2 week after last session | 26.5 (5.6) | 23.6 (7.4) | 18.1 (6.6) on BDI | 17.2 (10.9) on BDI |
| Control | Right DLPFC and SMA | 10 | Treatment-resistant OCD | Yes, n = 10 (stable SRI, benzodiazepine treatment) | Sham condition | 14 sessions of 10 min in 2 week; measurement 2 week after last session | 26.3 (4.1) | 22.9 (6.2) | 16.7 (10.0) on BDI | 15.8 (14.4) on BDI | |
| Intervention | Mantovani et al. [18•] (2010) | SMA | 9 | OCD | Yes, n = 13 (stable SRI treatment) | 1 Hz (100% of motor threshold) | 20 sessions of 20 min in 4 week; measurement directly after last stimulation | 26.0 (5.4) | 19.4 (5.6) | 15.3 (10.6) on HAM-D | 12.1 (11.4) on HAM-D |
| Control | SMA | 9 | OCD | Sham condition | 20 sessions of 20 min in 4 week; measurement directly after last stimulation | 26.7 (5.5) | 23.5 (9.0) | 14.8 (6.9) on HAM-D | 14.1 (8.8) on HAM-D | ||
| Intervention | Sarkhel et al. [20] (2010) | Right DLPFC | 21 | OCD | Yes, n = 21 (TCA, SRI treatment) | 10 Hz (110% of motor threshold) | 10 sessions in 2 week; measurement 2 week after last session | 25.7 (3.9) | Change in score, 5.0 (2.3) | 12.5 (2.2) on HAM-D | Change in score, 3.8 (1.6) on HAM-D |
| Control | Right DLPFC | 21 | OCD | Yes, n = 21 (TCA, SRI treatment) | Sham condition | 10 sessions in 2 week; measurement 2 week after last session | 23.6 (3.7) | Change in score, 4.2 (1.8) | 12.1 (2.7) on HAM-D | Change in score, 3.2 (1.0) on HAM-D |
aSame 12 individuals as investigated in the intervention group
BDI Beck depression inventory, DLPFC Dorsolateral prefrontal cortex, HAM-D Hamilton depression rating scale, OCD Obsessive-compulsive disorder, OFC Orbitofrontal cortex, PFC Prefrontal cortex, rTMS Repetitive transcranial magnetic stimulation, SMA Supplementary motor area, SRI Serotonin reuptake inhibitor, TCA Tricyclic antidepressant, TS Tourette’s syndrome, Y-BOCS Yale-brown obsessive compulsive scale