Use of right orbitofrontal repetitive transcranial magnetic stimulation (rTMS) augmentation for treatment-refractory obsessive-compulsive disorder with comorbid major depressive disorder

Psychiatry Res. 2022 Nov:317:114856. doi: 10.1016/j.psychres.2022.114856. Epub 2022 Sep 20.

Abstract

We examined the safety and efficacy of repetitive Transcranial Magnetic Stimulation (rTMS) of the right orbitofrontal cortex (OFC) in patients with refractory obsessive-compulsive disorder (OCD) and comorbid Major Depressive Disorder. All participants (n = 26) received excitatory stimulation of the left dorsolateral prefrontal cortex followed by inhibitory stimulation of bilateral supplementary motor area for 10 sessions. In 18 patients with poor early OCD response, treatment was augmented with OFC inhibitory stimulation after the tenth treatment session. Augmentation with OFC stimulation was well-tolerated, and associated with further alleviation of both OCD and depression symptoms, particularly in individuals with more severe illnesses.

Keywords: Comorbid OCD-MDD; Orbitofrontal cortex; rTMS.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Depressive Disorder, Major* / complications
  • Depressive Disorder, Major* / therapy
  • Humans
  • Motor Cortex*
  • Obsessive-Compulsive Disorder* / complications
  • Obsessive-Compulsive Disorder* / therapy
  • Prefrontal Cortex
  • Transcranial Magnetic Stimulation
  • Treatment Outcome