Arumugham Shyam Sundar, Vs Subhasini, Hn Madhuri, B Vinay, Ravi Malvika, Sharma Eesha, Thirthalli Jagadisha, Reddy Y C Janardhan
From the National Institute of Mental Health and Neuro Sciences, Bangalore, India.
J ECT. 2018 Dec;34(4):253-257. doi: 10.1097/YCT.0000000000000509.
The current study investigated the efficacy of low-frequency repetitive transcranial magnetic stimulation (rTMS) over bilateral presupplementary motor area (pre-SMA) in patients suffering from obsessive-compulsive disorder (OCD) with partial/poor response to pharmacotherapy, in a double-blinded randomized sham controlled trial.
Forty subjects with OCD, who were on stable medications with partial/poor response to pharmacotherapy were randomly divided into 2 groups (n = 20 in each group), to receive either active or sham low-frequency rTMS over bilateral pre-SMA. Thirty-six patients were eligible for intent-to-treat analysis. There was no significant difference in relevant demographic and clinical variables between the 2 groups at baseline.
There were no statistically significant differences between the 2 groups after 3 weeks of treatment in the Yale-Brown Obsessive Compulsive Scale score (time*group interaction, F2.48,84.16 = 0.80, P = 0.40) and other secondary outcome measures including responder rates and depressive and anxiety symptoms.
Low-frequency rTMS over pre-SMA may not be effective as an augmenting agent in partial/poor responders to SRIs. This study underlines the need to explore alternate rTMS protocols in OCD.
在一项双盲随机假对照试验中，本研究调查了低频重复经颅磁刺激（rTMS）对药物治疗部分反应不佳/反应差的强迫症（OCD）患者双侧辅助运动前区（pre-SMA）的疗效。
40名服用稳定药物但对药物治疗部分反应不佳/反应差的强迫症患者被随机分为2组（每组n = 20），接受双侧pre-SMA的主动或假低频rTMS治疗。36名患者符合意向性分析条件。两组在基线时的相关人口统计学和临床变量无显著差异。
治疗3周后，两组在耶鲁-布朗强迫症量表评分（时间*组交互作用，F2.48,84.16 = 0.80，P = 0.40）以及包括缓解率、抑郁和焦虑症状在内的其他次要结局指标方面均无统计学显著差异。
对选择性5-羟色胺再摄取抑制剂（SRI）部分反应不佳/反应差的患者，pre-SMA的低频rTMS作为增效剂可能无效。本研究强调了在强迫症中探索其他rTMS方案的必要性。
