What is the mechanism of action of this treatment?

Non-invasive brain stimulation techniques like Transcranial Magnetic Stimulation (TMS) and Transcranial Direct Current Stimulation (tDCS) work by modulating neural activity in specific brain regions implicated in OCD, such as the cortico-striato-thalamo-cortical (CSTC) loops. TMS uses magnetic fields to induce electrical currents in the brain, while tDCS applies a low electrical current to alter neuronal excitability. These methods aim to normalize dysfunctional brain circuits associated with OCD symptoms. Understanding these mechanisms is crucial for OCD patients as it offers a potential alternative to traditional treatments like Cognitive Behavioral Therapy (CBT) and pharmacotherapy, which may not be effective for everyone. By targeting the underlying neural pathways, non-invasive brain stimulation could provide relief for treatment-resistant cases.

What side effects are associated with this type of intervention?

The most common treatments for Obsessive-Compulsive Disorder (OCD) involving non-invasive brain stimulation include Transcranial Magnetic Stimulation (TMS) and Transcranial Direct Current Stimulation (tDCS). TMS is generally well-tolerated, but its most serious side effect is a generalized tonic-clonic seizure, which is rare. Other side effects may include headache, scalp discomfort, and, in rare cases, treatment-emergent mania. tDCS, another non-invasive technique, typically has mild side effects such as skin irritation at the electrode site, headache, and a tingling sensation. Both treatments are considered relatively safe with proper medical supervision.

What other types of research exist?

Promising novel alternatives to non-invasive brain stimulation for OCD patients include Theta Burst Stimulation coupled with Habit Override Training, which aims to modulate activity in target brain regions to reduce compulsive behaviors. This approach is being researched for its potential to treat compulsions more effectively by targeting specific brain regions.

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Transcranial Magnetic Stimulation + Habit Training for Compulsive Behavior

Q: What prior FDA approvals exist?

The FDA has approved several pharmacologic treatments for Obsessive-Compulsive Disorder (OCD), primarily focusing on selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, fluvoxamine, and sertraline. Additionally, clomipramine, a tricyclic antidepressant, has been approved for OCD treatment. While non-invasive brain stimulation techniques like transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) have shown promise in clinical trials for reducing OCD symptoms, they are not yet FDA-approved specifically for OCD treatment. These methods are being actively studied for their potential to modulate brain activity and alleviate compulsive behaviors.

N/A

Recruiting

Led By Rebecca B Price, PhD

Research Sponsored by Rebecca Price

Eligibility Criteria Checklist

Specific guidelines that determine who can or cannot participate in a clinical trial

Must have

Be between the ages of 18 and 60 years

Be between 18 and 65 years old

Timeline

Screening 3 weeks

Treatment Varies

Follow Up 90min-1 week

Summary

This trial uses a device that sends mild electrical signals to the brain and combines it with computer exercises. It aims to help people who have trouble controlling repetitive behaviors. The goal is to change brain activity and improve control over these behaviors.

Who is the study for?

This trial is for adults aged 18-60 with compulsive behaviors, who can stay in Pittsburgh for at least 5 weeks. Participants must be okay with being videotaped during interviews and not have metal implants (except dental fillings), history of brain injury/surgery, or conditions affecting seizure risk like epilepsy.

What is being tested?

The study tests if brain stimulation (Theta Burst Stimulation) combined with a computer task to practice habit control can influence compulsive behaviors. Some participants will receive real treatment while others get sham (fake) versions to compare effects.

What are the potential side effects?

Transcranial Magnetic Stimulation may cause discomfort at the stimulation site, headache, lightheadedness, or seizures in very rare cases. The side effects are generally mild and temporary.

Eligibility Criteria

Inclusion Criteria

You may be eligible if you check “Yes” for the criteria below

Select...

I am between 18 and 60 years old.

Timeline

Screening ~ 3 weeks3 visits

Treatment ~ Varies

Follow Up ~ 90min-1 week

Screening ~ 3 weeks

Treatment ~ Varies

Follow Up ~90min-1 week

This trial's timeline: 3 weeks for screening, Varies for treatment, and 90min-1 week for reporting.

Treatment Details

Study Objectives

Study objectives can provide a clearer picture of what you can expect from a treatment.

Secondary study objectives

Brain activation in target region

Duration of compulsive behaviors in response to laboratory triggers

Effort to resist compulsive behaviors in response to laboratory triggers

+5 more

Trial Design

4Treatment groups

Experimental Treatment

Active Control

Placebo Group

Group I: cTBS + Habit Override TrainingExperimental Treatment2 Interventions

Transcranial Magnetic Stimulation delivered in a continuous Theta Burst Stimulation (cTBS) pattern, paired with Habit Override Training.

Group II: Sham TBS + Habit Override TrainingActive Control2 Interventions

Sham Transcranial Magnetic Stimulation, paired with Habit Override Training.

Group III: cTBS + Sham TrainingActive Control2 Interventions

Transcranial Magnetic Stimulation delivered in a continuous Theta Burst Stimulation (cTBS) pattern, paired with Sham Training.

Group IV: Sham TBS + Sham TrainingPlacebo Group2 Interventions

Sham Transcranial Magnetic Stimulation, paired with Sham Training.

Treatment

First Studied

Drug Approval Stage

How many patients have taken this drug

Transcranial Magnetic Stimulation

2017

Completed Phase 4

~730

Habit Override Practice

2017

N/A

~80

0 / 1Eligibility criteria met

Research Highlights

Information in this section is not a recommendation. We encourage patients to speak with their healthcare team when evaluating any treatment decision.

Mechanism Of Action

Side Effect Profile

Prior Approvals

Other Research

Non-invasive brain stimulation techniques like Transcranial Magnetic Stimulation (TMS) and Transcranial Direct Current Stimulation (tDCS) work by modulating neural activity in specific brain regions implicated in OCD, such as the cortico-striato-thalamo-cortical (CSTC) loops. TMS uses magnetic fields to induce electrical currents in the brain, while tDCS applies a low electrical current to alter neuronal excitability. These methods aim to normalize dysfunctional brain circuits associated with OCD symptoms. Understanding these mechanisms is crucial for OCD patients as it offers a potential alternative to traditional treatments like Cognitive Behavioral Therapy (CBT) and pharmacotherapy, which may not be effective for everyone. By targeting the underlying neural pathways, non-invasive brain stimulation could provide relief for treatment-resistant cases.

Invasive and Non-invasive Neurostimulation for OCD.Transcranial Direct Current Stimulation for Obsessive-Compulsive Disorder: A Systematic Review.Brain stimulation techniques in the treatment of obsessive-compulsive disorder: current and future directions.