Obsessive-Compulsive Disorder Clinical Trial
Official title:
Stimulation magnétique transcrânienne répétitive Dans le Traitement Des Troubles Obsessionnels Compulsifs
Evaluate the therapeutic effect of a functional Magnetic Resonance Imaging (fMRI)-guided and robotized neuronavigated theta burst Transcranial Magnetic Stimulation (TMS) targeting right inferior frontal region in resistant obsessive compulsive disorder (OCD) in a double-blind, randomized, placebo-controlled, monocentric study.
This study evaluates the therapeutic effect of a fMRI-guided and robotized neuronavigated
theta burst Transcranial Magnetic Stimulation (TMS) targeting right inferior frontal region
in resistant obsessive compulsive disorder (OCD) in a double-blind, randomized,
placebo-controlled, monocentric study. The study will also assess the interest of some
clinical, neuropsychological, neuroimaging, electrophysiological variables in response
prediction, besides physiopathological information.
There is an increasing interest in developping treatments for resistant OCD, which are not
responding to the conventional treatment, represented by pharmacotherapy associated to
cognitive behavioral therapy. Repetitive TMS represents a promising non invasive brain
stimulation approach, but efficacy, best available brain target, optimal responder profile
and stimulation parameters need to be further documented.
In this study, the included patients will be randomly assigned to an active (theta burst TMS)
or sham-placebo treatment group. TMS will be added to their stable pharmacotherapy. The brain
target, the right inferior frontal region, involved in the inhibition control brain network,
will be defined in a personalized manner via a fMRI paradigm for each patient. TMS will be
delivered daily for 2 successive weeks. Measures of different clinical, neuropsychological ,
electrophysiological (cortical excitability) variables will be performed at baseline, as well
as at the end of the TMS course, and 1 week after. Other assessments are planned at 3 and 6
months, in order to highlight the evolution of the potential benefit.
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