Better than treated as usual

Transcranial magnetic stimulation augmentation in selective serotonin reuptake inhibitor-refractory obsessive-compulsive disorder, mini-review and pilot open-label trial

Stefano Pallanti, Anna Marras, Luana Salerno, Nikos Makris, Eric Hollander

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective: 1 Hz repetitive transcranial magnetic stimulation (rTMS) over the supplementary motor area has been shown to be effective in a subset of obsessive-compulsive disorder (OCD) subjects, yet these results are still to be confirmed. This preliminary study compares the efficacy of augmentation with 1 Hz rTMS over the supplementary motor area and the usual augmentation treatment (TAU; treated as usual) with antipsychotics in a sample of selective serotonin reuptake inhibitor (SSRI)-refractory OCD patients. Method: Fifty SSRI-refractory OCD patients consecutively admitted were studied: 25 were treated with a three-week trial of 1Hz, bilateral rTMS over the supplementary motor area and 25 with antipsychotic drugs. Yale-Brown Obsessive-Compulsive Scale (Y-BOCS; primary outcome measure), Hamilton Depression and Hamilton Anxiety scales were administered at first, second and third week of treatment. Results: Y-BOCS showed a statistically significant time effect from the baseline to the third week, with a 68% of responders (Y-BOCS score reduction of ≥ 25%), in comparison with 24.0% in the TAU group. In the rTMS group, 17.6% of patients achieved remission. Conclusions: 1 Hz rTMS over the supplementary motor area appeared to be effective in approximately 2/3 of SSRI-refractory OCD subjects, whereas in the TAU group only 1/4 of subjects were responders. The supplementary motor area might be a new target area to be further explored with neuromodulation for OCD treatment.

Original languageEnglish (US)
Pages (from-to)568-578
Number of pages11
JournalJournal of Psychopharmacology
Volume30
Issue number6
DOIs
StatePublished - 2016

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Transcranial Magnetic Stimulation
Obsessive-Compulsive Disorder
Serotonin Uptake Inhibitors
Motor Cortex
Antipsychotic Agents
Therapeutics
Anxiety
Outcome Assessment (Health Care)
Depression

Keywords

  • obsessive-compulsive disorder
  • OCD
  • Repetitive transcranial magnetic stimulation
  • rTMS
  • SMA
  • SSRI-refractory OCD
  • supplementary motor area

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Psychiatry and Mental health

Cite this

@article{322ce9c4e32647f398a738a7e176bde5,
title = "Better than treated as usual: Transcranial magnetic stimulation augmentation in selective serotonin reuptake inhibitor-refractory obsessive-compulsive disorder, mini-review and pilot open-label trial",
abstract = "Objective: 1 Hz repetitive transcranial magnetic stimulation (rTMS) over the supplementary motor area has been shown to be effective in a subset of obsessive-compulsive disorder (OCD) subjects, yet these results are still to be confirmed. This preliminary study compares the efficacy of augmentation with 1 Hz rTMS over the supplementary motor area and the usual augmentation treatment (TAU; treated as usual) with antipsychotics in a sample of selective serotonin reuptake inhibitor (SSRI)-refractory OCD patients. Method: Fifty SSRI-refractory OCD patients consecutively admitted were studied: 25 were treated with a three-week trial of 1Hz, bilateral rTMS over the supplementary motor area and 25 with antipsychotic drugs. Yale-Brown Obsessive-Compulsive Scale (Y-BOCS; primary outcome measure), Hamilton Depression and Hamilton Anxiety scales were administered at first, second and third week of treatment. Results: Y-BOCS showed a statistically significant time effect from the baseline to the third week, with a 68{\%} of responders (Y-BOCS score reduction of ≥ 25{\%}), in comparison with 24.0{\%} in the TAU group. In the rTMS group, 17.6{\%} of patients achieved remission. Conclusions: 1 Hz rTMS over the supplementary motor area appeared to be effective in approximately 2/3 of SSRI-refractory OCD subjects, whereas in the TAU group only 1/4 of subjects were responders. The supplementary motor area might be a new target area to be further explored with neuromodulation for OCD treatment.",
keywords = "obsessive-compulsive disorder, OCD, Repetitive transcranial magnetic stimulation, rTMS, SMA, SSRI-refractory OCD, supplementary motor area",
author = "Stefano Pallanti and Anna Marras and Luana Salerno and Nikos Makris and Eric Hollander",
year = "2016",
doi = "10.1177/0269881116628427",
language = "English (US)",
volume = "30",
pages = "568--578",
journal = "Journal of Psychopharmacology",
issn = "0269-8811",
publisher = "SAGE Publications Ltd",
number = "6",

}

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T1 - Better than treated as usual

T2 - Transcranial magnetic stimulation augmentation in selective serotonin reuptake inhibitor-refractory obsessive-compulsive disorder, mini-review and pilot open-label trial

AU - Pallanti, Stefano

AU - Marras, Anna

AU - Salerno, Luana

AU - Makris, Nikos

AU - Hollander, Eric

PY - 2016

Y1 - 2016

N2 - Objective: 1 Hz repetitive transcranial magnetic stimulation (rTMS) over the supplementary motor area has been shown to be effective in a subset of obsessive-compulsive disorder (OCD) subjects, yet these results are still to be confirmed. This preliminary study compares the efficacy of augmentation with 1 Hz rTMS over the supplementary motor area and the usual augmentation treatment (TAU; treated as usual) with antipsychotics in a sample of selective serotonin reuptake inhibitor (SSRI)-refractory OCD patients. Method: Fifty SSRI-refractory OCD patients consecutively admitted were studied: 25 were treated with a three-week trial of 1Hz, bilateral rTMS over the supplementary motor area and 25 with antipsychotic drugs. Yale-Brown Obsessive-Compulsive Scale (Y-BOCS; primary outcome measure), Hamilton Depression and Hamilton Anxiety scales were administered at first, second and third week of treatment. Results: Y-BOCS showed a statistically significant time effect from the baseline to the third week, with a 68% of responders (Y-BOCS score reduction of ≥ 25%), in comparison with 24.0% in the TAU group. In the rTMS group, 17.6% of patients achieved remission. Conclusions: 1 Hz rTMS over the supplementary motor area appeared to be effective in approximately 2/3 of SSRI-refractory OCD subjects, whereas in the TAU group only 1/4 of subjects were responders. The supplementary motor area might be a new target area to be further explored with neuromodulation for OCD treatment.

AB - Objective: 1 Hz repetitive transcranial magnetic stimulation (rTMS) over the supplementary motor area has been shown to be effective in a subset of obsessive-compulsive disorder (OCD) subjects, yet these results are still to be confirmed. This preliminary study compares the efficacy of augmentation with 1 Hz rTMS over the supplementary motor area and the usual augmentation treatment (TAU; treated as usual) with antipsychotics in a sample of selective serotonin reuptake inhibitor (SSRI)-refractory OCD patients. Method: Fifty SSRI-refractory OCD patients consecutively admitted were studied: 25 were treated with a three-week trial of 1Hz, bilateral rTMS over the supplementary motor area and 25 with antipsychotic drugs. Yale-Brown Obsessive-Compulsive Scale (Y-BOCS; primary outcome measure), Hamilton Depression and Hamilton Anxiety scales were administered at first, second and third week of treatment. Results: Y-BOCS showed a statistically significant time effect from the baseline to the third week, with a 68% of responders (Y-BOCS score reduction of ≥ 25%), in comparison with 24.0% in the TAU group. In the rTMS group, 17.6% of patients achieved remission. Conclusions: 1 Hz rTMS over the supplementary motor area appeared to be effective in approximately 2/3 of SSRI-refractory OCD subjects, whereas in the TAU group only 1/4 of subjects were responders. The supplementary motor area might be a new target area to be further explored with neuromodulation for OCD treatment.

KW - obsessive-compulsive disorder

KW - OCD

KW - Repetitive transcranial magnetic stimulation

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