Transcranial magnetic stimulation (TMS) for patients with exposure therapy-resistant obsessive-compulsive disorder (OCD): TETRO – a multicenter randomized controlled trial
Obsessive-compulsive disorder (OCD) is a serious and disabling mental disorder, characterised by obsessions and compulsions and associated with substantial comorbidity and morbidity. Approximately 50% of patients treated with standard treatments (exposure therapy with response prevention (ERP) with/without medication) fail to respond fully. This results in in chronicity and poor participation in social and educational/occupational domains. We propose to fill the gap between (1) the standard treatments (exposure therapy with/without medication) and (2) invasive end-stage strategies (brain surgery). We do this using a non-invasive alternative: repetitive transcranial magnetic stimulation (rTMS). Despite proven efficacy rTMS for OCD is not yet covered by the Dutch insurance system. While rTMS for treatment resistant depression is. This multi-center randomised controlled trial is supported by the ‘veelbelovende zorg’ grant of Zorginstituut Nederland (ZiNL). We aim to establish the added value of rTMS applied over the pre-supplementary motor area (preSMA) when combined with ERP in OCD patients, who show no/insufficient response to ERP (alone or combined with medication). In case of proven cost-effectiveness it will lead to the addition of rTMS as insured health care for patients with OCD.
Locations
There are 5 centers involved in the execution of the multi-center trial. They perfectly cover the country, enabling treatment in the catchment area of the patients’ home. These 5 sites are located in:
- Amsterdam (Amsterdam UMC/GGZ inGeest),
- Nijmegen (Radboudumc/ProPersona, with MRI scans at Donders Center of Cognitive Neuroimaging),
- Maastricht (Maastricht UMC+/Mondriaan groep, with MRI scans at Scannexus),
- Eindhoven (NeuroCare group)
- Groningen (NeuroCare group).
This study is funded by Zorginstituut Nederland.
