Accelerated Repetitive Transcranial Magnetic Stimulation in Hospitalized Patients With Obsessive-Compulsive Disorder: a Feasibility and Mechanistic Randomized Clinical Trial

What this Trial Is About

Researchers are evaluating a new treatment approach for adults with Obsessive-Compulsive Disorder (OCD), a condition marked by unwanted repetitive thoughts and behaviors. This study aims to determine whether combining specialized inpatient care with repetitive Transcranial Magnetic Stimulation (rTMS) is feasible, well-tolerated, and effective. Two types of rTMS will be tested: deep TMS (dTMS) and intermittent theta burst stimulation (iTBS), using an accelerated protocol over two weeks. Participants will be randomly assigned to one of three groups: one group will receive dTMS plus Exposure and Response Prevention (ERP), another will receive iTBS plus ERP, and the third will receive ERP alone without rTMS. Both rTMS treatments involve four sessions per day, four days per week, totaling 32 sessions over two weeks. ERP therapy includes cognitive behavioral techniques, psychoeducation, and exposure exercises, with family involvement. The treatment occurs during a twelve-week hospitalization. During the study, participants complete questionnaires before, immediately after, and four weeks post-treatment. Brain imaging (MRI) and brain wave recordings (EEG) are done before and after treatment. Patients keep a daily diary of any side effects during rTMS. Researchers will monitor safety, feasibility, clinical outcomes, and brain changes related to treatment. Total participation lasts about ten weeks, integrated into usual inpatient care including medication and psychotherapy.

Accelerated rTMS in Hospitalized Patients With OCD: a Feasibility and Mechanistic Study