rTMS + Cognitive Behavioural Therapy for Obsessive-Compulsive Disorder
Recruiting in Palo Alto (17 mi)
Overseen byNeil A. Rector, Ph.D.
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Phase 1
Recruiting
Sponsor: Sunnybrook Health Sciences Centre
Must be taking: OCD medications
Disqualifiers: Severe mood disorder, Schizophrenia, Substance abuse, others
No Placebo Group
Trial Summary
What is the purpose of this trial?Cognitive behavioural therapy (CBT), incorporating exposure/response prevention (ERP) and cognitive therapy, is considered the gold-standard first-line treatment for obsessive-compulsive disorder (OCD). Because CBT is a psychological treatment that aims to change patterns of thinking and behaving, it may be that improvement in cognitive functioning before treatment starts could lead CBT to be even more effective. One area of research that has shown potential benefit for OCD sufferers is rTMS. rTMS is a non-invasive procedure that uses pulses of energy to stimulate regions of the brain. Brief treatment with rTMS has shown to improve attention, memory, and other aspects of cognitive functioning that may facilitate learning in CBT. The proposed study aims to provide a pilot test of the clinical effectiveness of adding brief rTMS prior to completing CBT for OCD. If rTMS can demonstrate enhancement of cognitive functioning, which in turn, can improve treatment response to CBT, then the findings could easily be translated into routine clinical care.
Will I have to stop taking my current medications?
If you are taking medications for OCD, you must be on a stable dose for at least 8 weeks before starting the study. The protocol does not specify if you need to stop other medications, so it's best to discuss this with the study team.
What data supports the effectiveness of the treatment rTMS for Obsessive-Compulsive Disorder?
Research shows that repetitive transcranial magnetic stimulation (rTMS) can be effective in reducing symptoms of obsessive-compulsive disorder (OCD), as well as associated anxiety and depression. Studies have demonstrated its safety and short-term benefits, particularly in severe cases of OCD.
12345Is rTMS safe for treating OCD?
Research shows that repetitive transcranial magnetic stimulation (rTMS) is generally safe for treating obsessive-compulsive disorder (OCD), with no serious side effects reported, although some people may experience mild headaches.
12678How does the rTMS + Cognitive Behavioural Therapy treatment for OCD differ from other treatments?
This treatment combines repetitive transcranial magnetic stimulation (rTMS), which uses magnetic fields to stimulate specific brain areas, with cognitive behavioral therapy (CBT), a type of talk therapy. This combination is unique because rTMS targets brain activity directly, potentially enhancing the effects of CBT, especially for patients who do not respond well to standard treatments.
12589Eligibility Criteria
This trial is for individuals with Obsessive-Compulsive Disorder (OCD) who are seeking treatment. Specific eligibility criteria details were not provided, so it's important to contact the study organizers for more information on who can participate.Inclusion Criteria
My OCD medication dose has been stable for at least 8 weeks.
I am between 18 and 65 years old.
Experiencing clinically significant obsessive-compulsive symptoms based on the Yale-Brown Obsessive Compulsive Scale (YBOCS; score > 16)
Exclusion Criteria
I might have a disease caused by physical or bodily changes.
Concurrent diagnosis of a severe mood disorder, schizophrenia or other psychotic disorders, or substance abuse/dependence
I have a health condition that might need urgent care during treatment.
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
rTMS Treatment
Participants receive 10 sessions of rTMS treatment Monday through Friday for two weeks
2 weeks
10 visits (in-person)
CBT Treatment
Participants receive 12 weeks of cognitive behavioural therapy (CBT)
12 weeks
Follow-up
Participants are monitored for safety and effectiveness after treatment
4 weeks
Participant Groups
The trial is testing whether using rTMS, a non-invasive brain stimulation technique, before Cognitive Behavioural Therapy (CBT) can improve outcomes for OCD patients. It explores if enhancing cognitive functions with rTMS leads to better CBT results.
2Treatment groups
Experimental Treatment
Active Control
Group I: Brief rTMS + Group CBTExperimental Treatment2 Interventions
Participants in this study arm will receive 10 sessions of rTMS treatment Monday through Friday for two weeks. Following rTMS treatment, participants will receive 12 weeks of CBT.
Group II: Group CBT onlyActive Control1 Intervention
Participants in this study arm will receive 12 weeks of CBT
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Sunnybrook Health Sciences CentreToronto, Canada
Loading ...
Who Is Running the Clinical Trial?
Sunnybrook Health Sciences CentreLead Sponsor
References
Safety and efficacy of repetitive transcranial magnetic stimulation in the treatment of obsessive-compulsive disorder: a review. [2012]Obsessive-compulsive disorder (OCD) is a chronic, often severe, neuropsychiatric disorder leading to a dramatic impairment in interpersonal and occupational functions. rTMS has been tried out in several studies in patients with OCD with different characteristics. In this paper, we review the safety and efficacy of rTMS in the treatment of mostly severe resistant OCD.
Repetitive transcranial magnetic stimulation for the treatment of obsessive compulsive disorder: a double-blind controlled investigation. [2007]To determine the efficacy and tolerability of repetitive transcranial magnetic stimulation (rTMS) as a treatment for obsessive compulsive disorder (OCD) in a double-blind placebo-controlled study.
An updated meta-analysis: Short-term therapeutic effects of repeated transcranial magnetic stimulation in treating obsessive-compulsive disorder. [2022]This study was conducted to evaluate the short-term therapeutic effects of using repeated transcranial magnetic stimulation (rTMS) to treat obsessive-compulsive disorder (OCD) and to examine potential influencing factors.
Right prefrontal repetitive transcranial magnetic stimulation in obsessive-compulsive disorder: a double-blind, placebo-controlled study. [2006]The efficacy of repetitive transcranial magnetic stimulation (rTMS) of the right prefrontal cortex for patients with obsessive-compulsive disorder (OCD) was studied under double-blind, placebo-controlled conditions.
Efficacy of Repetitive Transcranial Magnetic Stimulation on Comorbid Anxiety and Depression Symptoms in Obsessive-Compulsive Disorder: A Meta-Analysis of Randomized Sham-Controlled Trials. [2023]To systematically evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) in reducing comorbid anxiety and depressive symptoms in patients with obsessive-compulsive disorder (OCD).
A randomized controlled study of sequentially applied repetitive transcranial magnetic stimulation in obsessive-compulsive disorder. [2019]The present study investigated possible therapeutic effects and safety of sequentially combined low-frequency repetitive transcranial magnetic stimulation (rTMS) to the right dorsolateral prefrontal cortex and supplementary motor area in patients with treatment-resistant obsessive-compulsive disorder.
Effectiveness of Repetitive Transcranial Magnetic Stimulation in Depression, Schizophrenia, and Obsessive-Compulsive Disorder: An Umbrella Meta-Analysis. [2023]Objective: To analyze the safety and efficacy of repetitive transcranial magnetic stimulation (rTMS) for major depressive disorder, schizophrenia, and obsessive-compulsive disorder (OCD) via umbrella meta-analysis.
Assessing the Effectiveness of Repetitive Transcranial Magnetic Stimulation in the Treatment of Obsessive- Compulsive Disorder. [2022]Objective. Obsessive-compulsive disorder (OCD) is a frequent and disabling neuropsychiatric disorder with a lifetime prevalence of 3%. About 40% to 60% of patients show no or just partial symptom improvement to treatment with a first-line drug and cognitive behavior therapy. Ten percent of patients remain treatment refractory despite several treatments. For these patients, repetitive Transcranial Magnetic Stimulation (rTMS) has been suggested as a treatment option. Method. We investigated the efficacy of rTMS on the Supplementary Motor Area (SMA) in 16 right handed pharmaco-resistant OCD patients in an outpatient setting. The patients have been diagnosed with OCD by two psychiatrists and referred for rTMS intervention. Patients received 16 sessions of low frequency (0.5 HZ) rTMS on SMA,100% motor threshold, 1200 stimuli/day for 40 minutes every other day. OCD, depression, and anxiety symptoms were measured at baseline, 2, 6, and 12 weeks by Yale-Brown Obsessive Compulsive Scale(Y-BOCS) and Hamilton Depressive and Anxiety rating scales (HAM-D and HAM-A). We assessed the side effects of rTMS by a self-administrative questionnaire. Results. Patients' scores in Y-BOCS, HAM-D, and HAM-A were significantly decreased following rTMS treatment. The baseline and 12 weeks scores of Y-BOCS were 28.94 and 18.31 (P-value < 0.01), HAM-D were 14.69 and 7.94 (P-value <0.01) and HAM-A were 16.38 and 6.94 (P- value < 0.01), respectively. The patients reported no serious side effects of rTMS except two case that reported light headach. Conclusion. This study showed that low-frequency rTMS on SMA improved OCD, anxiety, and depression symptoms after 16 sessions.
TMS-induced plasticity improving cognitive control in OCD I: Clinical and neuroimaging outcomes from a randomised trial of rTMS for OCD. [2023]Repetitive transcranial magnetic stimulation (rTMS) is an emerging treatment option for obsessive-compulsive disorder (OCD). The neurobiological mechanisms of rTMS in OCD have, however, been incompletely characterized. We compared clinical outcomes and changes in task-based brain activation following three different rTMS stimulation protocols, all combined with exposure and response prevention (ERP).