Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation procedure that is FDA-cleared for treating obsessive-compulsive disorder (OCD). Evidence suggests that controlling brain state during rTMS treatment can influence treatment outcomes. We present the case of a patient with refractory OCD who received symptom provocation immediately preceding rTMS treatment sessions. The patient experienced more subjective and objective improvement in OCD symptoms targeted by provocations than in other symptom domains. These results suggest the importance of brain state during rTMS and could be used to guide and optimize neuromodulation treatment for OCD.
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