Repetitive Transcranial Magnetic Stimulation (rTMS) Treatment for Obsessive Compulsive Disease
Condition: Obsessive-Compulsive Disorder; Transcranial Magnetic Stimulation; Functional Magnetic Resonance Imaging; Event-Related Potentials
MeSH terms: Compulsive Personality Disorder; Obsessive-Compulsive Disorder
Study type: Interventional

Summary: 
      To investigate the treatment effect of repetitive transcranial magnetic stimulation on
      Obsessive-compulsive disorder, and the underlying neural mechanism by functional MRI.
    

Detailed description: 
      All patients underwent a medical evaluation that included physical examination and routine
      laboratory studies before and after repetitive transcranial magnetic stimulation (rTMS)
      treatment. Patients were randomly allocated to rTMS group and the sham group. There are about
      30 patients in each group. For the first 30 patients, allocation was by coin toss. For the
      subsequent 30 patients, allocation was according to computer generated random numbers. The
      decision to enroll a patient was always made prior to randomization. Patients were studied
      using a double-blind design. Study participants, clinical raters, and all personnel
      responsible for the clinical care of the patient remained masked to allocated condition and
      allocation parameters. Only rTMS administrators had access to the randomization list; they
      had minimal contact with the patients, and no role in assessing the Yale-Brown Obsessive
      Compulsive Scale(Y-BOCS). Each patient would be treated for continuous 15 days by rTMS.

      Before the rTMS treatment, Y-BOCS, Padua Inventory-Washington State University
      Revision(PI-WSUR), Hamilton Depression Scale(HAMD-17) and Hamilton Anxiety Scale (HAMA-14)
      were obtained by a trained investigator to assess baseline severity of and other symptoms.
      The patients had receiving a battery measure of neuropsychological tests (standardized tests
      to investigate their cognitive problems, anxiety and depressive symptoms in daily life),
      magnetic resonance imaging scan in multimodalities, electroencephalography (EEG),
      event-related potentials during stop signal test and task switch paradigm record.

      After the last treatment, Y-BOCS, PI-WSUR, HAMD-17 and HAMA-14 were obtained, as well as the
      Global Index of Safety to assess adverse events of the treatment. Patients were instructed to
      focus their answers on the past 15 days. The patients had also receiving a battery measure of
      neuropsychological tests, magnetic resonance imaging scan in multimodalities, and EEG record.

      A month after the last treatment, participants were interviewed to obtain the Y-BOCS,
      PI-WSUR, HAMD-17 and HAMA-14. They were instructed to focus their answers on the past week.
      Additionally, they were also asked to assess the battery of neuropsychological tests, and
      have magnetic resonance imaging scan in multimodalities, and EEG record. Afterwards, they
      were unblinded by the study coordinator.
    

Intervention name(s): transcranial magnetic stimulation with real coil; transcranial magnetic stimulation with sham coil
Intervention type(s): Device; Device
Intervention description(s): TMS with real coil is a noninvasive technique to activate and modify the activity of the neurons; TMS with sham coil is a placebo
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment