Can Continuous Theta Burst Stimulation Help People with Moderate OCD Symptoms?

What you need to know

• Continuous theta burst stimulation (cTBS) is a form of non-invasive brain stimulation that may help reduce OCD symptoms
• The treatment appears most effective for people with moderate OCD symptoms rather than severe symptoms
• The technique was found to be safe with minimal side effects

Understanding OCD and Current Treatments

Obsessive-compulsive disorder (OCD) is a challenging mental health condition characterized by unwanted, intrusive thoughts (obsessions) and repetitive behaviors or mental acts (compulsions). Current first-line treatments - antidepressant medications called selective serotonin reuptake inhibitors (SSRIs) and cognitive behavioral therapy - don’t work for up to 60% of patients.

This has led researchers to explore alternative treatments, including brain stimulation techniques. One such technique is continuous theta burst stimulation (cTBS), which uses magnetic pulses to influence brain activity in targeted regions. cTBS requires shorter treatment sessions and lower intensity compared to traditional forms of brain stimulation.

What the Research Found

This study included two parts:

1. A preliminary experiment with 50 hospitalized OCD patients who received either real or fake (sham) cTBS treatment
2. A follow-up experiment with 32 outpatients to validate the findings

The researchers found that:

• About 56% of patients who received real cTBS showed significant improvement in their OCD symptoms
• The treatment was particularly effective for patients with moderate OCD symptoms
• Patients with severe OCD symptoms showed less improvement
• The benefits were mainly seen in reducing obsessive thoughts rather than compulsive behaviors
• The treatment was safe with very few side effects - only mild headaches in a few patients

Why Symptom Severity Matters

An important finding was that cTBS worked better for patients with moderate rather than severe OCD symptoms. This may be because:

• Severe OCD involves more extensive disruption of brain circuits and behavior patterns
• People with moderate symptoms may have more flexibility in their brain networks, allowing the treatment to be more effective
• Understanding this difference could help doctors better select which patients are most likely to benefit from cTBS

The Treatment Process

The cTBS treatment involved:

• Targeting a specific brain region called the pre-supplementary motor area
• Using magnetic pulses delivered through a figure-eight shaped coil
• Treatment sessions lasting just a few minutes each
• Multiple sessions per day for inpatients or daily sessions for outpatients
• Personalized targeting based on brain imaging

Conclusions

• cTBS appears to be a promising treatment option for people with moderate OCD symptoms
• The treatment is most effective when used early, before symptoms become severe
• The technique is safe and well-tolerated by patients
• More research is needed to understand long-term effects and to confirm these findings in larger groups of patients
• Future studies should examine why the treatment affects obsessive thoughts more than compulsive behaviors