A Case Series of Deep Transcranial Magnetic Stimulation Treatment for Patients with Obsessive-Compulsive Disorder in the Tokyo Metropolitan Area

Abstract

Obsessive-compulsive disorder (OCD) is a chronic illness in which patients do not achieve remission sufficiently with conventional medication. Deep repetitive transcranial magnetic stimulation (dTMS) for OCD neuromodulates the bilateral anterior cingulate cortex (ACC) and dorsal medial prefrontal cortex (mPFC), which are known to be impaired in OCD. While dTMS treatment for OCD has shown effective results overseas, TMS treatment for OCD has rarely been implemented in Japan, and its effectiveness is unknown. We conducted an FDA-approved dTMS protocol to 26 patients with OCD. In addition, individual exposure stimulation that elicited each patient’s obsessive thoughts was also combined during dTMS treatment. Before and after 30 sessions of TMS treatment, the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was used to assess changes in the severity of each patient’s obsessive-compulsive disorder. Response to dTMS treatment in patients with OCD was determined by whether the total score on the Y-BOCS after a course of treatment was reduced by 30% or more compared with the score at baseline. The percentage of responders in this case series following the 30 sessions of dTMS treatment was 53.9%. In addition, total Y-BOCS scores and scores on each item were significantly improved. The percent changes in total Y-BOCS scores did not differ between the sexes or between on- and off-medication patients. No obvious adverse events were observed in this case series. In line with the results of TMS studies for OCD patients reported overseas, dTMS treatment for Japanese patients with OCD may have a favorable therapeutic effect.

A Case Series of Continuous Theta Burst Stimulation Treatment for the Supplementary Motor Area Twice a Day in Patients with Obsessive-Compulsive Disorder: A Real World TMS Registry Study in Japan

“…In our recent case series of a different TMS protocol for 26 patients with OCD [ 25 ], we stimulated the medial prefrontal cortex as the therapeutic target with deep TMS using a butterfly coil at high frequency and combined this with an exposure and reaction prevention method before each session of rTMS, and we found that approximately 54% of patients responded to this combined treatment protocol. On the other hand, although the number of patients in this case series was small, the treatment response rate of this study was 67%, even without the combination of the exposure and response prevention method, indicating that the SMA-cTBS therapeutic intervention may be promising as a neuromodulation treatment for OCD, since it has the advantage of a short treatment time within a few minutes, as well as an overall intervention period of 3 to 5 weeks.…”

“…Therefore, in this case series, we performed a total of 30 sessions of cTBS treatment targeting bilateral SMA [ 24 ] without any exposure and response prevention and aimed to retrospectively compare the effectiveness of the treatment with the results of our recent case series of OCD treated with TMS combined with exposure and response prevention [ 25 ].…”

Anti-idiotype isolation of a broad and potent influenza A virus-neutralizing human antibody

“…Single-cell immunoglobulin sequencing was performed as described previously ( 24 ). Briefly, plates were removed from -80 °C and centrifuged briefly.…”

Past, present, and future of deep transcranial magnetic stimulation: A review in psychiatric and neurological disorders

“…Based on previous studies, the response of patients with OCD to DTMS treatment was determined by whether the total score on the Y-BOCS decreased by 30% or more from baseline[ 32 ]. We summarised the available studies and found that the remission rate of OCD treated with DTMS was 29.22%-53.90%[ 31 , 33 , 34 ].…”