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The Efficacy of Transcranial Magnetic Stimulation in the Treatment of Obsessive-Compulsive Disorder: An Umbrella Review of Meta-Analyses

Published online by Cambridge University Press:  06 December 2023

Sujita Kumar Kar Open the ORCID record for Sujita Kumar Kar [Opens in a new window] ,
Aditya Agrawal ,
Amílcar Silva-dos-Santos Open the ORCID record for Amílcar Silva-dos-Santos [Opens in a new window] ,
Yogesh Gupta  and
Zhi-De Deng
Sujita Kumar Kar*
Affiliation:
Department of Psychiatry, King George’s Medical University, Lucknow, India
Aditya Agrawal
Affiliation:
Department of Psychiatry, King George’s Medical University, Lucknow, India
Amílcar Silva-dos-Santos
Affiliation:
Neuroscience Unit, CUF Tejo Hospital, Lisbon, Portugal Mental Health Department, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal Department of Psychiatry, Universidade do Mindelo, Mindelo, Cape Verde Psychiatry Unit, Hospital de Cascais, Cascais, Portugal
Yogesh Gupta
Affiliation:
Department of Psychiatry, King George’s Medical University, Lucknow, India
Zhi-De Deng
Affiliation:
Computational Neurostimulation Research Program, Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
*
Corresponding author: Sujita Kumar Kar; Email: sujitakumarkar@kgmcindia.edu
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Abstract

Background

Repetitive transcranial magnetic stimulation (rTMS) has been increasingly used for treating obsessive-compulsive disorder (OCD). Although several meta-analyses have explored its effectiveness and safety, there is no umbrella review specifically focused on rTMS for OCD. This umbrella review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and analyzed relevant meta-analyses on rTMS for OCD.

Methods

Twenty-three articles were identified from PubMed, and after screening, 12 meta-analyses were included in the review. The studies analyzed in the meta-analyses ranged from 10 to 27, with total participants ranging from 282 to 791. The most commonly studied regions were the dorsolateral prefrontal cortex (DLPFC), supplementary motor area (SMA), and orbito-frontal cortex (OFC).

Result

The majority of the meta-analyses consistently supported the effectiveness of rTMS in reducing OCD symptoms when applied to the DLPFC and SMA. Encouraging results were also observed when targeting the medial prefrontal cortex (mPFC) and anterior cingulate cortex (ACC) through deep transcranial magnetic stimulation (dTMS). However, there was a high level of heterogeneity in the findings of nine out of 12 meta-analyses.

Conclusion

In conclusion, existing evidence suggests that rTMS targeting the DLPFC and SMA consistently reduces OCD symptoms, but targeting the mPFC and ACC through dTMS shows variable results. However, the high heterogeneity in the study findings indicates a need for further research and standardization in the field.

Keywords

Transcranial magnetic stimulationobsessive-compulsive disorderefficacyevidencemeta-analysis
Type
Original Research
Information
CNS Spectrums , Volume 29 , Issue 2 , April 2024 , pp. 109 - 118
Copyright
© The Author(s), 2023. Published by Cambridge University Press

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