TMS for obsessive-compulsive disorder

Obsessive compulsive disorder (OCD) is characterized by repetitive, unwanted thoughts or sensations (fixations) that cause patients to perform monotypic actions (impulses).

Thus, performing repetitive compulsive actions such as washing, constant checks, etc. can significantly impair personal daily activities and social contacts.

Who suffers from OCD?

OCD occurs in about 1.1% of the general population. In other words, 12 out of every 1,000 people suffer from OCD. It is likely that the actual number of those affected is higher because many of them are unwilling to share their symptoms.

What are the symptoms of OCD?

OCD presents as a combination of symptoms ranging from physiological to mental. They vary from patient to patient. OCD patients present with fixations, impulsive actions, or a combination thereof. Intrusive thoughts (fixations) cause constant anxiety.

Intrusive thoughts

Obsessions are repetitive thoughts or images that cause severe anxiety and nausea. Many OCD patients assume that these obsessions are the result of brain activity and are abnormal and unhelpful. However, compulsions cannot be mentally normalized. Many OCD sufferers ignore or tone down the presence of such compulsions or counter them with competing ideas or actions.

• Obsession with the thought or idea of ​​death of a loved one
• Obsession that someone or something (God, the devil, or disease) will harm the sufferer or someone close to them
• Fear of infection and disease (e.g. AIDS, COVID-19, etc.)
• Sexual obsessions – imagining or thinking about kissing, touching, sex, rape, etc. with strangers, acquaintances, parents, children, family members, colleagues, animals, religious persons. They can be heterosexual or homosexual in content
• Obsessive fears about sexual orientation

Intrusive actions

Intrusive thoughts cause the development of anxiety based on the fear that something bad will happen. The sufferer feels compelled to perform irrational, time-consuming actions to relieve anxiety. In very severe cases, the repetitive actions take up the entire day, making the performance of daily activities virtually impossible.

Some of the most common compulsions are as follows:

• Frequent hand washing
• Arrange objects in a straight line
• Constantly checking that the door is locked
• Organizing things in a specific way
• Touch the objects a certain number of times before leaving the room
• Walking along a certain route
• Climbing the stairs always ending on the same foot
• Irritation from things that are out of place
• Counting specific things (eg steps) – often in a specific way (eg in increments of two)
• Perfectionism

TMS treatment of OCD

TMS uses focused magnetic pulses to affect specific brain regions. In OCD, magnetic pulses are directed to the dorsolateral prefrontal cortex (DLPFC), anterior cingulate cortex (ACC), supplementary motor area (SMA).

Personalized treatment: Before starting TMS, our medical center uses neuroimaging techniques such as qEEG to identify the specific areas of the brain that may be hyperexcited or suppressed in OCD patients. These regions often include the DLPFC, ACC, and SMA, which are involved in cognitive control and emotion regulation. Magnetic pulses in TMS modulate neuronal activity in target brain regions. In OCD, the goal is to normalize the activity in these regions. By modulating brain activity, the main symptoms of OCD are significantly alleviated - obsessive thoughts and actions, anxiety.

Neuroplasticity and long-term effect: TMS can induce neuroplastic changes in the brain leading to long-term improvement in OCD symptoms. Changes occur in synaptic connections, neurotransmitter levels, and neural networks. Clinical studies show that TMS improvement is not only observed during therapy sessions, and the beneficial therapeutic effects are durable and long-term.

Benefits of TMS for OCD

1. Non-invasive treatment: TMS is a non-invasive procedure and does not require anesthesia and operative interventions.
2. Minimal side effects: Compared to medication for OCD, TMS has negligible side effects – mild scalp discomfort or headaches that disappear after the sessions are over.
3. Therapeutic effectiveness: Various studies have shown that OCD is an effective procedure, especially in patients who do not respond to standard medical treatment. The rate of therapeutic response in OCD reaches 80%.
4. Complementary therapy: TMS can be used as a complementary treatment to medication and cognitive behavioral therapy. Combining TMS with another therapy significantly increases the therapeutic effect.
5. Improved quality of life: By reducing symptoms, TMS can significantly improve the quality of life of OCD sufferers. This includes improvement in mood, social contacts and daily activity.