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
Department of Psychiatry, King George’s Medical University, Lucknow, Uttar Pradesh, India
Correspondence to: Sujita Kumar Kar
Department of Psychiatry, King George’s Medical University, Shahmina Road, Chowk, Lucknow, Uttar Pradesh 226003, India
E-mail: drsujita@gmail.com
ORCID: https://orcid.org/0000-0003-1107-3021
Received: July 8, 2024; Revised: August 21, 2024; Accepted: November 22, 2024; Published online: January 8, 2025.
© The Korean College of Neuropsychopharmacology. All rights reserved.

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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 continuous theta burst stimulation (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; Motor cortex

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