Transcranial magnetic stimulation for teens with OCD

Treating Adolescent Obsessive Compulsive Disorder With Transcranial Magnetic Stimulation

This project will test two types of transcranial magnetic stimulation to see if they are safe, tolerable, and show early benefit for teenagers (13–17) with moderate-to-severe OCD who have not improved enough with usual treatments.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 30 (estimated)
• Ages: 13 Years to 17 Years
• Sex: All
• Sponsor: University of California, San Francisco (Academic / other)
• Locations: 1 site (San Francisco, California)
• Trial ID: NCT07065669 on ClinicalTrials.gov

What this trial studies

This randomized, single-blind pilot compares two theta-burst TMS targets—dorsal medial prefrontal cortex (dmPFC) and orbito-frontal cortex (OFC)—in adolescents with treatment-resistant OCD. Participants aged 13–17 will receive active TMS at their assigned site on every weekday for three consecutive weeks (15 sessions total, delivered as three stimulations per session). MRI scans are performed before and after the treatment course, and an independent masked evaluator will track safety, tolerability, and symptom changes using standardized measures. The trial is designed to characterize side effects, feasibility of daily adolescent TMS, and signal(s) of early efficacy to inform larger future trials.

Who should consider this trial

Good fit: Ideal candidates are outpatients aged 13–17 with moderate-to-severe OCD (CY-BOCS II >16), who have had limited improvement from first-line treatments, are stable on medications/therapy for at least eight weeks, and can attend daily weekday clinic visits for three weeks.

Not a fit: Patients with a history of seizure disorder, certain structural brain lesions, schizophrenia or bipolar disorder, current high suicide risk, prior psychosurgery or ECT, severe neurocognitive disorder, or those unable to tolerate daily clinic visits or MRI are unlikely to benefit or be eligible.

Why it matters

Potential benefit: If successful, this approach could provide a noninvasive treatment option that reduces OCD symptoms in adolescents who have not responded adequately to medications or therapy.

How similar studies have performed: TMS (including theta-burst protocols) has shown benefit and is FDA-cleared for adult OCD, but evidence in adolescents is limited and this application in youth remains relatively untested.

Eligibility criteria

Inclusion Criteria:

1. outpatients
2. ages 13 - 17 years
3. meets current DSM-5 criteria for Obsessive Compulsive Disorder with screening CY-BOCS II score \> 16 (moderate to severe).
4. stable on chronic psychotropic medications and/or therapy for 8 weeks prior to the study and agreeable to continue throughout the study without changes.
5. participants may continue to take medications and record daily usage throughout the study.
6. capacity to provide informed assent and parent or legal guardian able to provide consent.
7. ability to tolerate clinical study procedures.
8. successfully complete the screening forms without any contraindications.

Exclusion Criteria:

1. Psychiatric: history of schizophrenia, bipolar disorder, substance/alcohol abuse disorder, current elevated suicide risk, prior psychosurgery, prior ECT.
2. Neurologic: severe neurocognitive disorder, seizure disorder, certain structural brain lesions (e.g., intracranial mass lesions, hydrocephalus, sequelae of meningitis, frank brain injury).
3. TMS contraindications: implanted device; presence of metal in the head, including eyes and ears (excluding dental implants); certain tics; medications or systemic illness that predispose seizure risk; family history of 1st degree relative with seizure disorder.
4. Subjects with an unstable physical, systemic, or metabolic disorder (e.g., unstable hypertension, malnutrition secondary to eating disorder).
5. Females who are pregnant or nursing (as determined by a questionnaire and pregnancy test).
6. Current and anticipated continued treatment with excluded medication (See prohibited list).
7. Inability to complete the research protocol as determined by the Principal Investigator.

Where this trial is running

San Francisco, California

• University of California, San Francisco — San Francisco, California, United States (Recruiting)

Study contacts

• Principal investigator: James T McCracken, MD — University of California, San Francisco
• Study coordinator: Starlette Khim, BA

Conditions Obsessive-Compulsive Disorder; Adolescent; transcranial magnetic stimulation