Long term efficacy of repetitive transcranial magnetic stimulation over supplement motor area in patients with the obsessive-compulsive disorder: A double-blind, randomized control trial

BACKGROUND: OCD is a very debilitating illness that is difficult to treat. Uses of rTMS have been studied in the last decade, but its long-term efficacy as an adjunctive modality is still under trial. OBJECTIVES: 1) to compare the efficacy of adjunctive low-frequency true rTMS over SMA in patients with OCD with sham stimulation. 2) to observe the long-term effects of true r-TMS in patients with OCD. METHODOLOGY: it was prospective randomized, double-blind, sham-controlled study, and 30 patients were selected from the outpatient department of the Institute of mental health and hospital, Agra. Patients were diagnosed with OCD as per the international classification of disease version 10(ICD-10) and were deemed treatment resistant-OCD. Patients were divided into true rTMS and sham rTMS groups by using systematic random sampling. Patient’s symptoms severity assessed on Y-BOCS, HAM-D and CGI on the baseline, 2(nd) week and monthly onwards for six months. rTMS was administered 5 days in a week for two weeks and no change in pharmacological treatment was done during this period. RESULT: 11 out of 15 patients in true rTMS group while 1out of 15 patients in sham rTMS group were found to have more than 25% reduction of Y-BOCS at the end of 2(nd) week. i.e., the improvement was significant in the true rTMS group (p<0.001) than sham rTMS. 10 out of 11 responders sustained the effect until the end of the 3(rd) month while only six patients sustained the response at the end of the 6(th) month. (p>0.05). CONCLUSION: the result of this study is suggestive of “short term efficacy” of adjunctive low-frequency rTMS over SMA in patients with OCD