Cognitive Function and Treatment Outcomes in Trichotillomania: A Case Series Evaluating the Efficacy of TMS.

OBJECTIVES

Trichotillomania is a psychiatric disorder characterized by the compulsive pulling of one's own hair, eyelashes, or eyebrows. Depression and obsessive-compulsive disorder comorbidity is frequently observed in patients with trichotillomania. In this case series, we will report how a patient diagnosed with trichotillomania was successfully treated with transcranial magnetic stimulation (TMS) therapy in our clinic.

METHODS

The TMS protocol was delivered using the MagVenture X100 device, with treatment intensity calibrated to 100% of each participant's motor threshold. Following the established treatment protocol for trichotillomania, patients received repetitive TMS at 1 Hz, with each train lasting 300 seconds and a 60-second intertrain interval, for a total of 1200 pulses per session. The bilateral supplementary motor area (SMA) was targeted as the site of stimulation.

RESULTS

The efficacy of TMS in reducing hair-pulling behaviors in patients with trichotillomania was evaluated in a case series of 3 patients who underwent 20 TMS sessions. The findings demonstrated a significant reduction in hair-pulling behaviors post-treatment. According to the Massachusetts General Hospital Hair Pulling Scale (MGH-HP), over 50% improvement was observed in all patients.

CONCLUSIONS

The findings suggest that TMS may serve as a promising intervention for trichotillomania, warranting further exploration in larger, controlled trials. The utilization of the MGH-HP scale provided a robust measure for assessing behavioral changes, highlighting the potential of TMS in managing compulsive disorders.