Transcranial magnetic stimulation combined with therapy for OCD
Precision Medicine for OCD - Biobehavioral Tracking of Transcranial Magnetic Stimulation (TMS) With Exposure and Response Prevention (ERP) for Refractory OCD
NA · University of Southern California · NCT07146438
This trial will test whether combining repetitive transcranial magnetic stimulation (rTMS) with either Exposure and Response Prevention (ERP) or supportive therapy helps adults with OCD.
Quick facts
| Phase | NA |
|---|---|
| Study type | Interventional |
| Enrollment | 48 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | University of Southern California (other) |
| Locations | 1 site (Los Angeles, California) |
| Trial ID | NCT07146438 on ClinicalTrials.gov |
What this trial studies
This randomized, controlled pilot enrolls adults with OCD to receive daily rTMS targeted to the dorsomedial prefrontal cortex/anterior cingulate cortex five days per week for six weeks while also receiving either virtual ERP or supportive therapy twice weekly. Participants wear a Fitbit and complete daily smartphone check-ins to collect behavior and physiology data, and undergo baseline and repeat resting-state fMRI to study neural predictors and mechanisms of response. The protocol uses an FDA-cleared rTMS treatment approach and collects symptom, functioning, and quality-of-life measures across a 16-week study period. The design tests feasibility, tolerability, preliminary clinical effects, and whether wearable and imaging markers can help predict who benefits.
Who should consider this trial
Good fit: Adults with DSM-5 OCD who live in Southern California, have completed at least ten ERP sessions previously, have tried SRI medication, can attend in-person rTMS five days per week for six weeks, and can keep psychotropic medications stable are the ideal candidates.
Not a fit: People with a primary psychiatric diagnosis other than OCD, active substance use disorder, active suicidality or psychosis, a history of seizures, severe neurological impairment, pregnancy, or prior rTMS are unlikely to be eligible or to benefit.
Why it matters
Potential benefit: If successful, the combination could produce larger or faster reductions in OCD symptoms and help personalize treatment using wearable and brain-imaging markers.
How similar studies have performed: Prior trials (and FDA clearance for certain TMS approaches) support rTMS as beneficial for some people with OCD, but combining rTMS with ERP and using wearables plus rsfMRI for prediction is relatively novel and less tested.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Diagnosis of Obsessive-Compulsive Disorder (OCD) as determined by Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria. * Live in Southern California and be willing to attend in-person to receive repetitive Transcranial Magnetic Stimulation (rTMS) 5 times per week for 6 weeks. * Have completed a prior course of Exposure and Response Prevention (ERP) therapy (at least ten sessions) * Currently take or have previously tried Serotonin Reuptake Inhibitor (SRI) medication for OCD * Willing to maintain psychotropic medication levels throughout the 16 weeks of the study Exclusion Criteria: * Primary psychiatric diagnosis other than OCD * Active substance use disorder * Active suicidality * Active psychosis * History of seizures * Severe neurological impairment * Pregnant or planning to become pregnant * Received a prior rTMS course
Where this trial is running
Los Angeles, California
- University of Southern California Health Sciences Campus — Los Angeles, California, United States (RECRUITING)
Study contacts
- Principal investigator: Adam C. Frank, MD, PhD — Keck School of Medicine of USC
- Study coordinator: USC Frank OCD Lab
- Email: frankocdlab@usc.edu
- Phone: 323-442-3632
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.
Conditions: Obsessive - Compulsive Disorder, TMS, Transcranial Magnetic Stimulation, OCD, Obsessive Compulsive Disorder, Obsessive-Compulsive Disorder, rTMS, repetitive Transcranial Magnetic Stimulation