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Kar SK, Agrawal A, Silva-Dos-Santos A, Gupta Y, Deng ZD. The Efficacy of Transcranial Magnetic Stimulation in the Treatment of Obsessive-Compulsive Disorder: An Umbrella Review of Meta-Analyses. CNS Spectr 2024; 29:109-118. [PMID: 38053347 DOI: 10.1017/s1092852923006387] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
BACKGROUND Repetitive transcranial magnetic stimulation (rTMS) has been increasingly used for treating obsessive-compulsive disorder (OCD). Although several meta-analyses have explored its effectiveness and safety, there is no umbrella review specifically focused on rTMS for OCD. This umbrella review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and analyzed relevant meta-analyses on rTMS for OCD. METHODS Twenty-three articles were identified from PubMed, and after screening, 12 meta-analyses were included in the review. The studies analyzed in the meta-analyses ranged from 10 to 27, with total participants ranging from 282 to 791. The most commonly studied regions were the dorsolateral prefrontal cortex (DLPFC), supplementary motor area (SMA), and orbito-frontal cortex (OFC). RESULT The majority of the meta-analyses consistently supported the effectiveness of rTMS in reducing OCD symptoms when applied to the DLPFC and SMA. Encouraging results were also observed when targeting the medial prefrontal cortex (mPFC) and anterior cingulate cortex (ACC) through deep transcranial magnetic stimulation (dTMS). However, there was a high level of heterogeneity in the findings of nine out of 12 meta-analyses. CONCLUSION In conclusion, existing evidence suggests that rTMS targeting the DLPFC and SMA consistently reduces OCD symptoms, but targeting the mPFC and ACC through dTMS shows variable results. However, the high heterogeneity in the study findings indicates a need for further research and standardization in the field.
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Affiliation(s)
- Sujita Kumar Kar
- Department of Psychiatry, King George's Medical University, Lucknow, India
| | - Aditya Agrawal
- Department of Psychiatry, King George's Medical University, Lucknow, India
| | - Amílcar Silva-Dos-Santos
- Neuroscience Unit, CUF Tejo Hospital, Lisbon, Portugal
- Mental Health Department, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
- Department of Psychiatry, Universidade do Mindelo, Mindelo, Cape Verde
- Psychiatry Unit, Hospital de Cascais, Cascais, Portugal
| | - Yogesh Gupta
- Department of Psychiatry, King George's Medical University, Lucknow, India
| | - Zhi-De Deng
- Computational Neurostimulation Research Program, Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
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Silva-Dos-Santos A, Youssef NA, Bravo J, Sales M, Velho MV, Simões F, Gaspar B, Gracias MJ, Lopes J, Duarte R, Lara E, Gusmão R, Sackeim HA. Single session subconvulsive electrical stimulation has rapid therapeutic effects and reduces length of hospitalization in patients in an acute manic episode. Brain Stimul 2023; 16:1452-1454. [PMID: 37769989 DOI: 10.1016/j.brs.2023.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 09/21/2023] [Indexed: 10/03/2023] Open
Affiliation(s)
- Amilcar Silva-Dos-Santos
- Hospital CUF Tejo, Lisbon, Portugal; NOVA Medical School (NMS/FCM) - NOVA University of Lisbon, Lisbon, Portugal; Universidade do Mindelo, Rua Patrice Lumumba, CP 648, Mindelo, São Vicente, Republic of Cabo Verde; Psychiatry Department, Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal
| | - Nagy A Youssef
- Department of Psychiatry, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Joana Bravo
- Psychiatry Department, Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal
| | - Miguel Sales
- Psychiatry Department, Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal; Psychiatry Department, Centro Hospitalar do Oeste, Unidade de Caldas da Rainha, Caldas da Rainha, Portugal
| | - Maria Vaz Velho
- Psychiatry Department, Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal
| | - Fábio Simões
- Psychiatry Department, Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal
| | - Beatriz Gaspar
- Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Maria João Gracias
- Psychiatry Department, Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal
| | - Joana Lopes
- Psychiatry Department, Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal
| | - Rita Duarte
- Cardiology Department, Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal
| | | | - Ricardo Gusmão
- EpiUnit, Public Health Institute, University of Porto (ISPUP), Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal; Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto (FMUP), Portugal
| | - Harold A Sackeim
- Departments of Psychiatry and Radiology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.
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Bravo J, Buta FL, Talina M, Silva-Dos-Santos A. Avoiding revolving door and homelessness: The need to improve care transition interventions in psychiatry and mental health. Front Psychiatry 2022; 13:1021926. [PMID: 36226101 PMCID: PMC9548635 DOI: 10.3389/fpsyt.2022.1021926] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/07/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Joana Bravo
- Department of Psychiatry, Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal
| | - Francisco Lima Buta
- Department of Psychiatry, Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal
| | - Miguel Talina
- NOVA Medical School, NOVA University of Lisbon, Lisboa, Portugal
| | - Amílcar Silva-Dos-Santos
- Department of Psychiatry, Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal.,NOVA Medical School, NOVA University of Lisbon, Lisboa, Portugal.,Hospital CUF Tejo, Lisbon, Portugal
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