Accelerated personalized rTMS for treatment‑resistant obsessive‑compulsive disorder
A Study on the Efficacy and Safety of Accelerated Transcranial Magnetic Stimulation for Obsessive-Compulsive Disorder and Its Underlying Neurological Mechanisms
This study will try a fast, personalized course of repetitive transcranial magnetic stimulation (rTMS) targeting the right inferior frontal cortex to see if it reduces symptoms in adults with treatment‑resistant OCD.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 20 (estimated) |
| Ages | 18 Years to 60 Years |
| Sex | All |
| Sponsor | Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University Academic / other |
| Locations | 1 site (Shanghai, Shanghai Municipality) |
| Trial ID | NCT07198594 on ClinicalTrials.gov |
What this trial studies
The protocol delivers individualized, accelerated rTMS to the right inferior frontal cortex combined with symptom provocation in adults with treatment‑resistant OCD. Participants receive six rTMS sessions per day for five consecutive days with baseline, immediate post‑treatment, and four‑week follow‑up visits for symptom and safety assessments. Target locations are individualized for each participant and safety monitoring focuses on right IFC stimulation. Eligible participants must have moderate‑to‑severe OCD, be right‑handed, medication‑stable, and meet predefined treatment‑resistance criteria.
Who should consider this trial
Good fit: Adults 18–60 with DSM‑5 OCD, Y‑BOCS ≥16, right‑handed, medication‑stable, and who have had inadequate response to adequate SSRI/clomipramine and augmentation trials are the intended candidates.
Not a fit: People with mild OCD (Y‑BOCS <16), recent rTMS within the past six months, associated tic disorders/Tourette's, left‑handedness, or who cannot attend daily in‑person treatments in Shanghai are unlikely to benefit from this protocol.
Why it matters
Potential benefit: If successful, this approach could produce faster and larger symptom improvement for adults with OCD who have not responded to standard treatments.
How similar studies have performed: Prior rTMS studies for OCD have shown modest benefits for some targets, but accelerated, individualized targeting of the inferior frontal cortex is relatively novel with limited published evidence.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria:
* Volunteer subjects with Obsessive Compulsive Disorders (OCD) according to the Diagnostic and Statistical Manual of Mental Disorders (DSM V) criteria
* without associated tics ("Gilles de la Tourette" Syndrome)
* Age 18-60 years, right-handed
* Disease severity: Yale-Brown Obsessive Compulsive Scale score ≥16 for OCD patients
* Medication stable for at least 4 weeks
* Resistant patients to standard treatments: partial but insufficient response (reduction of Y-BOCS score \< 35%) or lack of response to previous well conducted treatment including: optimal tolerated dose and adequate duration (\> 12 weeks) of at least 2 Serotonin Reuptake Inhibitors (selective serotonin reuptake inhibitors, clomipramine), or 1 Serotonin Reuptake Inhibitors + 1 augmentation strategy (adjunction of an antipsychotic - such as risperidone or olanzapine or aripiprazole - or lithium or buspirone)
* No systematic rTMS therapy in the past six months;
* Signature of informed consent form;
* Normal vision or corrected vision;
* Capacity to complete protocol-specified tests.
Exclusion Criteria:
* Abnormal cognitive status (assessed using MoCA with score \<24);
* Other primary diagnosis than OCD (comorbid mild depression is tolerated)
* Comorbid diagnosis of schizophrenia/ psychotic disorder, bipolar disorder, substance abuse or dependance3)
* Significant self-harm intent or severe suicidal tendencies within the past year;
* Irreversible visual or auditory impairment preventing completion of scales or related assessments;
* Presence of metallic implants, such as pacemakers or stents;
* Any current or potential medical, psychological, social, or geographical factors compromising patient safety or study participation;
* Poor compliance;
* Claustrophobia;
* History of epilepsy or familial epilepsy
* Pregnant or lactating women (women of childbearing potential must obtain a negative pregnancy test result prior to study commencement and employ medically approved contraceptive measures);
* Deterioration or failure of vital organ function (cardiac, pulmonary, hepatic, renal, etc.); or unstable vital signs;
* Conditions unsuitable for this stimulation site, such as increased intracranial pressure, elevated intraocular pressure, or glaucoma
* History of or concomitant neurological disorders: cerebrovascular disease, central nervous system infections, Creutzfeldt-Jakob disease, Huntington's disease and Parkinson's disease, Lewy body dementia, traumatic brain injury dementia, other physical/chemical factors (drugs, alcohol, CO, etc.), significant somatic diseases (hepatic encephalopathy, pulmonary encephalopathy, etc.), intracranial space-occupying lesions (subdural haematoma, brain tumours), endocrine system disorders (thyroid disease, parathyroid disease), and dementia caused by vitamin deficiency or any other cause
Where this trial is running
Shanghai, Shanghai Municipality
- Shanghai Pudong New Area Mental Health Centre — Shanghai, Shanghai Municipality, China (Recruiting)
Study contacts
- Study coordinator: Yijie Zhao
- Email: yj_zhao@tongji.edu.cn
- Phone: +86 13585960699
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.