Evidence map›Paper›PMID 29423665›Full record

SynthesisThe Psychiatric quarterly2018

A Meta-Analysis of the Effectiveness of Different Cortical Targets Used in Repetitive Transcranial Magnetic Stimulation (rTMS) for the Treatment of Obsessive-Compulsive Disorder (OCD).

Simone Rehn, Guy D Eslick, Vlasios Brakoulias

2 registry-linked trialsAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in The Psychiatric quarterly, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 53 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
53citing papers in PubMed, 9 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05331937 phase3recruitingnot on this mapstarted 2022, after this paper: background citation

Transcranial Magnetic Stimulation (TMS) for Patients With Exposure Therapy-resistant Obsessive-compulsive Disorder (OCD): TETRO - a Multicenter Randomized Controlled Trial

TypeinterventionalSponsorAmsterdam UMC, location VUmcRan2022 to 2027Enrolled250Conditions1 Hz Real rTMS to the Pre-SMA, 1 Hz Sham rTMS to the Pre-SMAArmsrepetitive transcranial magnetic stimulation (rTMS)
NCT06490965 narecruitingnot on this mapstarted 2024, after this paper: background citation

Improving Obsessive-compulsive Disorder Treatments: from Lesions to Neuromodulation Targets

TypeinterventionalSponsorFundacao ChampalimaudRan2024 to 2026Enrolled32ConditionsObsessive-Compulsive DisorderArmsRepetitive Transcranial Magnetic Stimulation, Neuronavigation, Magnetic Resonance Imaging
3 · Its place in the literature

Who cites it

53 citing papers in PubMed, 9 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Simone RehnSchool of Psychology, The University of Sydney, Sydney, NSW, Australia. sreh6183@uni.sydney.edu.au.ORCID 0000-0001-7590-5486
Guy D EslickThe Whiteley-Martin Research Centre, Discipline of Surgery, The University of Sydney, Nepean Hospital, Sydney/Penrith, NSW, Australia.
Vlasios BrakouliasSydney Medical School - Nepean, Discipline of Psychiatry, The University of Sydney, Sydney/Penrith, NSW, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Randomised and sham-controlled trials (RCTs) of repetitive transcranial magnetic stimulation (rTMS) in the treatment of obsessive-compulsive disorder (OCD) have yielded conflicting results, which may be due to the variability in rTMS parameters used. We performed an updated systematic review and meta-analysis on the effectiveness of rTMS for the treatment of OCD and aimed to determine whether certain rTMS parameters, such as cortical target, may be associated with higher treatment effectiveness. After conducting a systematic literature review for RCTs on rTMS for OCD through to 1 December 2016 using MEDLINE, PubMed, Web of Science, PsycINFO, Google, and Google Scholar, we performed a random-effects meta-analysis with the outcome measure as pre-post changes in Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores. To determine whether rTMS parameters may have influenced treatment effectiveness, studies were further analysed according to cortical target, stimulation frequency, and length of follow-up. Data were obtained from 18 RCTs on rTMS in the treatment of OCD. Overall, rTMS yielded a modest effect in reducing Y-BOCS scores with Hedge's g of 0.79 (95% CI = 0.43-1.15, p < 0.001). Stimulation of the supplementary motor area yielded the greatest reductions in Y-BOCS scores relative to other cortical targets. Subgroup analyses suggested that low frequency rTMS was more effective than high frequency rTMS. The effectiveness of rTMS was also greater at 12 weeks follow-up than at four weeks follow-up. Our meta-analysis implies that low frequency rTMS applied over the supplementary motor area may offer the greatest effectiveness in the treatment of OCD. The therapeutic effects of rTMS also appear to persist post-treatment and may offer beneficial long-term effectiveness. With our findings, it is suggested that future large-scale studies focus on the supplementary motor area and include follow-up periods of 12 weeks or more.

Indexed as

Cerebral CortexHumansObsessive-Compulsive DisorderTranscranial Magnetic StimulationCortical targetLong-term effectivenessObsessive-compulsive disorderOCDRepetitive transcranial magnetic stimulationrTMSrTMS parametersStimulation frequencyTreatment

Identifiers

PMID29423665

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.