Zaman, R., & Robbins, T. W. (2017). Is there potential for repetitive Transcranial Magnetic Stimulation (rTMS) as a treatment of OCD? Psychiatria Danubina, 29(3), 672-678.
In this review, the authors discuss the importance of looking for alternative therapies for OCD patients who are either treatment-resistant, unwilling to try psychopharmacological management or cognitive behavioural therapy, or for whom deep brain stimulation would be an overly invasive alternative. They discuss the past 20 years of research into the efficacy of rTMS as an alternative treatment for these OCD patients, covering both positive and negative study outcomes. The main stimulation sites covered within the review are the dorsolateral prefrontal cortex (DLPFC), supplementary motor area (SMA), and pre-supplementary motor area (preSMA). The review highlights the mixed findings with stimulation over the DLPFC, which have involved left, right, and bilateral stimulation protocols, both at low (1Hz) and high (10-20Hz) frequencies. In contrast, the authors highlight generally more positive outcomes from research stimulating the SMA and preSMA, often utilizing bilateral, low frequency (1Hz) stimulation. They also discuss a more limited number of trials that have focused on low frequency (1Hz) stimulation of the orbitofrontal cortex (OFC), continuous theta burst stimulation (cTBS) of the right DLPFC, and low or high frequency deep rTMS using a double cone coil over the anterior cingulate cortex (ACC) or the medial prefrontal cortex (mPFC). They suggest rTMS may provide a future therapeutic alternative for treatment-resistant OCD patients. However, due to the different methodologies and patient groups across the reviewed literature, they conclude further research is needed to conclusively identify effective treatment sites and protocols in OCD treatment.
*For original abstract/publication see the link below.
Publication link: Dnb-29_S-3_151_718_All.pdf (researchgate.net)