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Is Repetitive Transcranial Magnetic Stimulation an Effective OCD Treatment?

The Evidence is Limited

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Updated July 02, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Although there are currently a number of effective medical and psychological treatments for OCD, these treatments don't work for everyone. As such, there has been great interest in developing new OCD treatments or using new methods to improve the effectiveness of existing treatments. Repetitive transcranial magnetic stimulation, or rTMS, has received considerable attention as a possible alternative treatment to reduce OCD symptoms. Let's explore repetitive transcranial magnetic stimulation and OCD treatment.

What is Repetitive Transcranial Magnetic Stimulation?

Repetitive TMS is a relatively non-invasive procedure that involves placing a small device directly on the skull. This sealed device contains a coil of wire that carries electricity. The flow of electricity through the device causes cells in the brain called neurons to become either more or less active. The activity level of neurons has been linked to symptoms of mental illness, like OCD.

Specific brain regions can be stimulated repeatedly to cause long-lasting changes in the activity of the neurons. It is thought that these changes could lead to a decrease in symptoms. The side of the brain and brain area targeted often depends on the illness being treated.

TMS is generally considered safe when used in accordance with established guidelines, although some patients report experiencing headaches and other mild symptoms. Epileptic seizure is a more serious, although rare, side effect of TMS. Treatments can be given once a day or many times a day for days or weeks at a time, depending on the treatment protocol.

Repetitive Transcranial Magnetic Stimulation and OCD

Although first developed nearly 30 years ago as tool to treat major depression, rTMS has now been widely investigated for effectiveness in treating a variety of mental illnesses, including OCD.

While there have been some reports of rTMS being effective in reducing OCD symptoms, the majority of research findings indicate that rTMS is not effective in reducing OCD symptoms either alone or in combination with medication. There is, however, some indication that rTMS could indirectly improve the psychological well-being of people coping with OCD by reducing the symptoms of depression that often go along with OCD.

Although clinical results have initially been disappointing, more research is needed. Specifically, there is a need to standardize the treatment of OCD with rTMS. Although rTMS for OCD has been looked at in a number of studies, the stimulation parameters used, the brain areas targeted, and the length of treatment has varied from study to study, making it difficult to compare results. Having a standard protocol will allow the effectiveness of rTMS for OCD to be evaluated more conclusively.

Sources:

Ruffini, C., Locatelli, M., Lucca, A., Benedetti, F., Insacco, C., Smeraldi, E. "Augmentation effects of repetitive transcranial magnetic stimulation over the orbitofrontal cortex in drug resistant obsessive-comulsive disorder patients: A controlled investigation. Primary Care Companion to The Journal of Clinical Psychiatry 2009 11: 226-230.

Slotema, C.W., Blom, J.D., Hoek, H.W., Sommer, I.E.C. "Should we expand the toolbox of psychiatric treatment methods to include repetitive transcranial magnetic stimulation (rTMS)? A meta-analysis of the efficacy of rTMS in psychiatric disorders. Journal of Clinical Psychiatry 2010 (e-published ahead of print).

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