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TMS-induced plasticity improving cognitive control in OCD I: Clinical and neuroimaging outcomes from a randomised trial.
Fitzsimmons, Sophie M D D; Postma, Tjardo; van Campen, A Dilene; Vriend, Chris; Batelaan, Neeltje M; van Oppen, Patricia; Hoogendoorn, Adriaan W; van der Werf, Ysbrand D; van den Heuvel, Odile A.
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  • Fitzsimmons SMDD; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, de Boelelaan, 1117, Amsterdam, The Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy & Neurosciences, de Boelelaan, 1117, Amsterdam, The Netherlands. Electronic address: s.fitzsimmons@amsterdamum
  • Postma T; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, de Boelelaan, 1117, Amsterdam, The Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy & Neurosciences, de Boelelaan, 1117, Amsterdam, The Netherlands.
  • van Campen AD; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, de Boelelaan, 1117, Amsterdam, The Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy & Neurosciences, de Boelelaan, 1117, Amsterdam, The Netherlands.
  • Vriend C; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, de Boelelaan, 1117, Amsterdam, The Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy & Neurosciences, de Boelelaan, 1117, Amsterdam, The Netherlands; Amsterdam Neuroscience, Compulsivity, Impulsi
  • Batelaan NM; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, de Boelelaan, 1117, Amsterdam, The Netherlands; Amsterdam Public Health, Amsterdam, The Netherlands; GGZ inGeest, Amsterdam, The Netherlands.
  • van Oppen P; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, de Boelelaan, 1117, Amsterdam, The Netherlands; Amsterdam Public Health, Amsterdam, The Netherlands; GGZ inGeest, Amsterdam, The Netherlands.
  • Hoogendoorn AW; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, de Boelelaan, 1117, Amsterdam, The Netherlands; Amsterdam Public Health, Amsterdam, The Netherlands.
  • van der Werf YD; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy & Neurosciences, de Boelelaan, 1117, Amsterdam, The Netherlands; Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention program, Amsterdam, The Netherlands.
  • van den Heuvel OA; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, de Boelelaan, 1117, Amsterdam, The Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy & Neurosciences, de Boelelaan, 1117, Amsterdam, The Netherlands; Amsterdam Neuroscience, Compulsivity, Impulsi
Biol Psychiatry ; 2024 Jul 30.
Article en En | MEDLINE | ID: mdl-39089567
ABSTRACT

BACKGROUND:

Repetitive transcranial magnetic stimulation (rTMS) is an emerging treatment for obsessive-compulsive disorder (OCD). The neurobiological mechanisms of rTMS in OCD have 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).

METHODS:

In this three-arm proof-of-concept randomized trial, 61 treatment-refractory adult OCD patients received 16 sessions of rTMS immediately prior to ERP over 8 weeks, with task-based functional MRI (tb-fMRI) scans and clinical assessments pre- and post-treatment. Patients received either high frequency (HF) rTMS to the left dorsolateral prefrontal cortex (DLPFC)(n=19(6M/13F)); HF rTMS to the left pre-supplementary motor area (preSMA)(n=23(10M/13F)); or control rTMS to the vertex(n=19(6M/13F)). Changes in tb-fMRI activation pre-post treatment were compared using both a Bayesian region-of-interest and a general linear model whole-brain approach.

RESULTS:

Mean OCD symptom severity decreased significantly in all treatment groups (delta=-10.836, p<0.001, 95% CI[-12.504,-9.168]), with no differences between groups. Response rate in the entire sample was 57.4%. The DLPFC rTMS group showed decreased planning-related activation post-treatment that was associated with greater symptom improvement. No group-level activation changes were observed for the preSMA or vertex rTMS groups. Participants with greater symptom improvement in the preSMA group showed decreased error-related activation, and symptom improvement in the vertex group was associated with increased inhibition-related activation.

CONCLUSIONS:

PreSMA and DLPFC rTMS combined with ERP led to activation decreases in targeted task networks in individuals showing greater symptom improvement, although we observed no differences in symptom reduction between groups.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Biol Psychiatry Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Biol Psychiatry Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos