Journal: Journal of Psychiatric Research
Authors: Eric A Storch, Aron Tendler, Sophie C Schneider, Andrew G Guzick, Valerie La Buissonniere-Ariza, Wayne K Goodman
Background:
Deep TMS has emerged as a treatment option for adults with OCD who continue to exhibit impairing symptoms following an adequate response to first line interventions. Currently, little is known about the predictors or moderators of Deep TMS outcome for OCD.
Objective:
This paper examined if several theoretically relevant variables may predict and moderate treatment effects including OCD symptom severity, functional impairment, co-occurring depressive symptoms, age, gender, age of OCD onset, and family history of OCD.
Methods:
As part of a previously reported study, 100 patients received 29 Deep TMS or sham stimulation treatments over 6 weeks. Deep TMS was administered using a Magstim Rapid2 TMS (The Magstim Co. Ltd., Whitland, Carmarthenshire, United Kingdom) stimulator equipped with an H shaped coil design, which was specifically designed to stimulate the dorsal mPFC-ACC bilaterally.
Results:
Findings suggest older participants and those with lower OCD severity and disability respond faster to both Deep TMS and sham stimulation. Deep TMS of the dorsal mPFC/ACC appeared to have larger benefits for individuals with greater OCD severity, whereas the difference between treatment arms was minimal in those with lower severity.
Conclusions:
This suggests that having a higher minimum of OCD severity inclusion criteria may best serve to understand actual treatment effects since those with lower OCD severity seem to respond similarly to active and sham interventions. This is also important with regards to treatment selection as it suggests Deep TMS may be effective for those with particularly high levels of OCD, who usually do not benefit from alternative treatments.
