Study explores TMS treatment for OCD

A collaborative study by Monash University and the Epworth Centre for Innovation in Mental Health (ECIMH) explores the benefits of Transcranial Magnetic Stimulation (TMS) on people with obsessive–compulsive disorder (OCD).

The study offers participants individualised treatment using a process known as Neuronavigation, which involves mapping an individual’s brain and then matching that to MRI images so that the treatment site can be found with more precision.

TMS has shown success in management of treatment-resistant depression and has recently been added to the Medicare Benefits Schedule.

Using a form of TMS, a non-invasive brain stimulation treatment that can change brain activity, researchers will use Theta-burst stimulation (TBS) to try to normalise brain activity in OCD patients.

The study, being conducted at ECIMH is a collaboration between Professor Paul Fitzgerald from Monash University and Epworth Healthcare, Associate Professor Andrew Zalesky from the University of Melbourne and Associate Professor Luca Cocchi from Research QIMR Berghofer, and is coordinated by Dr Oscar Murphy from the Monash Central Clinical School.

Dr Murphy said TMS is approved for the treatment of OCD by the US Food & Drug Administration; however, the same evidence base has not been established in Australia. This study will investigate the efficacy of TMS for OCD in Australia.

“TMS is a very promising technology and has already shown efficacy in treating other conditions, such as depression, and is a promising step forward in developing individualised treatments,” Dr Murphy said.

Involving a daily two- to three-week treatment period with a three-month break in between, the trial is looking to recruit people aged between 18 and 75 until the end of 2021.

Considering many individuals with OCD may display fears of contamination or infection, the ongoing global pandemic has added a significant additional psychological burden for these individuals, with fewer people accessing treatments for OCD due to fears of going out in public, reduced capacity at clinics, longer waiting times to see clinicians due to the increased demand for mental health services and less social support.

Experiencing symptoms of OCD since early childhood, Rachel* was diagnosed in her early twenties. Her symptoms and fears included things being dirty, that people around her are going to be injured or die, and that things often feel out of place. The feelings increased in intensity throughout her life, and now in her sixties, she is often fearful to leave home and unable to work.

“My compulsions relate to those obsessions, including rigid ordering and routine, excessive cleaning and counting rituals. I’ve tried a plethora of typical pharmacological treatments for OCD but I’ve been unable to tolerate medications well, often suffering debilitating nausea every time I try a new medication. The TMS trial is an alternative I just have to try — it gives me hope.”

Dr Murphy said, “The study we are running is particularly promising as we have identified regions of the brain that are typically altered in individuals with OCD and can then use MRI scans of the participant’s brain to identify where we will stimulate with TMS.

For more information on the trial or to register as a participant, click here.

*A pseudonym has been used to protect the identity of the participant.

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