The International Journal of Neuropsychopharmacology

Brief Report

Repetitive transcranial magnetic stimulation (rTMS) in the treatment of obsessive–compulsive disorder (OCD) and Tourette's syndrome (TS)

Antonio Mantovani a1a2c1, Sarah H. Lisanby a2, Fulvio Pieraccini a3, Monica Ulivelli a4, Paolo Castrogiovanni a3 and Simone Rossi a4
a1 Department of Neuroscience, Section of Psychiatry, Section of Neurophysiology, Postgraduate School in Applied Neurological Sciences, Siena University, Siena, Italy
a2 New York State Psychiatric Institute, Biological Psychiatry, Columbia University, New York, NY, USA
a3 Department of Neuroscience, Section of Psychiatry, Siena University, Siena, Italy
a4 Department of Neuroscience, Section of Neurophysiopathology, Siena University, Siena, Italy

Article author query
mantovani a   [PubMed][Google Scholar] 
lisanby sh   [PubMed][Google Scholar] 
pieraccini f   [PubMed][Google Scholar] 
ulivelli m   [PubMed][Google Scholar] 
castrogiovanni p   [PubMed][Google Scholar] 
rossi s   [PubMed][Google Scholar] 


There is evidence that motor and premotor cortex are hyperexcitable in obsessive–compulsive disorder (OCD) and Tourette's syndrome (TS). We tested whether low-frequency repetitive transcranial magnetic stimulation (rTMS) could normalize overactive motor cortical regions and thereby improve symptoms. Subjects with OCD or TS were treated with active rTMS to the supplementary motor area (SMA) for 10 daily sessions at 1 Hz, 100% of motor threshold, 1200 stimuli/day. Suggestions of clinical improvement were apparent as early as the first week of rTMS. At the second week of treatment, statistically significant reductions were seen in the YBOCS, YGTSS, CGI, HARS, HDRS, SAD, BDI, SCL-90, and SASS. Symptoms improvement was correlated with a significant increase of the right resting motor threshold and was stable at 3 months follow-up. Slow rTMS to SMA resulted in a significant clinical improvement and a normalization of the right hemisphere hyperexcitability, thereby restoring hemispheric symmetry in motor threshold.

(Published Online June 28 2005)
(Received December 21 2004)
(Reviewed February 22 2005)
(Revised April 29 2005)
(Accepted May 1 2005)

Key Words: Obsessive–compulsive disorder; rTMS; supplementary motor area; Tourette's syndrome.

c1 Magnetic Brain Stimulation Laboratory, Department of Biological Psychiatry, New York State Psychiatric Institute (NYSPI), 1051 Riverside Drive, Unit 126, New York, NY 10032, USA. Tel.: 212-543-6081 Fax: 212-543-5088 E-mail: