Two failed trials of repetitive transcranial magnetic stimulation (rTMS) in obsessive-compulsive disorder (OCD): Is this rTMS-resistant OCD?

Abstract

Treatment options for obsessive-compulsive disorder (OCD) includes serotonergic medications and cognitive-behavioral therapy, however, many patients show poor response to treatment. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive intervention which has shown some efficacy in OCD, and newer treatment protocols are being studied. We report a case of treatment-resistant OCD which did not improve with 20 sessions of high-frequency primed low frequency rTMS over supplementary motor area, and 15 sessions of accelerated continuous theta burst stimulation of the right frontal pole, raising the possibility of TMS-resistant OCD.