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Repetitive transcranial magnetic stimulation for the treatment of obsessive compulsive disorder: a double-blind controlled investigation

Published online by Cambridge University Press:  26 July 2007

PERMINDER S. SACHDEV ,
COLLEEN K. LOO ,
PHILIP B. MITCHELL ,
TARA F. McFARQUHAR  and
GIN S. MALHI
PERMINDER S. SACHDEV*
Affiliation:
School of Psychiatry, University of New South Wales, Australia Neuropsychiatric Institute, Northern Clinical School, Sydney, Australia
COLLEEN K. LOO
Affiliation:
School of Psychiatry, University of New South Wales, Australia Black Dog Institute, Prince of Wales Hospital; Northern Clinical School, Sydney, Australia
PHILIP B. MITCHELL
Affiliation:
School of Psychiatry, University of New South Wales, Australia Black Dog Institute, Prince of Wales Hospital; Northern Clinical School, Sydney, Australia
TARA F. McFARQUHAR
Affiliation:
School of Psychiatry, University of New South Wales, Australia Black Dog Institute, Prince of Wales Hospital; Northern Clinical School, Sydney, Australia
GIN S. MALHI
Affiliation:
Black Dog Institute, Prince of Wales Hospital; Northern Clinical School, Sydney, Australia Academic Discipline of Psychological Medicine, Northern Clinical School, Sydney, Australia
*
*Address for correspondence: Dr P. S. Sachdev, NPI, Euroa Centre, Prince of Wales Hospital, Barker Street, Randwick NSW 2031, Australia. (Email: p.sachdev@unsw.edu.au)
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Abstract

Background

To determine the efficacy and tolerability of repetitive transcranial magnetic stimulation (rTMS) as a treatment for obsessive compulsive disorder (OCD) in a double-blind placebo-controlled study.

Method

Subjects with treatment-resistant OCD were randomized to rTMS (n=10) or sham rTMS (n=8) for 10 sessions of daily stimulation over the left dorsolateral prefrontal cortex (DLPFC), with subjects and raters being blind to the treatment. Subjects were offered an open extension of up to 20 sessions of rTMS.

Results

The two groups did not differ on change in Yale–Brown Obsessive Compulsive Scale (YBOCS) or Maudsley Obsessive-Compulsive Inventory scores over 10 sessions, with or without correction for depression ratings. Over 20 sessions, there was a significant reduction in total YBOCS scores, but not after controlling for depression. rTMS over 20 sessions was well tolerated.

Conclusion

Two weeks of rTMS over the left DLPFC is ineffective for treatment-resistant OCD.

Information

Type
Original Article
Information
Psychological Medicine , Volume 37 , Issue 11 , November 2007 , pp. 1645 - 1649
Copyright
Copyright © Cambridge University Press 2007

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References

REFERENCES

Alonso, P., Pujol, J., Cardoner, N., Benlloch, L., Deus, J., Menchon, J. M., Capdevila, A. & Vallejo, J. (2001). Right prefrontal repetitive transcranial magnetic stimulation in obsessive-compulsive disorder: a double-blind, placebo-controlled study. American Journal of Psychiatry 158, 1143–1145.CrossRefGoogle ScholarPubMed
Baxter, L. R. Jr., Phelps, M. E., Mazziotta, J. C., Guze, B. H., Schwartz, J. M. & Selin, C. E. (1987). Local cerebral glucose metabolic rates in obsessive-compulsive disorder. A comparison with rates in unipolar depression and in normal controls. Archives of General Psychiatry 44, 211–218.CrossRefGoogle ScholarPubMed
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J. & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry 4, 561–571.Google Scholar
George, M. S., Stallings, L. E., Speer, A. M., Nahas, Z., Spicer, K. M., Vincent, D. J., Bohning, D. E., Cheng, K. T., Molloy, M., Teneback, C. C. & Risch, S. C. (1999). Prefrontal repetitive transcranial magnetic stimulation (rTMS) changes relative perfusion locally and remotely. Human Psychopharmacology 14, 161–170.3.0.CO;2-2>CrossRefGoogle Scholar
Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Fleischmann, R. L., Hill, C. L., Heninger, G. R. & Charney, D. S. (1989). The Yale–Brown Obsessive Compulsive Scale., I: development, use, and reliability. Archives of General Psychiatry 46, 1006–1011.Google Scholar
Greenberg, B. D., George, M. S., Martin, J. D., Benjamin, J., Schlaepfer, T. E., Altemus, M., Wassermann, E. M., Post, R. M. & Murphy, D. L. (1997). Effect of prefrontal repetitive transcranial magnetic stimulation in obsessive-compulsive disorder: a preliminary study. American Journal of Psychiatry 154, 867–869.Google ScholarPubMed
Hodgson, R. J. & Rachman, S. (1977). Obsessional-compulsive complaints. Behaviour Research and Therapy 15, 389–395.CrossRefGoogle ScholarPubMed
Loo, C. K., Mitchell, P. B., Croker, V. M., Malhi, G. S., Wen, W., Gandevia, S. C. & Sachdev, P. S. (2003). Double-blind controlled investigation of bilateral prefrontal transcranial magnetic stimulation for the treatment of resistant major depression. Psychological Medicine 33, 33–40.Google Scholar
Loo, C., Mitchell, P., Sachdev, P., McDarmont, B., Parker, G. & Gandevia, S. (1999). Double-blind controlled investigation of transcranial magnetic stimulation for the treatment of major depression. American Journal of Psychiatry 156, 946–948.CrossRefGoogle ScholarPubMed
Loo, C. K. & Mitchell, P. B. (2005). A review of the efficacy of transcranial magnetic stimulation (TMS) treatment for depression, and current and future strategies to optimize efficacy. Journal of Affective Disorders 88, 255–267.CrossRefGoogle ScholarPubMed
Loo, C., Mitchell, P. B., McFarquhar, T. F., Malhi, G. S. & Sachdev, P. (2007). A sham-controlled trial of the efficacy and safety of twice-daily rTMS in major depression. Psychological Medicine 37, 341–349.Google Scholar
Loo, C. K., Taylor, J. L., Gandevia, S. C., McDarmont, B. N., Mitchell, P. B. & Sachdev, P. S. (2000). Transcranial magnetic stimulation (TMS) in controlled treatment studies: are some ‘sham’ forms active? Biological Psychiatry 47, 325–331.CrossRefGoogle ScholarPubMed
Mantovani, A., Lisanby, S. H., Pieraccini, F., Ulivelli, M., Castrogiovanni, P. & Rossi, S. (2005). Repetitive transcranial magnetic stimulation (rTMS) in the treatment of obsessive-compulsive disorder (OCD) and Tourette's syndrome (TS). International Journal of Neuropsychopharmacology 9, 95–100.Google Scholar
Montgomery, S. A. & Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry 134, 382–389.Google Scholar
Piccinelli, M., Pini, S., Bellantuono, C. & Wilkinson, G. (1995). Efficacy of drug treatment in obsessive compulsive disorder. A meta-analytic review. British Journal of Psychiatry 166, 424–443.CrossRefGoogle ScholarPubMed
Prasko, J., Paskova, B., Zalesky, R., Novak, T., Kopecek, M., Bares, M. & Horacek, J. (2006). The effect of repetitive transcranial magnetic stimulation (rTMS) on symptoms in obsessive compulsive disorder. A randomized double-blind, sham-controlled study. Neuroendocrinology Letters 27, 327–332.Google Scholar
Sachdev, P., McBride, R., Loo, C. K., Mitchell, P. B., Malhi, G. S. & Croker, V. M. (2001). Right versus left prefrontal transcranial magnetic stimulation for obsessive-compulsive disorder: a preliminary investigation. Journal of Clinical Psychiatry 62, 981–984.CrossRefGoogle ScholarPubMed
Spielberger, C. D. (1972). Anxiety as an emotional state. In Anxiety: Current Trends in Theory and Research, Vol. 1 (ed. Spielberger, C. D.), pp. 23–49. Academic Press: New York.CrossRefGoogle Scholar