Efficacy of Repetitive Transcranial Magnetic Stimulation on Comorbid Anxiety and Depression Symptoms in Obsessive-Compulsive Disorder: A Meta-Analysis of Randomized Sham-Controlled Trials

Navya Spurthi Thatikonda; Pratibha Vinod; Srinivas Balachander; Binukumar Bhaskarpillai; Shyam Sundar Arumugham; Y. C. Janardhan Reddy

doi:10.1177/07067437221121112

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Efficacy of Repetitive Transcranial Magnetic Stimulation on Comorbid Anxiety and Depression Symptoms in Obsessive-Compulsive Disorder: A Meta-Analysis of Randomized Sham-Controlled Trials

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Efficacy of Repetitive Transcranial Magnetic Stimulation on Comorbid Anxiety and Depression Symptoms in Obsessive-Compulsive Disorder: A Meta-Analysis of Randomized Sham-Controlled Trials

Navya Spurthi Thatikonda, Pratibha Vinod, Srinivas Balachander, Binukumar Bhaskarpillai, Shyam Sundar Arumugham and Y. C. Janardhan Reddy

Canadian journal of psychiatry, Vol.68(6), pp.407-417

06/01/2023

DOI: 10.1177/07067437221121112

PMCID: PMC10331254

PMID: 35989677

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https://pmc.ncbi.nlm.nih.gov/articles/PMC10331254/pdf/10.1177_07067437221121112.pdfView

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Abstract

Objective To systematically evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) in reducing comorbid anxiety and depressive symptoms in patients with obsessive-compulsive disorder (OCD). Methods Three electronic databases were searched for randomized, sham-controlled clinical trials evaluating rTMS for the treatment of OCD. Hedge's g was calculated as the effect size for anxiety/depression symptom severity (primary outcome) and OCD severity (secondary outcome). Subgroup analyses and meta-regression analyses were carried out to evaluate the most promising target and whether a reduction in OCD severity moderates the change in anxiety or depression scores. Results Twenty studies (n = 688) were included in the meta-analysis. rTMS had small-medium effect size on OCD (Hedge's g = 0.43; 95% confidence interval [CI]: [0.20, 0.65]; P < 0.001), anxiety (Hedge's g = 0.3; 95% CI: [0.11, 0.48]; P = 0.001) and depression (Hedge's g = 0.24; 95% CI: [0.07, 0.40]; P = 0.003) symptoms. Subgroup analysis showed that protocols targeting dorsolateral prefrontal cortex (DLPFC) were effective for 3 outcome measures. The change in anxiety, but not depression severity, was moderated by a change in OCD symptom scores. However, the findings are uncertain as a majority of the studies had some concerns or a high risk of bias. Conclusions Active rTMS protocol targeting DLPFC is effective in reducing the comorbid anxiety/depression symptoms along with OCD severity. The antidepressant effect is not moderated by the anti-obsessive effect of rTMS. Abrege

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Title: Subtitle: Efficacy of Repetitive Transcranial Magnetic Stimulation on Comorbid Anxiety and Depression Symptoms in Obsessive-Compulsive Disorder: A Meta-Analysis of Randomized Sham-Controlled Trials
Creators: Navya Spurthi Thatikonda - National Institute of Mental Health and Neurosciences
Pratibha Vinod - National Institute of Mental Health and Neurosciences
Srinivas Balachander - National Institute of Mental Health and Neurosciences
Binukumar Bhaskarpillai - National Institute of Mental Health and Neurosciences
Shyam Sundar Arumugham - National Institute of Mental Health and Neurosciences
Y. C. Janardhan Reddy - National Institute of Mental Health and Neurosciences
Resource Type: Journal article
Publication Details: Canadian journal of psychiatry, Vol.68(6), pp.407-417
DOI: 10.1177/07067437221121112
PMID: 35989677
PMCID: PMC10331254
NLM abbreviation: Can J Psychiatry
ISSN: 0706-7437
eISSN: 1497-0015
Publisher: Sage
Number of pages: 11
Language: English
Date published: 06/01/2023
Academic Unit: Psychiatry
Record Identifier: 9984843250102771

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