Efficacy and Influencing Factors of Deep Transcranial Magnetic Stimulation in the Treatment of OCD

Zhen Wang

Status: Enrolling

Conditions: Obsessive-Compulsive Disorder

Treatments: Device: Deep Transcranial Magnetic Stimulation, DTMS active; Device: Deep Transcranial Magnetic Stimulation, DTMS sham

Study type: Interventional

Funder types: Other

Identifiers

NCT06692114

SMHC-OCD-012

Details and patient eligibility

About

This study aims to explore the efficacy and influencing of accelerated dTMS (deep Transcranial Magnetic Stimulation) treatment in patients with obsessive-compulsive disorder (OCD), and explores the potential neural mechanisms of treatment effect by magnetic resonance imaging (MRI) and electroencephalography (EEG).

Full description

The study is to recruit eligible patients with obsessive-compulsive disorder (OCD) from the Shanghai Mental Health Center for deep transcranial magnetic stimulation (dTMS) intervention, and recruit healthy controls who meet the enrollment criteria from the community. Among them, patients with OCD will be randomly divided into a real stimulation group and a sham stimulation group. After baseline assessment, dTMS treatment will be administered twice a day. EEG data collection, MRI data, cognitive tasks, psychological self-assessment scales and clinical symptom assessment will be conducted before treatment and 2 weeks after treatment. During the treatment process, patients will receive two treatments per day, each lasting 20 minutes, for a total of 2 weeks, or 28 treatments in total.

Enrollment: 70 estimated patients

Sex: All

Ages: 18 to 50 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Aged between 18 and 50, both genders are welcome.
• DSM-5 criteria for OCD.
• Y-BOCS total score ≥ 20 despite therapeutic-dose SRI treatment or completion of at least one full course of CBT. The treatment regimen must have been stable for at least 8 weeks prior to enrollment and remain unchanged throughout the study.
• More than 9 years of education.
• Right-handed.

Exclusion criteria

• Any additional current psychiatric comorbidity, except for obsessive- compulsive personality disorder.
• Severe obsessive symptoms prevent the completion of necessary assessments.
• Has a history of receiving ECT therapy.
• Has received rTMS or tDCS treatment within the past two months.
• Has severe physical illnesses or any physical conditions that can induce epilepsy or intracranial hypertension, including cardiovascular and respiratory diseases, among others.
• Has a past history of neurological disorders (such as epilepsy, cerebrovascular accidents, etc.) or brain injuries, or a history of brain surgery.
• Has implanted medical devices such as intracranial stents, cardiac pacemakers, coronary stents, cochlear implants, etc.
• Serious suicide risk.
• Pregnancy or nursing of an infant.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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70 participants in 2 patient groups

active treatment group

Experimental group

Description:

The resting motor threshold (RMT) of the patient was measured before the first treatment. Symptom induction was performed before each treatment to achieve moderate anxiety in patients. The magnetic stimulation intensity was 100% RMT, using the deep transcranial magnetic stimulation coil H7 for treatment, with the stimulation area being the anterior cingulate cortex (ACC) and medial prefrontal cortex (mPFC). Treatment was administered twice daily for 20 minutes each time for 2 weeks.

Treatment:

Device: Deep Transcranial Magnetic Stimulation, DTMS active

sham group

Sham Comparator group

Description:

The same RMT test as the active treatment group was accepted, and symptom induction was performed before treatment to achieve moderate anxiety. During treatment, the coil in the shame treatment group only produces sound and scalp vibration, and does not generate a real magnetic field. There is no other difference between the two coils. The frequency and number of treatments were the same as those in the active treatment group.

Treatment:

Device: Deep Transcranial Magnetic Stimulation, DTMS sham