Effects of repetitive transcranial magnetic stimulation over supplementary motor area in patients with schizophrenia with obsessive-compulsive-symptoms: A pilot study

Psychiatry Res. 2016 Aug 30:242:34-38. doi: 10.1016/j.psychres.2016.05.031. Epub 2016 May 24.

Abstract

In patients with schizophrenia, obsessive-compulsive symptoms (OCS) are associated with lower rates of quality of life and polypharmacy. No previous controlled studies have tested the efficacy of repetitive transcranial magnetic stimulation (rTMS) on the treatment of OCS in this population. The present study examined the therapeutic effects of rTMS applied to the supplementary motor area (1Hz, 20min, 20 sessions) on OCS and general symptoms in patients with schizophrenia or schizoaffective disorder, and whether this intervention can produce changes in plasma levels of brain derived neurotrophic factor (BDNF). A double-blind randomized controlled trial was conducted. Active and sham rTMS were delivered to 12 patients (6 on each group). Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and Brief Psychiatric Rating Scale (BPRS) scores, as well as BDNF levels, were assessed before, after, and 4 weeks after treatment. rTMS did not significantly change the outcomes after treatment and on the follow-up (Y-BOCS: Wald's X(2)=3.172; p=0.205; BPRS: X(2)=1.629; p=0.443; BDNF: X(2)=2.930; p=0.231). There seemed to be a trend towards improvement of BPRS scores 4 weeks after rTMS treatment comparing with sham (Cohen's d=0.875, with 32.9% statistical power). No side effects were reported. Future studies with larger sample sizes are needed.

Keywords: Neuromodulation; Obsessive-compulsive symptoms; Schizophrenia; Supplementary motor area; Transcranial magnetic stimulation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Brain-Derived Neurotrophic Factor / blood
  • Brief Psychiatric Rating Scale
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Motor Cortex / physiopathology
  • Obsessive-Compulsive Disorder / physiopathology
  • Obsessive-Compulsive Disorder / psychology
  • Obsessive-Compulsive Disorder / therapy*
  • Pilot Projects
  • Quality of Life
  • Schizophrenia / complications
  • Schizophrenia / physiopathology
  • Schizophrenia / therapy*
  • Schizophrenic Psychology*
  • Transcranial Magnetic Stimulation / methods*
  • Treatment Outcome

Substances

  • Brain-Derived Neurotrophic Factor
  • BDNF protein, human