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