Clinical Scorecard: Efficacy of Non-Navigated Low-Frequency Repetitive Transcranial Magnetic Stimulation in Treating Obsessive-Compulsive Disorder: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

At a Glance

Key Highlights

• 14 RCTs included with a total of 460 participants.
• No statistically significant benefit of rTMS over sham stimulation (MD = -0.69, P = 0.21).
• Moderate heterogeneity was observed but reduced by excluding one outlier trial.
• Subgroup analyses by stimulation target, treatment duration, and frequency were non-significant.
• Findings are specific to low-frequency, non-neuronavigated protocols.

Guideline-Based Recommendations

Diagnosis

• Diagnosis of OCD should be based on clinical assessment and standardized criteria.

Management

• Consider established pharmacological and psychological interventions as first-line treatments.

Monitoring & Follow-up

• Monitor treatment response and side effects in patients undergoing rTMS.

Risks

• Potential risks include lack of efficacy and the need for further research on alternative neuromodulation strategies.

Patient & Prescribing Data

Patients with OCD who have not achieved full remission with first-line treatments.

Low-frequency, non-neuronavigated rTMS lacks demonstrated efficacy in controlled trials.

Clinical Best Practices

• Utilize established first-line treatments for OCD before considering rTMS.
• Ensure informed consent regarding the potential lack of efficacy of rTMS.

Related Resources & Content

• Systematic Review and Meta-Analysis