The functional connectivity predictor of therapeutic effect of continuous theta burst stimulation on obsessive-compulsive disorder: A preliminary study

J Affect Disord. 2022 Aug 15:311:231-238. doi: 10.1016/j.jad.2022.05.110. Epub 2022 May 21.

Abstract

Objective: To evaluate the efficacy of continuous theta burst stimulation (cTBS) on the bilateral supplementary motor area (SMA) among patients with obsessive-compulsive disorder (OCD) and to explore the potential predictors of cTBS outcome based on neuroimaging.

Methods: 29 OCD patients and 29 healthy controls (HCs) were enrolled in this pilot study. Twenty consecutive cTBS intervention targeting at bilateral SMA was applied. MRI scan was carried out before cTBS and 15 regions in the executive control and sensorimotor network were chosen and analyzed using MATLAB, DPABI, and SPM12.

Results: 11 out of 29 patients responded to cTBS (37.93%), and the clinical symptom of OCD patients was significantly relieved after receiving regular cTBS. Also, the FC between Cerebelum_Crus2_L and Frontal_Inf_Tri_L of OCD patients showed positive prognosis for the efficacy of cTBS, with the area under the curve (AUC) of 0.85 (95% confidence interval: 0.718-0.989, p = 0.002). None of the patients had any serious adverse event.

Conclusion: cTBS intervention on bilateral SMA can significantly improve the symptoms of medicated OCD patients with moderate severity. And the pretherapy FC could be a valuable potential predictor of the cTBS treatment outcome among OCD patients.

Keywords: Continuous theta burst stimulation; Functional connectivity; Obsessive compulsive disorder; Predictor; Supplementary motor area.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Humans
  • Magnetic Resonance Imaging / methods
  • Motor Cortex* / diagnostic imaging
  • Obsessive-Compulsive Disorder* / diagnostic imaging
  • Obsessive-Compulsive Disorder* / therapy
  • Pilot Projects
  • Transcranial Magnetic Stimulation / methods