Electrophysiology of obsessive-compulsive disorder after transcranial magnetic stimulation: A systematic review.

BACKGROUND

Obsessive-compulsive disorder (OCD) is one of the top ten most disabling diseases worldwide. In recent years, a significant number of OCD patients have not responded to psychological and pharmacological treatments, resulting in treatment-resistant OCD. Transcranial magnetic stimulation (TMS) has emerged as a promising alternative strategy for treating treatment-resistant OCD and has been widely used in clinical practice. However, the EEG indicators associated with the anti-OCD effects of TMS are still not fully understood. This review systematically synthesizes EEG changes before and after TMS in OCD and examines their associations with symptom improvement to identify candidate markers with potential predictive value.

METHODS

This systematic review evaluates the electrophysiological effects of TMS on patients with OCD. This review highlights the potential of TMS, particularly high-frequency TMS, to reduce OCD symptoms and alter brain activity patterns.

RESULTS

Studies reviewed indicate that high-frequency TMS can significantly decrease Y-BOCS scores, with effects lasting up to three months. Electrophysiological changes observed include increased delta band, theta band, and alpha band power and decreased beta band power post-treatment. The changes in power are mainly concentrated in the left temporal, the left central, and the parietal-occipital regions. However, there are some controversies regarding brain functional connectivity.

LIMITATIONS: Efficacy ranking of the treatments could be performed by evaluating relatively few RCT results.

CONCLUSIONS

These findings suggest that TMS can modulate neural circuits involved in OCD, offering a viable alternative or adjunctive treatment for patients unresponsive to traditional therapies. Incorporating EEG assessments into future TMS clinical trials will enhance the ability to predict treatment efficacy.