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The Efficacy and Acceptability of Non‐Invasive Brain Stimulation Interventions for Obsessive‐Compulsive Disorder Management: A Network Meta‐Analysis Based on 24 Stimulation Methods.

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Title: The Efficacy and Acceptability of Non‐Invasive Brain Stimulation Interventions for Obsessive‐Compulsive Disorder Management: A Network Meta‐Analysis Based on 24 Stimulation Methods.
Authors: Tseng, Ping‐Tao (AUTHOR), Hsu, Chih‐Wei (AUTHOR), Hung, Chao‐Ming (AUTHOR), Liang, Chih‐Sung (AUTHOR), Wang, Hung‐Yu (AUTHOR), Stubbs, Brendon (AUTHOR), Carvalho, Andre F. (AUTHOR), Brunoni, Andre R. (AUTHOR), Su, Kuan‐Pin (AUTHOR), Tu, Yu‐Kang (AUTHOR), Wu, Yi‐Cheng (AUTHOR), Chen, Tien‐Yu (AUTHOR), Li, Dian‐Jeng (AUTHOR), Lin, Pao‐Yen (AUTHOR), Chen, Yen‐Wen (AUTHOR), Hung, Kuo‐Chuan (AUTHOR), Chen, Jiann‐Jy (AUTHOR), Zeng, Bing‐Syuan (AUTHOR), Li, Cheng‐Ta (AUTHOR)
Source: Acta Psychiatrica Scandinavica. Aug2025, Vol. 152 Issue 2, p112-124. 13p.
Subjects: Obsessive-compulsive disorder, Brain stimulation, Transcranial direct current stimulation, Transcranial magnetic stimulation, Acceptance (Psychology), Clinical trials, Bayesian analysis
Abstract: Introduction: Despite the high lifetime prevalence and elevated disability rates, treatments for obsessive‐compulsive disorder (OCD) have limited efficacy. Considering the abnormal connectivity in the cortical‐striatal‐thalamic‐cortical loop circuits in OCD, several randomized controlled trials (RCTs) have addressed the efficacy of different non‐invasive brain stimulation (NIBS) modalities for the management of OCD. However, these RCTs yielded inconclusive results. Methods: This network meta‐analysis (NMA) included RCTs of NIBS interventions, such as transcranial direct current stimulation (tDCS) and various repetitive transcranial magnetic stimulation (rTMS), in OCD patients. The primary outcomes were changes in the overall severity of OCD and acceptability (i.e., dropout rates). Results: This NMA of 34 eligible RCTs (1089 participants) and 24 different NIBS interventions revealed that three NIBS interventions significantly improved overall OCD severity compared with sham controls, which were high‐frequency rTMS over the dorsolateral prefrontal cortex (DLPFC) [mean difference (MD) = −10.81, 95% confidence intervals (95% CIs) = −20.80 to −0.82], high‐frequency deep TMS over the dorsal medial prefrontal cortex/anterior cingulate cortex (dmPFC/ACC) (MD = −9.74, 95% CIs = −16.42 to −3.06), and low‐frequency rTMS over the right DLPFC (MD = −4.70, 95% CIs = −8.84 to −0.57). Conclusions: This study highlighted that excitatory stimulation over the dmPFC/ACC and bilateral DLPFC, or inhibitory stimulation over the right DLPFC, was associated with significant improvements in overall OCD severity. Further large‐scale RCTs with longer follow‐up periods are needed to investigate the true impact of NIBS‐based intervention to manage OCD. Trial Registration:PROSPERO: CRD42023394953 [ABSTRACT FROM AUTHOR]
Copyright of Acta Psychiatrica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: The Efficacy and Acceptability of Non‐Invasive Brain Stimulation Interventions for Obsessive‐Compulsive Disorder Management: A Network Meta‐Analysis Based on 24 Stimulation Methods.
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  Data: <searchLink fieldCode="AR" term="%22Tseng%2C+Ping‐Tao%22">Tseng, Ping‐Tao</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hsu%2C+Chih‐Wei%22">Hsu, Chih‐Wei</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hung%2C+Chao‐Ming%22">Hung, Chao‐Ming</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Liang%2C+Chih‐Sung%22">Liang, Chih‐Sung</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wang%2C+Hung‐Yu%22">Wang, Hung‐Yu</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Stubbs%2C+Brendon%22">Stubbs, Brendon</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Carvalho%2C+Andre+F%2E%22">Carvalho, Andre F.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Brunoni%2C+Andre+R%2E%22">Brunoni, Andre R.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Su%2C+Kuan‐Pin%22">Su, Kuan‐Pin</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Tu%2C+Yu‐Kang%22">Tu, Yu‐Kang</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wu%2C+Yi‐Cheng%22">Wu, Yi‐Cheng</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chen%2C+Tien‐Yu%22">Chen, Tien‐Yu</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Li%2C+Dian‐Jeng%22">Li, Dian‐Jeng</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lin%2C+Pao‐Yen%22">Lin, Pao‐Yen</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chen%2C+Yen‐Wen%22">Chen, Yen‐Wen</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hung%2C+Kuo‐Chuan%22">Hung, Kuo‐Chuan</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chen%2C+Jiann‐Jy%22">Chen, Jiann‐Jy</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Zeng%2C+Bing‐Syuan%22">Zeng, Bing‐Syuan</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Li%2C+Cheng‐Ta%22">Li, Cheng‐Ta</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Acta+Psychiatrica+Scandinavica%22">Acta Psychiatrica Scandinavica</searchLink>. Aug2025, Vol. 152 Issue 2, p112-124. 13p.
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  Data: <searchLink fieldCode="DE" term="%22Obsessive-compulsive+disorder%22">Obsessive-compulsive disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Brain+stimulation%22">Brain stimulation</searchLink><br /><searchLink fieldCode="DE" term="%22Transcranial+direct+current+stimulation%22">Transcranial direct current stimulation</searchLink><br /><searchLink fieldCode="DE" term="%22Transcranial+magnetic+stimulation%22">Transcranial magnetic stimulation</searchLink><br /><searchLink fieldCode="DE" term="%22Acceptance+%28Psychology%29%22">Acceptance (Psychology)</searchLink><br /><searchLink fieldCode="DE" term="%22Clinical+trials%22">Clinical trials</searchLink><br /><searchLink fieldCode="DE" term="%22Bayesian+analysis%22">Bayesian analysis</searchLink>
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  Label: Abstract
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  Data: Introduction: Despite the high lifetime prevalence and elevated disability rates, treatments for obsessive‐compulsive disorder (OCD) have limited efficacy. Considering the abnormal connectivity in the cortical‐striatal‐thalamic‐cortical loop circuits in OCD, several randomized controlled trials (RCTs) have addressed the efficacy of different non‐invasive brain stimulation (NIBS) modalities for the management of OCD. However, these RCTs yielded inconclusive results. Methods: This network meta‐analysis (NMA) included RCTs of NIBS interventions, such as transcranial direct current stimulation (tDCS) and various repetitive transcranial magnetic stimulation (rTMS), in OCD patients. The primary outcomes were changes in the overall severity of OCD and acceptability (i.e., dropout rates). Results: This NMA of 34 eligible RCTs (1089 participants) and 24 different NIBS interventions revealed that three NIBS interventions significantly improved overall OCD severity compared with sham controls, which were high‐frequency rTMS over the dorsolateral prefrontal cortex (DLPFC) [mean difference (MD) = −10.81, 95% confidence intervals (95% CIs) = −20.80 to −0.82], high‐frequency deep TMS over the dorsal medial prefrontal cortex/anterior cingulate cortex (dmPFC/ACC) (MD = −9.74, 95% CIs = −16.42 to −3.06), and low‐frequency rTMS over the right DLPFC (MD = −4.70, 95% CIs = −8.84 to −0.57). Conclusions: This study highlighted that excitatory stimulation over the dmPFC/ACC and bilateral DLPFC, or inhibitory stimulation over the right DLPFC, was associated with significant improvements in overall OCD severity. Further large‐scale RCTs with longer follow‐up periods are needed to investigate the true impact of NIBS‐based intervention to manage OCD. Trial Registration:PROSPERO: CRD42023394953 [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Acta Psychiatrica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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