Right Versus Left Prefrontal Transcranial Magnetic Stimulation for Obsessive-Compulsive Disorder: A Preliminary Investigation
J Clin Psychiatry 2001;62(12):981-984
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: There is preliminary evidence that repetitive transcranial
magnetic stimulation (rTMS) may be useful for the treatment of obsessive-compulsive
disorder (OCD), but no definitive study has been published, and the effect of
laterality of stimulation is uncertain.
Method: Subjects (N = 12) with resistant OCD were allocated randomly
to either right or left prefrontal rTMS daily for 2 weeks and were assessed
by an independent rater at 1 and 2 weeks and 1 month later.
Results: Subjects had an overall significant improvement in the
obsessions (p < .01), compulsions (p < .01), and total (p < .01) scores
on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) after 2 weeks and at 1-month
follow-up. This improvement was significant for obsessions (p < .05) and
tended to significance for total Y-BOCS scores (p = .06) after correction for
changes in depression scores on the Montgomery-Asberg Depression Rating Scale.
There was no significant difference between right- and left-sided rTMS on any
of the parameters examined. Two subjects (33%) in each group showed a clinically
significant improvement that persisted at 1 month but with relapse later in
Conclusion: A proportion (about one quarter) of patients with
resistant OCD appear to respond to rTMS to either prefrontal lobe, although
in the absence of a sham treatment group in this study, we cannot rule out the
possibility of this being a placebo response. This treatment warrants further
investigation to better establish its efficacy and examine the best parameters