A case series on the effect of continuous theta burst stimulation over supplementary motor cortex in obsessive-compulsive disorder
SUJITA KUMAR KAR *, Babli Kumari , Mohita Joshi , Amit Singh
King George's Medical University, Lucknow, U.P
Received: July 3, 2024; Revised: November 22, 2024; Accepted: November 22, 2024; Published online: November 22, 2024.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Abstract
Objective: Transcranial magnetic stimulation is an effective treatment modality for obsessive-compulsive disorder (OCD). In this large case series, we attempted to discuss various factors that might have a bearing on therapeutic response in OCD.
Methods: This study included patients with OCD receiving continuous theta burst stimulation over the supplementary motor area attending a tertiary care centre between April and December 2023.
Results: Our study evaluated 11 patients, of which seven showed a significant reduction in their symptoms (based on reduction in Yale-Brown Obsessive Compulsive Scale score) by more than 35% from the baseline, indicating a positive response to the treatment. We found that patients who received twice-daily sessions had a higher response rate (four out of five patients or 80%). However, four patients reported experiencing a transient headache during the sessions, with two patients being from the twice-daily sessions group and the other two from the once-daily sessions group. In our case series, even patients with early onset, multiple obsessions, treatment resistance, chronic illness, and psychiatric comorbidities responded to add-on cTBS.
Conclusion: cTBS is a potentially promising add-on treatment modality in OCD that warrants further investigation and the presence of predictors of poor response should not discourage it’s use.
Keywords: Obsessive-Compulsive Disorder, Neuromodulation, Transcranial Magnetic Stimulation, Continuous Theta Burst Stimulation, Supplementary Motor Area

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