Rapid relief of severe freezing of gait after accelerated high-dose magnetic stimulations

Sun, Jinmei; Ji, Gong‐Jun; Xing, Fengbo; Tian, Yanghua; Liu, Hesheng; Hu, Panpan; Wang, Kai

doi:10.1016/j.brs.2021.10.389

Cited by 2 publications

(2 citation statements)

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“…If the study were limited to patients with drug-refractory OCD, perhaps ahTBS would have shown superior efficacy compared to 1-Hz TMS. While the same high-dose sequence (18,000 pulses per day and a total dose of 90,000 pulses) achieved significant efficacy in patients with depression [ 10 ] and Parkinson's disease [ 11 ], this stimulation pattern may not be as effective in patients with OCD. Indeed, there may be substantial individual and group differences in the response to noninvasive brain stimulation protocols [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…This accelerated high-dose TBS (ahTBS) [ 10 ] protocol, which is delivered over only 5 consecutive days, demonstrated promising results among patients with refractory depression and is currently under study to address safety, tolerability, and efficacy for several other neuropsychiatric and neurological disorders. Sun et al [ 11 ] found that ahTBS provided remarkable relief from freezing of gait in 91.7% of Parkinson's disease patients after 5 days of treatment without adverse events. Williams et al [ 12 ] also applied ahTBS at the right frontal pole for 5 consecutive days to treat a small group of patients with refractory OCD and found a 57% response rate by the second week.…”

Section: Introductionmentioning

confidence: 99%

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A Controlled Clinical Study of Accelerated High-Dose Theta Burst Stimulation in Patients with Obsessive–Compulsive Disorder

Jiang,

Wan,

Liu

et al. 2023

Neural Plasticity

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Background. Obsessive–compulsive disorder (OCD) is frequently treated using a combination of counseling, drugs, and, more recently various transcranial stimulation protocols, but all require several weeks to months for clinically significant improvement, so there is a need for treatments with faster onset. This study investigated whether an accelerated high-dose theta burst stimulation (ahTBS) protocol significantly improves the efficacy of OCD compared to traditional 1-Hz repetitive transcranial magnetic stimulation (rTMS) in the routine clinical setting. Method. Forty-five patients with OCD were randomized into two groups and treated with ahTBS or 1-Hz rTMS for 5 days. Patients were assessed at baseline at the end of treatment using the Yale–Brown Obsessive–Compulsive Scale (Y-BOCS). Results. After 5 days of treatment, there was a significant decrease in Y-BOCS scores in both groups ( p < 0.001 ), and the difference between the two groups was not statistically significant (group × time interaction, F = 1.90, p = 0.18 ). There was also no statistically significant difference in other secondary outcome indicators, including depression, anxiety symptoms, and response rate. However, the ahTBS group had a greater trend in response rate. Neuropsychological testing showed no negative cognitive side effects of either treatment. Conclusion. Accelerated high-dose TBS is as safe and has comparable short-term efficacy to traditional 1-Hz rTMS for the clinical treatment of OCD. Further research is needed to explore optimal ahTBS parameters, validate the utility of this treatment modality, and identify factors predictive of rapid clinical response to guide clinical decision-making. This trial is registered with NCT05221632.

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